Respiratory microbes present in the nasopharynx of children hospitalised with suspected pulmonary tuberculosis in Cape Town, South Africa

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dc.contributor.authorDube, Felix S
dc.contributor.authorKaba, Mamadou
dc.contributor.authorRobberts, F J Lourens
dc.contributor.authorTow, Lemese A
dc.contributor.authorLubbe, Sugnet
dc.contributor.authorZar, Heather J
dc.contributor.authorNicol, Mark P
dc.date.accessioned2016-10-25T09:29:28Z
dc.date.available2016-10-25T09:29:28Z
dc.date.issued2016-10-24
dc.date.updated2016-10-24T18:04:06Z
dc.description.abstractBackground: Lower respiratory tract infection in children is increasingly thought to be polymicrobial in origin. Children with symptoms suggestive of pulmonary tuberculosis (PTB) may have tuberculosis, other respiratory tract infections or co-infection with Mycobacterium tuberculosis and other pathogens. We aimed to identify the presence of potential respiratory pathogens in nasopharyngeal (NP) samples from children with suspected PTB. Method: NP samples collected from consecutive children presenting with suspected PTB at Red Cross Children’s Hospital (Cape Town, South Africa) were tested by multiplex real-time RT-PCR. Mycobacterial liquid culture and Xpert MTB/RIF was performed on 2 induced sputa obtained from each participant. Children were categorised as definite-TB (culture or qPCR [Xpert MTB/RIF] confirmed), unlikely-TB (improvement of symptoms without TB treatment on follow-up) and unconfirmed-TB (all other children). Results: Amongst 214 children with a median age of 36 months (interquartile range, [IQR] 19–66 months), 34 (16 %) had definite-TB, 86 (40 %) had unconfirmed-TB and 94 (44 %) were classified as unlikely-TB. Moraxella catarrhalis (64 %), Streptococcus pneumoniae (42 %), Haemophilus influenzae spp (29 %) and Staphylococcus aureus (22 %) were the most common bacteria detected in NP samples. Other bacteria detected included Mycoplasma pneumoniae (9 %), Bordetella pertussis (7 %) and Chlamydophila pneumoniae (4 %). The most common viruses detected included metapneumovirus (19 %), rhinovirus (15 %), influenza virus C (9 %), adenovirus (7 %), cytomegalovirus (7 %) and coronavirus O43 (5.6 %). Both bacteria and viruses were detected in 73, 55 and 56 % of the definite, unconfirmed and unlikely-TB groups, respectively. There were no significant differences in the distribution of respiratory microbes between children with and without TB. Using quadratic discriminant analysis, human metapneumovirus, C. pneumoniae, coronavirus 043, influenza virus C virus, rhinovirus and cytomegalovirus best discriminated children with definite-TB from the other groups of children. Conclusions: A broad range of potential respiratory pathogens was detected in children with suspected TB. There was no clear association between TB categorisation and detection of a specific pathogen. Further work is needed to explore potential pathogen interactions and their role in the pathogenesis of PTB.
dc.identifier10.1186/s12879-016-1934-z
dc.identifier.apacitationDube, F. S., Kaba, M., Robberts, F. J. L., Tow, L. A., Lubbe, S., Zar, H. J., & Nicol, M. P. (2016). Respiratory microbes present in the nasopharynx of children hospitalised with suspected pulmonary tuberculosis in Cape Town, South Africa. <i>BMC Infectious Diseases</i>, http://hdl.handle.net/11427/22285en_ZA
dc.identifier.chicagocitationDube, Felix S, Mamadou Kaba, F J Lourens Robberts, Lemese A Tow, Sugnet Lubbe, Heather J Zar, and Mark P Nicol "Respiratory microbes present in the nasopharynx of children hospitalised with suspected pulmonary tuberculosis in Cape Town, South Africa." <i>BMC Infectious Diseases</i> (2016) http://hdl.handle.net/11427/22285en_ZA
dc.identifier.citationDube, F. S., Kaba, M., Robberts, F. L., Tow, L. A., Lubbe, S., Zar, H. J., & Nicol, M. P. (2016). Respiratory microbes present in the nasopharynx of children hospitalised with suspected pulmonary tuberculosis in Cape Town, South Africa. BMC infectious diseases, 16(1), 597.
dc.identifier.issn1471-2334
dc.identifier.ris TY - Journal Article AU - Dube, Felix S AU - Kaba, Mamadou AU - Robberts, F J Lourens AU - Tow, Lemese A AU - Lubbe, Sugnet AU - Zar, Heather J AU - Nicol, Mark P AB - Background: Lower respiratory tract infection in children is increasingly thought to be polymicrobial in origin. Children with symptoms suggestive of pulmonary tuberculosis (PTB) may have tuberculosis, other respiratory tract infections or co-infection with Mycobacterium tuberculosis and other pathogens. We aimed to identify the presence of potential respiratory pathogens in nasopharyngeal (NP) samples from children with suspected PTB. Method: NP samples collected from consecutive children presenting with suspected PTB at Red Cross Children’s Hospital (Cape Town, South Africa) were tested by multiplex real-time RT-PCR. Mycobacterial liquid culture and Xpert MTB/RIF was performed on 2 induced sputa obtained from each participant. Children were categorised as definite-TB (culture or qPCR [Xpert MTB/RIF] confirmed), unlikely-TB (improvement of symptoms without TB treatment on follow-up) and unconfirmed-TB (all other children). Results: Amongst 214 children with a median age of 36 months (interquartile range, [IQR] 19–66 months), 34 (16 %) had definite-TB, 86 (40 %) had unconfirmed-TB and 94 (44 %) were classified as unlikely-TB. Moraxella catarrhalis (64 %), Streptococcus pneumoniae (42 %), Haemophilus influenzae spp (29 %) and Staphylococcus aureus (22 %) were the most common bacteria detected in NP samples. Other bacteria detected included Mycoplasma pneumoniae (9 %), Bordetella pertussis (7 %) and Chlamydophila pneumoniae (4 %). The most common viruses detected included metapneumovirus (19 %), rhinovirus (15 %), influenza virus C (9 %), adenovirus (7 %), cytomegalovirus (7 %) and coronavirus O43 (5.6 %). Both bacteria and viruses were detected in 73, 55 and 56 % of the definite, unconfirmed and unlikely-TB groups, respectively. There were no significant differences in the distribution of respiratory microbes between children with and without TB. Using quadratic discriminant analysis, human metapneumovirus, C. pneumoniae, coronavirus 043, influenza virus C virus, rhinovirus and cytomegalovirus best discriminated children with definite-TB from the other groups of children. Conclusions: A broad range of potential respiratory pathogens was detected in children with suspected TB. There was no clear association between TB categorisation and detection of a specific pathogen. Further work is needed to explore potential pathogen interactions and their role in the pathogenesis of PTB. DA - 2016-10-24 DB - OpenUCT DO - 10.1186/s12879-016-1934-z DP - University of Cape Town J1 - BMC Infectious Diseases LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 SM - 1471-2334 T1 - Respiratory microbes present in the nasopharynx of children hospitalised with suspected pulmonary tuberculosis in Cape Town, South Africa TI - Respiratory microbes present in the nasopharynx of children hospitalised with suspected pulmonary tuberculosis in Cape Town, South Africa UR - http://hdl.handle.net/11427/22285 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s12879-016-1934-z
dc.identifier.urihttp://hdl.handle.net/11427/22285
dc.identifier.vancouvercitationDube FS, Kaba M, Robberts FJL, Tow LA, Lubbe S, Zar HJ, et al. Respiratory microbes present in the nasopharynx of children hospitalised with suspected pulmonary tuberculosis in Cape Town, South Africa. BMC Infectious Diseases. 2016; http://hdl.handle.net/11427/22285.en_ZA
dc.language.rfc3066en
dc.publisherBioMed Central
dc.publisher.departmentDivision of Medical Microbiologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution 4.0 International License
dc.rights.holderThe Author(s).
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceBMC Infectious Diseases
dc.source.urihttp://bmcinfectdis.biomedcentral.com/
dc.subject.otherInfection
dc.subject.otherNasopharynx
dc.subject.otherMicrobiota
dc.subject.otherMycobacterium tuberculosis
dc.subject.otherTuberculosis
dc.subject.otherRespiratory microbes
dc.titleRespiratory microbes present in the nasopharynx of children hospitalised with suspected pulmonary tuberculosis in Cape Town, South Africa
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
uct.type.resourceResearchen_ZA
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