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. 2004 Oct;42(10):4604-9.
doi: 10.1128/JCM.42.10.4604-4609.2004.

Relative importance of nasopharyngeal versus oropharyngeal sampling for isolation of Streptococcus pneumoniae and Haemophilus influenzae from healthy and sick individuals varies with age

David Greenberg  1 , Arnon Broides, Irena Blancovich, Nechama Peled, Noga Givon-Lavi, Ron Dagan
Affiliations

Relative importance of nasopharyngeal versus oropharyngeal sampling for isolation of Streptococcus pneumoniae and Haemophilus influenzae from healthy and sick individuals varies with age

David Greenberg et al. J Clin Microbiol. 2004 Oct.

Abstract

Streptococcus pneumoniae and Haemophilus influenzae carriage is a useful index for measuring the emergence of resistance and outcome in vaccination trials. We performed a study to determine which sampling site, nasopharynx (NP) or oropharynx (OP), yields the highest rate of S. pneumoniae and H. influenzae isolation at different ages. Both NP and OP cultures were obtained from 216 children aged <60 months and their mothers. The total S. pneumoniae carriage rate was 68% among children and 15% among mothers (P < 0.001). Using NP alone for the isolation of S. pneumoniae would have missed 2, 2, and 42% and using OP alone would have missed 77, 66, and 45% of S. pneumoniae in children aged 0 to 23 months, 24 to 59 months, and mothers, respectively. Using NP cultures alone for H. influenzae would have missed 23, 24, and 81% of the isolates, respectively. The respective figures for H. influenzae isolation from OP alone are 38, 29, and 9%. In children, S. pneumoniae was carried mainly in the NP while H. influenzae was equally carried in the NP and OP. In mothers, S. pneumoniae was carried equally in the NP and OP while H. influenzae was carried significantly more often in the OP. In children, H. influenzae colonization increased during illness, mainly in the NP. Culturing only one site significantly reduced the recovery of H. influenzae at all ages. NP cultures for S. pneumoniae detected close to 100% of isolates in children but only 58% of isolates in mothers.

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Figures

FIG. 1.
FIG. 1.
Relative importance of NP versus OP sampling in S. pneumoniae carriage in children and their mothers. NS, not significant.
FIG. 2.
FIG. 2.
Relative importance of NP versus OP sampling in H. influenzae carriage in children and their mothers. NS, not significant.
FIG. 3.
FIG. 3.
Carriage rate of H. influenzae in NP, OP, and NP plus OP samples from sick and healthy children. *, P value of <0.001 between NP-only sampling of H. influenzae carriage in sick and healthy children; #, P value of 0.052 between sick children aged 0 to 23 months and sick children aged 24 to 59 months.
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