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Journal article
The association between bacteria colonizing the upper respiratory tract and lower respiratory tract infection in young children: a systematic review and meta-analysis
Clinical microbiology and infection, Vol.27(9), pp.P1262-1270
2021
Abstract
Background
Bacteria colonizing the upper respiratory tract (URT) of young children play a key role in the pathogenesis of lower respiratory tract infection (LRTI).
Objectives
To systematically review the literature on the association between bacteria colonizing the URT and LRTI among young children.
Data sources
MEDLINE, Academic Search Premier, Africa-Wide Information and CINAHL, Scopus and Web of Science.
Study eligibility criteria
Studies published between 1923 and 2020, investigating URT bacteria from LRTI cases and controls.
Participants
Children under 5 years with and without acute LRTI.
Methods
Three reviewers independently screened titles, abstracts and full texts. Meta-analysis was done using Mantel–Haenszel fixed- or random-effects models.
Results
Most eligible studies (41/50) tested nasopharyngeal specimens when investigating URT bacteria. Most studies were of cross-sectional design (44/50). Twenty-four studies were performed in children in lower- or lower-middle-income countries (LMICs). There was higher prevalence of Haemophilus influenzae (pooled OR 1.60; 95% CI 1.23–2.07) and Klebsiella spp. (pooled OR 2.04; 95% CI 1.17–3.55) from URT specimens of cases versus controls. We observed a positive association between the detection of Streptococcus pneumoniae from URT specimens and LRTI after excluding studies where there was more antibiotic treatment prior to sampling in cases vs. controls (pooled OR 1.41; 95% CI 1.04–1.90). High density colonization with S. pneumoniae (>6.9 log10 copies/mL) was associated with an increased risk for LRTI. The associations between both Streptococcus and Haemophilus URT detection and LRTI were supported, at genus level, by 16S rRNA sequencing. Evidence for the role of Moraxella catarrhalis and Staphylococcus aureus was inconclusive.
Conclusions
Detection of H. influenzae or Klebsiella spp. in the URT was associated with LRTI, while evidence for association with S. pneumoniae was less conclusive. Longitudinal studies assessing URT microbial communities, together with environmental and host factors are needed to better understand pathogenesis of childhood LRTI.
Details
- Title
- The association between bacteria colonizing the upper respiratory tract and lower respiratory tract infection in young children: a systematic review and meta-analysis
- Authors/Creators
- Shantelle Claassen-WeitzKatherine Y. L. LimChristopher A MullallyHeather J. Zar - University of Cape TownMark P. Nicol - The University of Western Australia
- Publication Details
- Clinical microbiology and infection, Vol.27(9), pp.P1262-1270
- Publisher
- European Society of Clinical Microbiology and Infectious Diseases
- Identifiers
- 991005639668807891
- Copyright
- © 2021 The Authors.
- Murdoch Affiliation
- Murdoch University
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.23 Antibiotics & Antimicrobials
- 1.23.347 Streptococcus Pneumoniae
- Web Of Science research areas
- Infectious Diseases
- Microbiology
- ESI research areas
- Immunology