METHODS: We performed qualitative real-time PCR tests to detect common upper respiratory tract pathogens including 9 viruses and 3 bacteria in 1221 nasopharyngeal swabs from patients with fever and influenza-like symptoms in a Chinese city. A quantitative real-time PCR was also performed to measure the bacterial density of the colonizing Streptococcus pneumoniae in these samples.
RESULTS: We found very diverse pathogens including 81.7% viruses, 11.6% bacteria and 6.7% mixed viruses and bacteria. S. pneumoniae colonization was found in 8.0% of the cases but most of them had low bacterial density (Mean = 3.9 log cfu/ml). We also discovered an increase of S. pneumoniae colonization frequency (but not the density) in patients with detectable upper respiratory tract pathogens, in a pathogen variety-dependent manner.
CONCLUSIONS: Our study provided strong evidence against empiric antibiotic use for treating URTIs, and highlighted a strong need for improving the diagnostic capacity for URTIs by using more molecular testing in China.
方法:我们进行了定性实时PCR测试,以检测来自中国某市发热和流感样症状患者的1221例鼻咽拭子中常见的上呼吸道病原体,包括9种病毒和3种细菌。还进行了定量实时PCR以测量这些样品中定殖的肺炎链球菌的细菌密度。
结果:我们发现了非常多样的病原体,包括81.7%的病毒,11.6%的细菌和6.7%的混合病毒和细菌。在8.0%的病例中发现了肺炎链球菌定植,但大多数病例的细菌密度较低(平均值=3.9logcfu/ml)。我们还发现,在可检测上呼吸道病原体的患者中,肺炎链球菌定植频率(而不是密度)增加,以病原体品种依赖性的方式。
结论:我们的研究提供了强有力的证据,反对经验性抗生素用于治疗URTIs。并强调了通过在中国使用更多的分子检测来提高URTIs的诊断能力的强烈需求。