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Colonization of the oropharynx with Gram-negative bacilli in children with severe protein-calorie malnutrition
Insights
Severely malnourished children, especially young ones, show higher rates of Gram-negative bacteria colonization in their throats. This increased carriage may contribute to their higher risk of Gram-negative infections.
Area of Science:
- Microbiology
- Pediatrics
- Public Health
Background:
- Malnutrition is a significant health issue in children, potentially increasing susceptibility to infections.
- Gram-negative bacteria are common pathogens, and their carriage in the pharynx can indicate colonization.
- Understanding colonization patterns is crucial for infection prevention in vulnerable populations.
Purpose of the Study:
- To investigate the prevalence of oral pharyngeal Gram-negative bacteria isolation in different groups of Bengali children.
- To compare colonization rates between severely malnourished children and other groups, including less malnourished children, orphans, and well-controlled children.
- To explore the relationship between nutritional status, age, and Gram-negative colonization.
Main Methods:
- The study involved four groups of children in Bengal: acutely ill severely malnourished, less severely malnourished outpatients, orphans, and well-controlled children.
- Oral pharyngeal swabs were collected and analyzed for Gram-negative bacteria.
- Nutritional status was assessed using the expected weight for height percentage.
Main Results:
- Severely malnourished children (85%) had significantly higher Gram-negative bacteria isolation rates compared to outpatients (38%), orphans (22%), and controls (10%).
- Younger malnourished children (under 5 years) exhibited higher colonization rates (90%) than older malnourished children (63%).
- In ill children, Gram-negative pharyngeal colonization was inversely associated with nutritional indices and age.
Conclusions:
- Severely malnourished children, particularly the younger ones, demonstrate an increased rate of Gram-negative throat colonization.
- This elevated colonization may partially explain the heightened susceptibility to Gram-negative infections observed in these children.
- Nutritional status and age are significant factors influencing Gram-negative pharyngeal colonization in ill children.
Abstract:
Oral pharyngeal isolation of Gram-negative bacteria was compared in four groups of Bengali children; acutely ill, severely malnourished outpatients swabbed on hospital admission; ill but less severely malnourished outpatients from the same area as the malnourished children; orphans also less severely malnourished but not acutely ill; and well controls drawn from a priviledged socioeconomic group. The expected weight for height percentage (National Center Health Statistics/Center for Disease Control median) of the four groups was respectively 67, 91, 97, and 97%. Isolation of Gram-negative bacteria from 74 of 87 (85%) severely malnourished children was significantly greater (p less than 0.01) compared to 43 of 113 (38%) outpatients, to 20 of 93 (22%) orphans, and to five of 51 (10%) controls. A total of 71 malnourished children under 5 yr of age (90%) had higher rates of Gram-negative throat colonization than did 16 older children (63%) (p less than 0.01). Thus there was an increased rate of Gram-negative colonization in severely malnourished children especially among the younger age group. In the subset of ill children, Gram-negative pharyngeal colonization was significantly associated inversely with nutritional indices and age. The high rate of such carriage may be partly responsible for the increased susceptibility of Gram-negative infection demonstrated in these children.