title: Pathogenic bacterial nasopharyngeal colonization and its impact on respiratory diseases in the first year of life: the PATCH Birth Cohort Study.
abstract: BACKGROUND
  For acute respiratory diseases caused by bacteria, colonization in the respiratory tracts is often the first sign, although nasopharynx is the major source of secretions containing pathogens. To understand the pathogenesis of respiratory tract diseases, it is important to analyze the establishment of nasopharyngeal bacterial colonization.
  
  
  METHODS
  Infants with nasopharyngeal swabs were examined at the age of 1, 2, 4, 6 and 12 months for the detection of pathogens, including Streptococcus pneumoniae, Hemophilus influenzae, Moraxella catarrhalis, Streptococcus pyogenes and Staphylococcus aureus. The methods used for detection were bacterial culture and multiplex polymerase chain reaction.
  
  
  RESULTS
  From January 2012 to August 2013, a total of 320 neonates were enrolled, and 120 of them completed the first 12-month study. Staphylococcus aureus was the most common pathogen at all 5 time points while the rates declined; in contrast, the other 4 increased during the first year of life. Of our series, the multiplex polymerase chain reaction detection rates were higher than those of bacterial culture. More than 50% of Staphylococcus aureus was methicillin-resistant, and the trend decreased in the same period. In the analysis of factors associated with the development of infant wheeze, infants with maternal atopy [odds ratio (OR): 3.26; 95% confidence interval (CI): 1.20-8.88; P = 0.02] and pneumococcal colonization (OR: 15.64; 95% CI: 3.25-75.35; P = 0.001) had higher rates of wheeze.
  
  
  CONCLUSIONS
  Bacterial interactions may result in differing pathogen prevalence in the first year of life. In addition, nasopharyngeal pneumococcal colonization may have an effect on the risk of infant wheeze. The result could help clinicians to clarify the relation between bacterial colonization and respiratory illnesses in infancy.
authors.affiliation: From the *Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan; †Chang Gung University, College of Medicine, Taoyuan, Taiwan; ‡Department of Medical Laboratory, Chang Gung Memorial Hospital, Keelung, Taiwan; §Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; ¶Division of Allergy, Asthma, and Rheumatology, and ‖Division of Pulmonology, Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan.
authors.forename: Ming-Han
authors.initials: MH
authors.lastname: Tsai
authors.forename: Shu-Huan
authors.initials: SH
authors.lastname: Huang
authors.forename: Chyi-Liang
authors.initials: CL
authors.lastname: Chen
authors.forename: Chih-Yung
authors.initials: CY
authors.lastname: Chiu
authors.forename: Man-Chin
authors.initials: MC
authors.lastname: Hua
authors.forename: Sui-Ling
authors.initials: SL
authors.lastname: Liao
authors.forename: Tsung-Chieh
authors.initials: TC
authors.lastname: Yao
authors.forename: Shen-Hao
authors.initials: SH
authors.lastname: Lai
authors.forename: Kuo-Wei
authors.initials: KW
authors.lastname: Yeh
authors.forename: Mei-Ping
authors.initials: MP
authors.lastname: Wang
authors.forename: Jing-Long
authors.initials: JL
authors.lastname: Huang
mesh_terms: D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D001431:Bacteriological Techniques; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D009305:Nasopharynx / Q000382:microbiology*; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D012135:Respiratory Sounds; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000382:microbiology*