Bacterial interference in upper respiratory tract infections: a systematic review

Area of Science:

• Microbiology
• Infectious Diseases
• Immunology

Background:

• Existing definitions of bacterial interference (BI) lack consensus, particularly for upper respiratory tract infections (URTI).
• A roundtable discussion highlighted the need for a unified definition of BI in the context of URTI.
• This study aimed to establish a consensus definition for BI in URTI.

Purpose of the Study:

• To systematically review existing data on bacterial interference in upper respiratory tract infections.
• To propose and justify a consensus definition for bacterial interference specific to URTI.
• To understand the impact of microbial interactions on infection and treatment outcomes.

Main Methods:

• Conducted systematic searches of MEDLINE, EMBASE, and the Cochrane Library.
• Included in vitro and in vivo studies on bacterial URTI, BI response to antimicrobials, and bacterial function.
• Applied refined search criteria focusing on interactions between normal and pathological flora.

Main Results:

• Twenty-nine studies met inclusion criteria, predominantly focusing on children with recurrent infections.
• Qualitative analysis supported the consensus definition of BI.
• Interfering organisms were shown to affect pathogen life cycles, colonization, invasiveness, and health outcomes.

Conclusions:

• Interactions between organisms in the same host can modify infection and treatment responses.
• Further research is needed, especially in adults, to elucidate the role of interfering organisms.
• Understanding antibiotic influence and post-treatment recolonization is crucial.