title: Nasal carriage of common bacterial pathogens among healthy kindergarten children in Chaoshan region, southern China: a cross-sectional study.
abstract: Nasal colonization with bacterial pathogens is associated with risk of invasive respiratory tract infections, but the related information for Chinese healthy children is scarce.
  
  
  
  This cross-sectional study was conducted with healthy children from 6 kindergartens in the Chaoshan region, southern China during 2011-2012. Nasal swabs were examined for five common bacterial pathogens: Streptococcus pneumoniae, Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, and Staphylococcus aureus.
  
  
  
  Among 1,088 children enrolled, 79.6 % (866) were target-bacterial carriers, of which 34.4 % (298/866) were positive for ≥2 bacteria species. The most common pathogen in the bacterial carriers was M. catarrhalis (76.6 %), followed by S. pneumoniae (26.6 %), S. aureus (21.8 %), H. parainfluenzae (12.7 %), and H. influenzae (2.3 %). Multiple logistic regression analyses showed negative associations between age and the overall or multiple bacterial carriage, and between the father's education level and multiple bacterial carriage (all p < 0.05). Age was negatively associated with the carriage of M. catarrhalis and S. pneumoniae, and positively associated with the S. aureus carriage (all p < 0.0001).
  
  
  
  This study shows high nasal carriage of common pathogenic bacteria and coexistence of multiple pathogens in healthy Chaoshan kindergarten children, with M. catarrhalis as the commonest colonizer. Increasing age of children and higher paternal education are associated with lower risk of bacterial carriage. Longitudinal follow-up studies would be helpful for better understanding the infection risk in bacterial pathogen carriers.
authors.affiliation: Shantou-Oxford Clinical Research Unit, Shantou University Medical College, 22 Xinling Road, Jinping, Shantou, Guangdong, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Pan
authors.affiliation: Pediatric Department, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
authors.forename: Binglin
authors.initials: B
authors.lastname: Cui
authors.affiliation: Department of Clinical Microbiology, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
authors.forename: Yuanchun
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Jiacai
authors.initials: J
authors.lastname: Yang
authors.affiliation: Shantou-Oxford Clinical Research Unit, Shantou University Medical College, 22 Xinling Road, Jinping, Shantou, Guangdong, China. wbathein@stu.edu.cn.|Department of Microbiology and Immunology, Shantou University Medical College, Shantou, Guangdong, 515041, China. wbathein@stu.edu.cn.
authors.forename: William
authors.initials: W
authors.lastname: Ba-Thein
mesh_terms: D002353:Carrier State / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006192:Haemophilus Infections / Q000175:diagnosis / Q000453:epidemiology*; D006193:Haemophilus influenzae / Q000302:isolation & purification; D044135:Haemophilus parainfluenzae / Q000302:isolation & purification; D006801:Humans; D008297:Male; D001936:Moraxella catarrhalis / Q000302:isolation & purification; D045828:Moraxellaceae Infections / Q000175:diagnosis / Q000453:epidemiology*; D009297:Nasal Mucosa / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000453:epidemiology*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification
keywords: Bacterial pathogen; China; Healthy children; Nasal carriage; Risk factor