Introduction
The nasopharyngeal culture in children is the most commonly used technique to determine the presence of bacteria causing upper respiratory tract infections. In most cases, the culture may test positive for bacteria, even in a healthy child. A good knowledge about the normal bacteria that are present and the pathogens causing disease is important. Interpretation of the nasopharyngeal culture that has been collected might become difficult because of this reason. The culture results inform us about the type of bacteria in the upper respiratory tract. Certain bacteria are resistant to a specific medication and sensitive to another. This culture allows us to identify the bacteria and help the physician choose the appropriate antibiotic treatment for that case. Predicting the type of bacteria can also give an idea about the associated risk of complications.
The nasopharyngeal culture determines the causative agent in upper respiratory tract infections. The most common infection for which it is used is acute otitis media. In this case, the pathogen or bacteria enters the middle ear via the nasopharynx and eustachian tube. The bacteria responsible for otitis media is detected in the nasopharyngeal culture. Certain conditions may also require nasopharyngeal cultures, such as sinusitis, asthma, or in severe cases, such as pneumonia and meningitis. Interpreting the culture is difficult as some bacteria are present in the nasopharynx of healthy children. These children are asymptomatic.
Knowing about the causative organism can help the physician choose an appropriate antibiotic treatment. It also indicates the risk of complications associated with certain diseases, such as otitis media. Little knowledge is available about the conditions in which the culture is performed in clinical practices and the efficiency of this culture for treatment.
What Is the Actual Purpose of Nasopharyngeal Culture in Children?
Certain viruses and bacteria can be the causative agents for upper respiratory tract infections in children. Physicians usually use nasopharyngeal culture to diagnose the pathogen responsible for the infection.
The common symptoms of respiratory infection are:
-
Chest tightness.
-
Running nose.
-
Chronic cough.
It is important to know the causative agent of the particular infection before choosing a treatment plan. Certain types of disease require only specific treatment that shows effective results in those cases. The conditions that require nasopharyngeal culture include:
-
Respiratory syncytial virus.
-
Influenza.
-
Whooping cough.
-
Staphylococcus infection.
The nasopharyngeal culture also gives an idea about any risk of complications present. These cultures can be used to detect the presence of multidrug-resistant Staphylococcus aureus.
How Is the Nasopharyngeal Culture in Children Obtained?
The physician can perform this culture test at his office. There is no requirement for any preparation.
-
The doctor advises the patient to sit or to lie down.
-
The doctor may then ask to cough to produce sputum.
-
The head of the patient is turned at a 70-degree angle.
-
The patient may lean his head against the wall or the pillow.
-
A small, soft cotton tip or ball is inserted in the nose. It is pushed gently to the back of the nose and twisted several times to collect the sample.
This procedure is repeated in the other nostril as well. This procedure can be accompanied by feeling nauseous, anxious, and discomfort.
What Is the Impact of Antibiotic Treatment on Culture Results?
Studies were conducted on children undergoing antibiotic treatment before collecting the nasopharyngeal culture sample, children on antibiotic treatment for two months, and a few children who had completed the antibiotic treatment. The results revealed that children undergoing antibiotic treatment had the least bacteria load in the nasopharyngeal culture.
The culture showed that during the antibiotic therapy and after the treatment, the presence of beta-lactamase-negative ampicillin-resistant BLNAR bacteria was seen. Pneumococci having less susceptibility to beta-lactams were decreased in number.
What Is the Impact of Nasopharyngeal Culture on the Treatment?
In patients showing positive results for nasopharyngeal culture, the treatment plan changes almost 30%. Only 1% of the patients undergo treatment changes in case of negative nasopharyngeal culture. The change in the treatment plan included a change in the antibiotic given to the patient before the culture results. The antibiotic most given is penicillin V. In this case, the causative agents are Mc and Hi, resistant to Penicillin V. In children who are undergoing treatment, there is less significance in performing a nasopharyngeal culture.
What Is the Association Between the Age of Children and Nasopharyngeal Culture?
Patients with acute otitis media and pertussis often call for a nasopharyngeal culture. These diseases are seen mostly in younger children, so the culture for bacteria diagnosis is done more often in younger children. As in most of the National vaccination programs, the vaccine for pertussis is included, so the nasopharyngeal culture to detect this disease is not done in older children as they are already vaccinated.
In case of any treatment failure or a recurrence of infection, the nasopharyngeal culture is recommended. The culture is not taken in children with uncomplicated Otitis Media, and antibiotics are started. The antibiotic most given is penicillin V. In this case, the causative agents are Mc and Hi, resistant to Penicillin V. In children who are undergoing treatment, there is less significance in performing a nasopharyngeal culture.
What Is the Influence of Nasopharyngeal Culture on Decision-Making?
The influence of nasopharyngeal culture on clinical decision-making is not fully established. Although it is appreciated that the nasopharyngeal culture result leads to a change in the treatment plan in certain cases. In some cases where the antibiotics were not changed, the culture confirmed the presence of bacteria sensitive to the previous treatment after the nasopharyngeal result.
Conclusion
The nasopharyngeal culture in children is used to diagnose the bacteria causing infection in the upper respiratory tract. This can help make a treatment plan; in some cases, the ongoing treatment plan can be changed after the culture results are obtained. It is very helpful in clinical decision-making. Further knowledge related to nasopharyngeal culture and diagnosis can greatly help the physician.
