SynthesisClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases2021
The association between bacteria colonizing the upper respiratory tract and lower respiratory tract infection in young children: a systematic review and meta-analysis.
Synthesis in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- From Conventional Detection to Point-of-care Tests (POCT) Method for Pediatric Respiratory Infections Diagnosis: A Systematic Review.Archives of Iranian medicine · 2025Pooled it
- The association between bacteria colonizing the upper respiratory tract and lower respiratory tract infection in young children: a systematic review and meta-analysis.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2021Pooled it
- Respiratory mucosal immunity: Biological functions, diseases, prevention and therapy.Genes & diseases · 2026Review
- Targeted next-generation sequencing reveals pathogen spectrum, drug resistance characteristics, and clinical determinants in children with community-acquired pneumonia.Translational pediatrics · 2026Article
- Respiratory Infection-Related Pathogens in the Pediatric Intensive Care Unit During 2019-2024 in Hubei, China.Pathogens (Basel, Switzerland) · 2026Article
- Induced sputum versus bronchoalveolar lavage in lower respiratory tract infection: an exploratory paired diagnostic study.Frontiers in medicine · 2026Article
- Benefits and challenges of host depletion methods in profiling the upper and lower respiratory microbiome.NPJ biofilms and microbiomes · 2025Article
- Identification of a Novel Antibacterial Function of Mammalian Calreticulin.Biomolecules · 2025Article
- Seasonal Dynamics of Microbial Communities in PMAnimals : an open access journal from MDPI · 2025Article
- Respiratory pathogens detected in children aged <5 years hospitalized with severe respiratory illness, South Africa, 2017.Frontiers in pediatrics · 2025Article
- Seven-year surveillance of antimicrobial resistance in respiratory pathogens at a Ugandan referral hospital: Emerging trends and stewardship priorities.African journal of thoracic and critical care medicine · 2025Article
- Global, regional, and national burden of pneumococcal disease among children and adolescents aged <20 years from 1990 to 2021: a predictive analysis.Frontiers in public health · 2025Article
- The dynamic etiology and epidemiological patterns of acute respiratory tract infections during and post non-pharmacological interventions of SARS-CoV-2 in Shenzhen, China: a two years' prospective cohort study from June 2022.Frontiers in cellular and infection microbiology · 2025Article
- Longitudinal prevalence and co-carriage of pathogens associated with nursing home acquired pneumonia in three long-term care facilities.PLOS global public health · 2025Article
- Multiplex droplet digital PCR for the detection and quantitation ofFrontiers in cellular and infection microbiology · 2025Article
- Clinical utility of nanopore-targeted sequencing for diagnosing and treating pulmonary infectious diseases from bronchoalveolar lavage fluid.Frontiers in cellular and infection microbiology · 2025Article
- Early detection of bacterial pneumonia by characteristic induced odor signatures.BMC infectious diseases · 2024Article
- A Longitudinal Study ofMicroorganisms · 2024Article
- The Microbiota in Children and Adolescents with Asthma.Children (Basel, Switzerland) · 2024Review
- Resistance Pattern ofMedicina (Kaunas, Lithuania) · 2024Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundBacteria colonizing the upper respiratory tract (URT) of young children play a key role in the pathogenesis of lower respiratory tract infection (LRTI).
objectivesTo systematically review the literature on the association between bacteria colonizing the URT and LRTI among young children. DATA SOURCES: MEDLINE, Academic Search Premier, Africa-Wide Information and CINAHL, Scopus and Web of Science. STUDY ELIGIBILITY CRITERIA: Studies published between 1923 and 2020, investigating URT bacteria from LRTI cases and controls.
participantsChildren under 5 years with and without acute LRTI.
methodsThree reviewers independently screened titles, abstracts and full texts. Meta-analysis was done using Mantel-Haenszel fixed- or random-effects models.
resultsMost eligible studies (41/50) tested nasopharyngeal specimens when investigating URT bacteria. Most studies were of cross-sectional design (44/50). Twenty-four studies were performed in children in lower- or lower-middle-income countries (LMICs). There was higher prevalence of Haemophilus influenzae (pooled OR 1.60; 95% CI 1.23-2.07) and Klebsiella spp. (pooled OR 2.04; 95% CI 1.17-3.55) from URT specimens of cases versus controls. We observed a positive association between the detection of Streptococcus pneumoniae from URT specimens and LRTI after excluding studies where there was more antibiotic treatment prior to sampling in cases vs. controls (pooled OR 1.41; 95% CI 1.04-1.90). High density colonization with S. pneumoniae (>6.9 log
conclusionsDetection of H. influenzae or Klebsiella spp. in the URT was associated with LRTI, while evidence for association with S. pneumoniae was less conclusive. Longitudinal studies assessing URT microbial communities, together with environmental and host factors are needed to better understand pathogenesis of childhood LRTI.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.