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Volume 14, Number 10—October 2008

CME ACTIVITY

Microbial Interactions during Upper Respiratory Tract Infections

Melinda M. PettigrewComments to Author , Janneane F. Gent, Krystal Revai, Janak A. Patel, and Tasnee Chonmaitree
Author affiliations: Yale School of Public Health, New Haven, Connecticut, USA (M. Pettigrew, J. Gent); University of Texas Medical Branch, Galveston, Texas, USA (K. Revai, J. Patel, T. Chonmaitree);

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Table 3

Predicted outcome of colonization with Stretococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis in young children after upper respiratory tract infection (968 swabs from 212 children; see Table 2)*

Parameters OR (95% CI)
S. pneumoniae H. influenzae M. catarrhalis
H. influenzae x M. catarrhalis (p = 0.0003)†
Neither (reference) 1.0
H. influenzae only 0.59 (0.40–0.88)
M. catarrhalis only 1.31 (0.95–1.81)
Both
2.13 (1.35–3.38)


S. pneumoniae x M. catarrhalis (p = 0.08)†
Neither (reference) 1.0
S. pneumoniae only 0.52 (0.32–0.83)
M. catarrhalis only 0.45 (0.29–0.69)
Both

0.82 (0.52–1.30)

H. influenzae x S. pneumoniae (p<0.0001)†
Neither (reference) 1.0
H. influenzae only 0.44 (0.30–0.63)
S. pneumoniae only 1.22 (0.88–1.70)
Both


2.09 (1.30–3.37)
S. aureus
Absent (reference) 1.0 1.0 1.0
Present
0.60 (0.36–0.99)
0.36 (0.17–0.76)
0.72 (0.42–1.25)
Age (1-mo increase)‡
0.98 (0.96–1.00)
1.01 (0.98–1.03)
0.98 (0.97–1.00)
Antimicrobial drug therapy in past 7 days
No (reference) 1.0 1.0 1.0
Yes
0.40 (0.22–0.72)
1.21 (0.69–2.13)
0.52 (0.28–0.96)
Time after URI onset, d
<7 (reference) 1.0 1.0 1.0
>7
1.47 (0.96–2.27)
1.10 (0.70–1.73)
1.21 (0.81–1.80)
Gender
F (reference) 1.0 1.0 1.0
M
1.05 (0.80–1.38)
1.44 (1.08–.93)
0.86 (0.65–1.14)
Race
Not white (reference) 1.0 1.0 1.0
White
1.12 (0.84–1.48)
0.42 (0.31–0.57)
0.80 (0.60–1.07)
Day care
No (reference) 1.0 1.0 1.0
Yes
1.32 (0.97–1.80)
1.51 (1.09–2.09)
1.09 (0.79–1.50)
Breast-fed >4 mo
No (reference) 1.0 1.0 1.0
Yes
0.94 (0.69–1.29)
0.92 (0.65–1.29)
0.81 (0.59–1.12)
Environmental exposure to tobacco smoke
No (reference) 1.0 1.0 1.0
Yes 1.13 (0.84–1.52) 0.93 (0.69–1.27) 0.91 (0.67–1.23)

*OR, odds ratio; CI, confidence interval. Significant ORs and 95% CIs are shown in boldface. Each model included variables representing presence or absence of other bacteria as well as all other variables listed. We did not model colonization of S. aureus because of low prevalence of this species (69/968 positive swabs).
†p value from logistic regression model for overall significance of bacterial interaction.
‡Age (mo) of the child at the time of swab collection.

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