Colonização da orofaringe por Streptococcus pneumoniae, Haemophilus influenzae e Moraxella catarrhalis em uma população de assentamento rural

Abstract

Bacterial colonization plays an important role in the health of human beings. Risk and inflammatory factors can result in the conversion of the asymptomatic state to invasive disease mediated by pathogens present in the local oropharyngeal microbiome, such as Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. This study aimed to evaluate the oropharynx colonization of residents of a rural settlement in relation to the pathogens most frequently isolated in cases of acute otitis media, as well as to analyze the presence of variables that act as risk factors for the development of ear infection. Demographic data was collected through questionnaires and oropharyngeal sample collections for identification of the pathogens by culture method and by the multiplex polymerase chain reaction in residents of the rural settlement Dona Carmem, located at Mirante do Paranapanema-SP. People who were interested in participating in the study and who lived in the settlement Dona Carmem were included. Participants who received any treatment with antibiotics within 72 hours before sampling were excluded, resulting in 55 study participants. A greater number of positive samples was observed for the pathogens investigated by multiplex PCR, revealing a high rate of colonization by the S.pneumoniae followed by the species M. catarrhalis, while the pathogen H. influenzae was not detected. Vaccination impacted the colonization of H. influenzae, however, the same was not observed for S. pneumoniae, probably due to incomplete vaccination coverage, colonization by non-vaccine serotypes and low seroconversion to the vaccine. Colonization rates for S. pneumoniae were higher than for M. catarrhalis in the presence of smoking, passive smoking, prematurity, food allergy, recurrent pneumonia and gastroesophageal reflux disease (p <0.05). It was also possible to verify that age, smoking, and passive smoking influence the colonization of M. catarrhalis bacteria, and smoking also influences the colonization of M. catarrhalis and S. pneumoniae bacteria simultaneously (p <0.05). The study demonstrates the importance of continuous monitoring of serotypes in order to provide evidence of the predominance of the etiological agents of diseases such as acute otitis media. In addition, the results highlight the vulnerability of rural settlement residents and the need to implement more effective education and health care actions.