Abstract:
Introduction. The diagnosis of the etiological agent of acute respiratory infections plays a key role in
ensuring the most appropriate and effective therapies for pediatric patients and is fundamental for guiding
prevention strategies. In most cases, sputum is not collected for microbiological diagnosis in children. One
of the limitations of this diagnostic technique is the young pediatric age, due to the impossibility of the
sputum expectoration. An alternative method, widely used to identify viral/bacterial etiology in pediatric
respiratory pathology, is the nasopharyngeal aspirate technique, which allows the detection of not only the
causative agent in most respiratory infections but also colonisation. Nasopharyngeal aspirates are generally
superior to swabs.
Aim of study. Nasopharyngeal aspirate is a diagnostic tool used for the etiological detection of respiratory
pathogens; the procedure involves collecting secretions from the nasopharyngeal area using, technically, a
suction source. It's a painless technique, applicable to infants and young children. The procedure is simple
to perform, it takes a relatively short time, it’s useful in detecting bacterial / viral etiology, carriage and
detection of bacterial susceptibility. It is essential to note that colonisation of the nasopharynx is a first step
towards the development of respiratory bacterial infections.
Methods and materials. A total of 105 children were enrolled during the study period. Pediatric patients
were from ≥ 8 weeks to 5 years, hospitalised within the Mother and Child Institute and the Municipal
Children's Clinical Hospital No. 1 from Chisinau, who showed acute respiratory symptoms and who were
not given antibiotic therapy previous this hospitalisation. Obtained informed consent, nasopharyngeal
aspirates were collected after 72 h after the onset of the first catarrhal symptoms and no later than 7 days
after the onset of the acute respiratory episode. Data analysis was performed using the Microsoft Excel
2010 calculation program. Descriptive data were presented as a percentage.
Results. The mean age at presentation was 18 ± 1.27 months. There were 49.52% of boys, with Boy / girl
ratio = 0,98 /1. Of the 105 samples analysed, 83 (79%) were positive for bacterial infection. Moraxella
Catarrhalis was detected as the predominant bacterial agent for colonisation of the nasopharynx in about
33%. S. aureus was highlighted in 30% of cases, and in 19% of cases S.Dysgalactiae groups C and G were
detected. The spectrum of respiratory etiology preventable by vaccination noted S. pneumoniae in 4,2% of
cases and H. influenzae in 4,2%, at the same time were noted in small titers, suggesting carrier status
highlighting a potential risk of invasive infection.
Conclusion. The nasopharyngeal aspirate technique increases the diagnostic yield of respiratory bacterial
etiology. In the Republic of Moldova this technique is not widely used, its implementation as a diagnostic
tool would favour both therapeutic management and would contribute to combating the phenomenon of
antibiotic resistance.
