title: Study of nasopharyngeal bacterial flora. Second report. Variations in nasopharyngeal bacterial flora in children aged 6 years or younger when administered antimicrobial agents. Part 1.
abstract: In our first report, we investigated nasopharyngeal bacterial flora related to penicillin-resistant Streptococcus pneumoniae (PRSP) and beta-lactamase-negative ampicillin-resistant Haemophilus influenzae (BLNAR) and their relation to acute upper respiratory tract infection (AURTI). This report analyzes the results of a study of nasopharyngeal bacterial flora before the administration of antimicrobial agents in 172 AURTI patients aged 6 years or younger. In addition to Gram staining, microscopic observation, and culturing, a polymerase chain reaction (PCR) method was used to identify PRSP (gPRSP) and BLNAR (gBLNAR) drug-resistant genes. Of the patients analyzed, 90% had acute otitis media (AOM) and were aged 2 years or younger. The antimicrobial agents administered were amoxicillin (34%), clavulanic acid/amoxicillin (11%), cefditren pivoxil (CDTR-PI) (43%), and others (12%). This was particularly true for patients administered CDTR-PI, among whom there were many who had already suffered one or more episodes of AOM by the age of 1 year or younger, and many in which gPRSP were detected (P < 0.01). There was a significant relation between the degree of nasopharyngeal inflammation indicated by leukocyte infiltration images and the amount of S. pneumoniae and H. influenzae detected, which are the main pathogenic bacteria causing AOM (P < 0.01). In addition to leukocyte infiltration images, there were cases in which shedding of ciliated cells was observed and/or giant monocytic cells. Both nasopharyngeal leukocyte infiltration images and/or shed cell findings observed in infant AURTI cases are important indices for the prompt detection of gPRSP and/or gBLNAR and appropriate doses of antimicrobial agents.
authors.affiliation: Teikyo University School of Medicine, Tokyo, Japan. mrsa@interlink.or.jp
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Konno
authors.forename: Shunkichi
authors.initials: S
authors.lastname: Baba
authors.forename: Haruki
authors.initials: H
authors.lastname: Mikawa
authors.forename: Kohei
authors.initials: K
authors.lastname: Hara
authors.forename: Fumio
authors.initials: F
authors.lastname: Matsumoto
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Kaga
authors.forename: Tadao
authors.initials: T
authors.lastname: Nishimura
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Furuya
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Moriyama
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Mituru
authors.initials: M
authors.lastname: Furukawa
authors.forename: Noboru
authors.initials: N
authors.lastname: Yamanaka
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Matsushima
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yoshizawa
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Morikawa
authors.forename: Shoichi
authors.initials: S
authors.lastname: Koizumi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Sunakawa
authors.forename: Matsuhisa
authors.initials: M
authors.lastname: Inoue
authors.forename: Kimiko
authors.initials: K
authors.lastname: Ubukata
mesh_terms: D000367:Age Factors; D000668:Ampicillin Resistance; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006192:Haemophilus Infections / Q000188:drug therapy / Q000382:microbiology; D006193:Haemophilus influenzae / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008297:Male; D009305:Nasopharynx / Q000187:drug effects / Q000382:microbiology*; D010033:Otitis Media / Q000188:drug therapy / Q000382:microbiology; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000382:microbiology; D016133:Polymerase Chain Reaction / Q000379:methods; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000235:genetics / Q000302:isolation & purification*; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000890:Anti-Infective Agents; D001618:beta-Lactamases