Microorganisms causing respiratory diseases in children in relation to age and diagnosis

  • H. O. Isaieva Kharkiv National Medical University
  • M. M. Mishyna Kharkiv National Medical University
  • M. O. Gonchar Kharkiv National Medical University
  • O. L. Logvinova Kharkiv National Medical University
  • M. A. Basiuk Kharkiv Regional Children’s Clinical Hospital
Keywords: children; pneumonia; Streptococcus pneumoniae; nasal swabs; pharyngeal swabs; induced sputum

Abstract

Community-acquired pneumonia (CAP) in children is still one of the leading causes of morbidity and mortality, especially in developing countries. The World Health Organization (WHO) has reported that pneumonia accounts for 15% of all deaths of children under 5 years old. The aim of the present study was to find out the predominance of microorganisms in the respiratory tract in children. 334 strains of microorganisms were isolated: Gram-positive – 293 strains, Gram-negative – 41. From the pharynx 183 strains were isolated, from the nose – 94, from sputum – 57. Among Gram-positive microorganisms the following were isolated: Staphylococcus aureus 44 strains of microorganisms, S. epidermidis – 75, Group A β-hemolytic streptococci – 39, viridans streptococci – 55, Streptococcus pneumoniae – 34, Enterococcus faecalis – 2, Candida spp. – 38, Corynebacterium pseudodiphthericum – 6. Among Gram-negative microorganisms the following were isolated: Escherichia coli 4 strains of microorganisms, Klebsiella pneumoniae – 13, Pseudomonas aeruginosa – 6, Haemophilus influenzae – 11, Enterobacter cloacae – 7. Children were divided by age and diagnosis into four groups: I group – children with acute bronchitis (0–5 years of age), II group – children with acute bronchitis (5–18 years of age), III group – children with CAP (0–5 years of age), IV group – children with CAP (5–18 years of age). Materials used in the research – nasal swabs, throat swabs and sputum. Microorganisms were isolated and identified using standard microbiological methods. S. aureus was the predominant microorganism isolate from the pharynx in children with bronchitis (0–5 years). Group A β-hemolytic streptococci were isolated most often from the pharynx in children with bronchitis older than 5 years and in children with CAP less than 5 years of age. S. pneumoniae was most often isolated from the pharynx in children older than 5 years of age with CAP. S. aureus was the main microorganism, isolated from the nose in children with bronchitis in all age groups; in patients with CAP it was the predominant microorganism in children older than 5 years of age. S. aureus was the predominant microorganism, isolated from sputum in children with bronchitis older than 5 years. S. pneumoniae was the predominant microorganism, isolated from sputum in children with CAP older than 5 years. The research showed that S. pneumoniae is still one of the main pathogens that cause CAP in school aged children.

References

Al Hazzani, A. A., Bawazeer, R. A. B., & Shehata, A. I. (2018). Epidemiological characterization of serotype group B Streptococci neonatal infections associated with interleukin-6 level as a sensitive parameter for the early diagnosis. Saudi Journal of Biological Science, 25(7), 1356–1364.

Arif, F. (2018). Updated recommendations of Rcog on prevention of early onset neonatal Group B Streptococcus infection. Journal of Ayub Medical College Abbottabad-Pakistan, 30(3), 490.

Baron, S., & Patterson, M. J. (1996). Medical Microbiology. 4th edition. University of Texas Medical Branch, Galveston.

Chen, J. C., Jenkins-Marsh, S., Flenady, V., Ireland, S., May, M., Grimwood, K., & Liley, H. G. (2019). Early-onset group B streptococcal disease in a risk factor-based prevention setting: A 15-year population-based study. The Australian and New Zealand Journal of Obstetrics and Gynaecology, 59(3), 422–429.

Cutts, F. T., Zaman, S. M., Enwere, G., Jaffar, S., Levine, O. S., Okoko, J. B., Oluwalana, C., Vaughan, A., Obaro, S. K., Leach, A., McAdam, K. P., Biney, E., Saaka, M., Onwuchekwa, U., Yallop, F., Pierce, N. F., Greenwood, B. M., Adegbola, R. A., & Gambian Pneumococcal Vaccine Trial Group (2005). Efficacy of nine-valent pneumococcal conjugate vaccine against pneumonia and invasive pneumococcal disease in The Gambia: Randomised, double-blind, placebo-controlled trial. The Lancet, 365(9465), 1139–1146.

Delpech, G., Sparo, M., Baldaccini, B., Pourcel, G., Lissarrague, S., & Allende, L. G. (2017). Throat carriage rate and antimicrobial resistance of Streptococcus pyogenes in rural children in Argentina. Journal of Preventive Medicine and Public health, 50(2), 127–132.

DiPersio, J. R., File Jr., T. M., Stevens, D. L., Gardner, W. G., Petropoulos, G., & Dinsa, K. (1996). Spread of serious disease-producing M3 clones of group A Streptococcus among family members and health care workers. Clinical Infectious Diseases, 22(3), 490–495.

Don, M., Fasoli, L., Paldanius, M., Vainionpaa, R., Kleemola, M., Raty, R., Leinonen, M., Korppi, M., Tenore, A., & Canciani, M. (2005). Aetiology of community-acquired pneumonia: Serological results of a paediatric survey. Scandinavian Journal of Infectious Diseases, 37, 806–812.

Dryahina, K., Sovova, K., Nemec, A., & Spanel, P. (2016). Differentiation of pulmonary bacterial pathogens in cystic fibrosis by volatile metabolites emitted by their in vitro cultures: Pseudomonas aeruginosa, Staphylococcus aureus, Stenotrophomonas maltophilia and the Burkholderia cepacia complex. Journal of Breath Research, 10(3), 037102.

Ferretti, J. J., Stevens, D. L., & Fischetti, V. A. (2016). Streptococcus pyogenes: Basic biology to clinical manifestations. University of Oklahoma Health Sciences Center, Oklahoma City.

GBD 2016 Lower Respiratory Infections Collaborators (2018). Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet Infectious Diseases, 18(11), 1191–1210.

Gessner, B. D., Sutanto, A., Linehan, M., Djelantik, I. G., Fletcher, T., Gerudug, I. K., Ingerani Mercer, D., Moniaga, V., Moulton, L. H., Moulton, L. H., Mulholland, K., Nelson, C., Soemohardjo, S., Steinhoff, M., Widjaya, A., Stoeckel, P., Maynard, J., & Arjoso, S. (2005). Incidences of vaccine-preventable Haemophilus influenzae type b pneumonia and meningitis in Indonesian children: Hamlet-randomised vaccine-probe trial. The Lancet, 365(9453), 43–52.

Harris, M., Clark, J., Coote, N., Fletcher, P., Harnden, A., McCean, M., Thomas, A., & British Thoracic Society Standards of Care Committee (2011). British Thoracic Society guidelines for the management of community acquired pneumonia in children: Update 2011. Thorax, 66(2), 1–23.

Josse, J., Laurent, F., & Diot, A. (2017). Staphylococcal adhesion and host cell invasion: Fibronectin-binding and other mechanisms. Frontiers in Microbiology, 8, 2433.

Knobee, R. B., Diallo, A., Fall, A., Gueye, A. D., Dieng, A., D van Immerzeel, T., Ba, A., Diop, A., Diop, A., Niang, M., & Boye, C. S. B. (2019). Pathogens causing respiratory tract infections in children less than 5 years of age in Senegal. Microbiology Insights, 12, 1–8.

Lahti, E., Peltola, V., Waris, M., Virkki, R., Rantakokko-Jalava, K., Jalava, J., Eerola, E., & Ruuskanen, O. (2009). Induced sputum in the diagnosis of childhood community-acquired pneumonia. Thorax, 64(3), 252–257.

Mertz, D., Frei, R., Periat, N., Zimmerli, M., Battegay, M., Flückiger, U., & Widmer, A. F. (2009). Exclusive Staphylococcus aureus throat carriage: At-risk populations. Archieves of Internal Medicine, 169(2), 172–178.

Morgenea, M. F., Botelho-Neversa, E., Grattarda, F., Pilleta, S., Berthelota, P., Pozzettoa, B., & Verhoeven, P. O. (2018). Staphylococcus aureus colonization and non-influenza respiratory viruses: Interactions and synergism mechanisms. Virulence, 9(1), 1354–1363.

Navne, J. E., Borresen, M. L., Slotved, H. C., Andersson, M., Melbye, M., Ladefoged, K., & Koch, A. (2016). Nasopharyngeal bacterial carriage in young children in Greenland: A population at high risk of respiratory infections 2016. Epidemiology and Infection, 144(15), 3226–3236.

Ning, G., Wang, X., Wu, D., Yin, Z., Li, Y., Wang, H., & Yang, W. (2017). The etiology of community-acquired pneumonia among children under 5 years of age in mainland China, 2001–2015: A systematic review. Human Vaccines and Immunotherapeutics, 13(11), 2742–2750.

O’Brien, K. L., Beall, B., Barrett, N. L., Ciselak, P. R., Reingold, A., Farley, M. M., Danila, R., Zell, E. R., Facklam, R., Schwartz, B., Schuchat, A., & Active Bacterial Core Surveillance/Emrging Infections Program Network (2002). Epidemiology of invasive group A Streptococcus disease in the United States, 1995–1999. Clinical Infectious Diseases, 35, 268–276.

O’Brien, K. L., Nohynek, H., & World Health Organization Pneumococcal Vaccine Trials Carriage Working Group (2003). Report from a WHO Working Group: Standard method for detecting upper respiratory carriage of Streptococcus pneumoniae. The Pediatric Infectious Disease Journal, 22(2), 1–11.

O’Brien, K. L., Wolfson, L. J., Watt, J. P., Henkle, E., Deloria-Knoll, M., McCall, N., Lee, E., Mulholland, K., Levine, O. S., Cherian, T., Hib & Pneumococcal Global Burden of Disease Study team (2009). Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: Global estimates. The Lancet, 374, 893–902.

Recco, R. A., Zaman, M. M., Cortes, H., Colucci, J., Poomkudy, G., & Kaplan, E. L. (2002). Intra-familial transmission of life-threatening group A streptococcal infection. Epidemiology and Infection, 129(2), 303–306.

Robinson, J. (2004). Colonization and infection of the respiratory tract: What do we know? Paediatrics and Child Health, 9(1), 21–24.

Roy, S., Kaplan, E. L., Rodriguez, B., Schreiber, J. R., Salata, R. A., Palavecino, E., & John, C. C. (2003). A family cluster of five cases of Group A streptococcal pneumonia. Pediatrics, 112(1), 61–65.

Rudan, I., O’Brien, K. L., Nair, H., Liu, L., Theodoratou, E., Qazi, S., Lukšić, I., Fischer Walker, C. L., Black, R. E., Campbell, H., & Child Health Epidemiology Reference Group (2013). Epidemiology and etiology of childhood pneumonia in 2010: Estimates of incidence, severe morbidity, mortality, underlying risk factors and causative pathogens for 192 countries. Journal of Global Health, 3(1), 010401.

Satzke, C., Turner, P., Virolainen-Julkunen, A., Adrian, P. V., Antonio, M., Hare, K. M., Henao-Restrepo, A. M., Leach, A. J., Klugman, K. P., Porter, B. D., Sá-Leão, R., Scott, J. A., Nohynek, H., O’Brien, K. L., & WHO Pneumococcal Carriage Working Group (2013). Standard method for detecting upper respiratory carriage of Streptococcus pneumoniae: Updated recommendations from the World Health Organization Pneumococcal Carriage Working Group. Vaccine, 32(1), 165–179.

Schwartz, B., Elliott, J. A., Butler, J. C., Simon, P. A., Jameson, B. L., Welch, G. E., & Facklam, R. R. (1992). Clusters of invasive group A streptococcal infections in family, hospital, and nursing home settings. Clinical Infectious Diseases, 15(2), 277–284.

Seale, A. C., Davies, M. R., Anampiu, K., Morpeth, S. C., Nyongesa, S., Mwarumba, S., Smeesters, P. R., Efstratiou, A., Karugutu, R., Mturi, N., Williams, T. N., Scott, J. A. G., Kariuki, S., Dougan, G., & Berkley, J. A. (2016). Invasive group A Streptococcus infection among children, Rural Kenya. Emerging Infectious Diseases, 22(2), 224–232.

The Pneumonia Etiology Research for Child Health Study Group (2019). Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: The PERCH multi-country case-control study. The Lancet, 394(10200), 757–779.

Tine, R. C., Ndiaye, L. A., Niang, M. N., Kiori, D. E., Dia, N., Gaye, O., & Broutin, H. (2018). Upper respiratory infections in a rural area with reduced malaria transmission in Senegal: A pathogens community study. BMC Infectious Diseases, 18, 459.

Tong, S. Y. C., Davis, J. S., Eichenberger, E., Holland, T. L., & Fowler Jr., V. G. (2015). Staphylococcus aureus infections: Epidemiology, pathophysiology, clinical manifestations, and management. Clinical Microbiology Reviews, 28(3), 603–661.

Van der Poll, T., & Opal, S. M. (2009). Pathogenesis, treatment, a6nd prevention of pneumococcal pneumonia. The Lancet, 374(9700), 1543–1556.

Verhoeven, D. (2019). Influence of immunological maturity on respiratory syncytial virus-induced morbidity in young children. Viral Immunology, 32(2), 76–83.

Verhoeven, P. O., Gagnaire, J., Botelho-Nevers, E., Grattard, F., Carricajo, A., Lucht, F., Pozzetto, B., & Berthelot, P. (2014). Detection and clinical relevance of Staphylococcus aureus nasal carriage: An update. Expert Review of Anti-Infective Therapy, 12(1), 75–89.

Verhoeven, P. O., Haddar, C. H., Grattard, F., Carricajo, A., Botelho-Nevers, E., Pozzetto, B., & Berthelot, P. (2015). Does pharyngeal sampling improve the detection of nasopharyngeal persistent carriers of Staphylococcus aureus? Journal of Infection, 70(5), 549–552.

Yadav, K. K., & Awasthi, S. (2016). The current status of community-acquired pneumonia management and prevention in children under 5 years of age in India: A review. Therapeutic Advances in Infectious Disease, 3(3–4), 83–97.

Zar, H. J., Tannenbaum, E., Hanslo, D., & Hussey, G. (2003). Sputum induction as a diagnostic tool for community-acquired pneumonia in infants and young children from a high HIV prevalence area. Pediatric Pulmonology, 36(1), 58–62.

Published
2020-11-14
How to Cite
Isaieva, H. O., Mishyna, M. M., Gonchar, M. O., Logvinova, O. L., & Basiuk, M. A. (2020). Microorganisms causing respiratory diseases in children in relation to age and diagnosis . Regulatory Mechanisms in Biosystems, 11(4), 552-556. https://doi.org/10.15421/022085