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Upper airway viruses and bacteria detection in clinical pneumonia in a population with high nasal colonisation do not relate to clinical signs

Brooks, Anne, Smith-Vaughan, Heidi C., Sloots, Theo, Valery, Patricia C., Whiley, David, Beissbarth, Jemima and Torzillo, Paul J. (2015). Upper airway viruses and bacteria detection in clinical pneumonia in a population with high nasal colonisation do not relate to clinical signs. Pneumonia,6:46-56.

Document type: Journal Article
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ARC Grant No. FT100100511
IRMA ID 11381xPUB155
NHMRC Grant No. 1040830
1058213
1024175
Title Upper airway viruses and bacteria detection in clinical pneumonia in a population with high nasal colonisation do not relate to clinical signs
Author Brooks, Anne
Smith-Vaughan, Heidi C.
Sloots, Theo
Valery, Patricia C.
Whiley, David
Beissbarth, Jemima
Torzillo, Paul J.
Journal Name Pneumonia
Publication Date 2015
Volume Number 6
ISSN 2200-6133   (check CDU catalogue  open catalogue search in new window)
Start Page 46
End Page 56
Total Pages 11
Place of Publication United States of America
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Indigenous Australian children have high (up to 90%) rates of nasopharyngeal microbial colonisation and of hospitalisation for pneumonia. In Indigenous children hospitalised with pneumonia in Central Australia, we describe the nasopharyngeal detection of viruses and bacteria and assessed whether their presence related to signs of pneumonia (tachypnoea and/or chest in-drawing) on hospital admission and during subsequent days. Nasopharyngeal swabs (NPS) and data were prospectively collected from 145 children (median age = 23.5 months, interquartile range [IQR] 8.7–50) hospitalised with pneumonia at Alice Springs Hospital, Australia, between April 2001 and July 2002. The cohort was enrolled in a randomised controlled study using zinc and/or vitamin A supplementation. NPS were taken within 24 hours of hospitalisation and kept frozen at -80oC until analysed in 2014. Polymerase chain reaction (PCR) was used to detect Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus, Chlamydophila pneumoniae, Mycoplasma pneumoniae, and 16 respiratory viruses. Uni- and multi-variate analyses were used to examine the relationships. One or more organisms were present in 137(94.5%) NPS; 133(91.7%) detected ³1 bacterium, 34(37.2%) for ³1 virus and 50(34.5%) were positive for both viruses and bacteria. C. pneumoniae (n = 3) and M. pneumoniae (n = 2) were rare. In multi-variate analyses, age <12 months (odds ratio [OR] 6.6 [95% confidence interval {CI} 1.7–25.4]) and fever (OR 4.1 [95% CI 1.7–10.4]) were associated with tachypnoea and chest in-drawing. However the presence of bacteria and/or virus type was not associated with tachypnoea and/or chest in-drawing on admission or during recovery. In children with high nasopharyngeal microbial colonisation rates, the utility of NPS in determining the diagnosis of clinical pneumonia or duration of tachypnoea or in-drawing is likely limited. Larger cohort and case-control studies are required to confirm our findings.
Keywords Microbiology
Pneumonia
Radiology
Aboriginal
Child
Symptoms
Hospitalised
DOI http://dx.doi.org/10.15172/pneu.2015.6/636   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 3.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 3.0 License
URL https://creativecommons.org/licenses/by/3.0/au


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