Etiology and antibiotic resistance of the microflora of the upper respiratory tract in children who sought outpatient care
https://doi.org/10.22627/2072-8107-2025-24-1-18-25
Abstract
The aim of the study was to identify the main microorganisms colonizing the mucous membrane of the nasal cavity and pharynx in children of different age groups, and their antibiotic sensitivity.
Materials and methods: 311 children aged 0 to 17 years who applied for outpatient care of St. Petersburg State Medical Establishment «City Polyclinic No. 63» for the period from March to December 2023 were examined. 511 samples were examined — 241 from the nasal mucosa and 270 from the pharyngeal mucosa. Antibiotic sensitivity has been determined. The frequency of colonization in children who sought outpatient care for upper respiratory tract infections (n = 186) and for other reasons (n = 103) was calculated.
Results. Clinically significant microorganisms were isolated from 176 (61.3% ± 2.87) children: S. aureus 30.0 ± 2.7, S. pyogenes 19.9 ± 2.3, M. cataralis 11.1 ± 1.9, S. pneumoniae 8.4 ± 1.6, H. influenzae 5.6 ± 1.3, others 3.8 ± 1.1. 41 (14.3%). The risk group for colonization of S. aureus are boys RR = 1.47 (95% CI: 1.02—2.12) p = 0.02. The risk group for colonization of M. cataralis and S. pneumoniae are children from 0 to 9 years old: RR = 9.45 (95% CI: 2.29—38.93); p (Fisher) = 0.00002 and RR = 4.9 (95% CI: 1.49—16.06); p (Fisher) = 0.0018, respectively. 59.8% of S. aureus strains were resistant to benzylppenicillin, 14% to roxithromycin and clindamycin, 13% to azithromycin and erythromycin, 18.7% of H. influenzae strains to ampicillin and amoxicillin, 87.5% of S. pneumoniae strains had intermediate resistance to cefaclor, 90.8% of S. aureus strains to clarithromycin. 99% of S. aureus strains, 98.4% of S. pyogenes and 97.4% of S. pneumoniae had intermediate resistance to levofloxacin.
About the Authors
A. V. Liubimova
Mechnikov Northwestern State Medical University
Russian Federation
Russian Federation
St. Petersburg
M. K. Afanasev
Mechnikov Northwestern State Medical University; St. Petersburg State Medical Establishment «City polyclinic №63»
Russian Federation
Russian Federation
St. Petersburg
T. G. Ivanova
Mechnikov Northwestern State Medical University
Russian Federation
Russian Federation
St. Petersburg
K. D. Vasilev
Mechnikov Northwestern State Medical University
Russian Federation
Russian Federation
St. Petersburg
L. V. Belova
Mechnikov Northwestern State Medical University
Russian Federation
Russian Federation
St. Petersburg
References
1. Rachina S.A., Kozlov R.S., Tatochenko V.K., Dudnikova E.V. et al. The practice of treating acute respiratory infections in children in outpatient clinics of the Russian Federation: results of a multicenter pharmacoepidemiological study. Klinicheskaya farmakologiya i terapiya=Clinical Рharmacology and Тherapy. 2016; 25(2):20—27. (In Russ.)
2. Fominykh S.G. Rating of medical misconceptions when prescribing antimicrobial agents: a retrospective analysis of the expert work of a clinical pharmacologist. Klinicheskaya mikrobiologiya i antimikrobnaya himioterapiya=Clinical Мicrobiology and Аntimicrobial Сhemotherapy. 2017; 19(1): 73—79. (In Russ.)
3. Safronenko L.A., Lukashevich M.G., Butko I.L. Dynamics of the level of professional competence of local pediatricians in matters of antibacterial therapy. Klinicheskaya mikrobiologiya i antimikrobnaya himioterapiya=Clinical Мicrobiology and Аntimicrobial Сhemotherapy. 2017; 19(1):63—66. (In Russ.)
4. Tsirigotaki M, Galanakis E. Impact of vaccines on Staphylococcus aureus colonization: A systematic review and meta-analysis. Vaccine. 2023 Oct 20; 41(44):6478—6487. doi: 10.1016/j.vaccine.2023.09.034.
5. Hung TY, Phuong LK, Grobler A, Tong SYC, Freeth P, Pelenda A, Gibney KB, Steer AC. Antibiotics to eradicate Streptococcus pyogenes pharyngeal carriage in asymptomatic children and adults: A systematic review. J Infect. 2024 Mar; 88(3):106104. doi: 10.1016/j.jinf.2024.01.003.
6. Perez AC, Murphy TF. A Moraxella catarrhalis vaccine to protect against otitis media and exacerbations of COPD: An update on current progress and challenges. Hum Vaccin Immunother. 2017 Oct 3; 13(10):2322— 2331. doi: 10.1080/21645515.2017.1356951.
7. Shmylenko V.A., Bondarenko A.P., Trotsenko O.E., Turkutyukov V.B. Frequency of detection of moraxella cataralis bacterial in children with recurrent respiratory diseases in Khabarovsk city in 2016—2017. Byulleten' fiziologii i patologii dyhaniya=Bulletin of Physiology and Вreathing Рathologies. 2018; 68:52—56. (In Russ.) https://doi.org/10.12737/article_5b18b82fc43524.59761242
8. Lazareva M.A., Kulichenko T.V., Alyabyeva N.M., Ponomarenko O.A., Lazareva A.V., Katosova L.K., Mayansky N.A. Nasopharyngeal carriage of Streptococcus pneumoniae in children's children homes, preschool institutions and unorganized children under 5 years of age. Issues of modern pediatrics=Voprosy Sovremennoy Рediatrii. 2015; 14(2):246—255. (In Russ.) https://doi.org/10.15690/vsp.v14i2.1293
9. Drozdova M.V., Larionova S.N., Tyrnova E.V. Evaluation of nasopharyngeal microbiota role in development of chronic lymphoproliferative syndrome of ENT organs in young children. Rossiiskaya otorinolaringologiya=Russian Otorhinolaryngology. 2022; 21(5):19—26. (In Russ.) https://doi.org/10.18692/1810-4800-2022-5-19-2
10. Yang L, Dharmaratne P, Zhu C, Sapugahawatte DN, Rahman N, Barua N, Li C, Kwok KO, Luo M, Liyanapathirana V, Ip M. Global epidemiology of asymptomatic colonisation of methicillin-resistant Staphylococcus aureus in the upper respiratory tract of young children: a systematic review and metaanalysis. Arch Dis Child. 2024 Mar 19; 109(4):267—274. doi: 10.1136/archdischild-2023-326124.
11. Isaeva G.Sh., Bayazitova L.T., Zaripova A.Z., Tyupkina O.F., Chazova T.A., Khusainova R.M., Tyurin Yu.A., Ziatdinov V.B. Regional features of the serotype composition of Streptococcus pneumoniae isolated from preschoolchildren carrying bacteria in the Republic of Tatarstan. Epidemiology and Vaccinal Prevention=Epidemiologiya i Vaktsinoprofilaktika. 2023; 22(3): 26—35. (In Russ.) https://doi.org/10.31631/2073-3046-2023-22-3-26-35
12. Girina A.A., Petrovsky F.I., Petrovskaya Yu.A., Zaplatnikov A.L. Frequency of carriage of S. pneumoniae in organized children of Khanty-Mansiysk. RMJ. Mother and Сhild=RMZH. Mat' i ditya. 2023; 6(2):164—168. (In Russ.) https://doi.org/10.32364/2618-8430-2023-6-2-164-168
13. Zharkova L.P., Krechikova O.I., Chagaryan A.N., Kozlov R.S. Carriage of Streptococcus pneumoniae among organized children of the city of Smolensk. Clinical microbiology and antimicrobial therapy=Klinicheskaya Мikrobiologiya i Аntimikrobnaya Тerapiya. 2020; 22(2):149—155. (In Russ.)
14. Fed'ko N.A., Voronkina E.N., Rubacheva O.E., Dzhanibekova A.S. The issue of pathogens antibiotic resistance in conditions of children's medical facility. Rossijskij pediatricheskij zhurnal=Russian Pediatric Journal. 2022; 3(1):319. (In Russ.)
15. Kalinogorskaya O.S., Belanov S.S., Volkova M.O., Gostev V.V., Sidorenko S.V. Antibiotic resistance and serotype composition of Streptococcus pneumoniae isolated from children in St. Petersburg in 2010—2013. Antibiotiki i himioterapiya=Antibiotics and Сhemotherapy. 2015; 60(1—2):10—18. (In Russ.)
16. Mayansky N.A., Alyab'eva N.M., Lazareva M.A., Ivanenko A.M., Ponomarenko O.A., Lazareva A.V., Katosova L.K., Kulichenko T.V. Sensitivity to antibiotics, clonal and serotype diversity of pneumococci in children with acute otitis media in Moscow. Klinicheskaya mikrobiologiya i antimikrobnaya himioterapiya=Clinical Мicrobiology and Аntimicrobial Сhemotherapy. 2016; 18(2):84—92. (In Russ.)
17. Tomic V., Dowzicky M.J. Regional and global antimicrobial susceptibility among isolates of Streptococcus pneumoniae and Haemophilus influenzae collected as part of the Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) from 2009 to 2012 and comparison with previous years of T.E.S.T. (2004—2008). Annals of Clinical Microbiology and Antimicrobials. 2014; 13:52. https://doi.org/10.1186/s12941-014-0052-2
18. Richter S.S. Musher D.M. The ongoing genetic adaptation of Streptococcus pneumoniae. The Journal of Clinical Microbiology. 2017; 55(3):681— 685. https://doi.org/10.1128/JCM.02283-16
19. Songa J.H. Dagan R., Klugman K.P., Fritzell B. The relationship between pneumococcal serotypes and antibiotic resistance. Vaccine. 2012; 30(17): 2728—2737. https://doi.org/10.1016/j.vaccine.2012.01.091
20. Protasova I.N., Wan T.W., Bakhareva N.V., Hung W.C. et al. Molecular characterization of Streptococcus pneumoniae, particularly serotype19A/ ST320, that emerged in Krasnoyarsk, Russia. Microbiol Immunol. 2017; 61(9):359—370. https://doi.org/10.1111/1348-0421.12503
Review
For citations:
Liubimova A.V., Afanasev M.K., Ivanova T.G., Vasilev K.D., Belova L.V. Etiology and antibiotic resistance of the microflora of the upper respiratory tract in children who sought outpatient care. CHILDREN INFECTIONS. 2025;24(1):18-25. (In Russ.) https://doi.org/10.22627/2072-8107-2025-24-1-18-25
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