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Journal of Clinical Microbiology, October 2004, p. 4604-4609, Vol. 42, No. 10
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.10.4604-4609.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Relative Importance of Nasopharyngeal versus Oropharyngeal Sampling for Isolation of Streptococcus pneumoniae and Haemophilus influenzae from Healthy and Sick Individuals Varies with Age

David Greenberg,1* Arnon Broides,2 Irena Blancovich,3 Nechama Peled,4 Noga Givon-Lavi,1 and Ron Dagan1

The Pediatric Infectious Disease Unit,1 The Clinical Microbiology Laboratory, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva,4 Primary Health Care Clinic Center, Dimona A,2 Primary Health Care Clinic Center, Ksefa, Israel3

Received 11 September 2003/ Returned for modification 10 November 2003/ Accepted 26 May 2004

Streptococcus pneumoniae and Haemophilus influenzae carriage is a useful index for measuring the emergence of resistance and outcome in vaccination trials. We performed a study to determine which sampling site, nasopharynx (NP) or oropharynx (OP), yields the highest rate of S. pneumoniae and H. influenzae isolation at different ages. Both NP and OP cultures were obtained from 216 children aged <60 months and their mothers. The total S. pneumoniae carriage rate was 68% among children and 15% among mothers (P < 0.001). Using NP alone for the isolation of S. pneumoniae would have missed 2, 2, and 42% and using OP alone would have missed 77, 66, and 45% of S. pneumoniae in children aged 0 to 23 months, 24 to 59 months, and mothers, respectively. Using NP cultures alone for H. influenzae would have missed 23, 24, and 81% of the isolates, respectively. The respective figures for H. influenzae isolation from OP alone are 38, 29, and 9%. In children, S. pneumoniae was carried mainly in the NP while H. influenzae was equally carried in the NP and OP. In mothers, S. pneumoniae was carried equally in the NP and OP while H. influenzae was carried significantly more often in the OP. In children, H. influenzae colonization increased during illness, mainly in the NP. Culturing only one site significantly reduced the recovery of H. influenzae at all ages. NP cultures for S. pneumoniae detected close to 100% of isolates in children but only 58% of isolates in mothers.

* Corresponding author. Mailing address: The Pediatric Infectious Disease Unit, Ben-Gurion University of the Negev, Soroka University Medical Center, Beer-Sheva, Israel. Phone: 972-8-6400547. Fax: 972-8-6232334. E-mail: dudi{at}bgumail.bgu.ac.il.

Journal of Clinical Microbiology, October 2004, p. 4604-4609, Vol. 42, No. 10
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.10.4604-4609.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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