Abstract
The nasopharyngeal microbiome is a dynamic microbial interface of the aerodigestive tract, and a diagnostic window in the fight against respiratory infections and antimicrobial resistance. As its constituent bacteria, viruses and mycobacteria become better understood and sampling accuracy improves, diagnostics of the nasopharynx could guide more personalized care of infections of surrounding areas including the lungs, ears and sinuses. This review will summarize the current literature from a clinical perspective and highlight its growing importance in diagnostics and infectious disease management.
Highlights
As a microbiological niche, the nasopharynx (NP) demands an increased understanding of its dynamics, as the last ecological reservoir bordering the relatively microbially scarce lower respiratory tract, sinuses and middle ear [1,2,3,4]
Lower socioeconomic indicators correlate with increased prevalence of M. catarrhalis, S. aureus and antibiotic-resistant S. pneumoniae, and epidemiological factors such as older siblings, daycare attendance and rural occupancy exerted a positive pressure toward pathogen carriage [33, 34]
The NP is an emerging as an arena in the fight against pneumonia and upper respiratory tract infections (RTIs), and a reservoir evolving specific resistance patterns [125]
Summary
The nasopharynx (NP) demands an increased understanding of its dynamics, as the last ecological reservoir bordering the relatively microbially scarce lower respiratory tract, sinuses and middle ear [1,2,3,4]. Infections of these three sites respectively represent the leading cause of childhood and neonatal mortality worldwide [5], the second most commonly antimicrobial-overprescribed [6], and the most common reason to seek medical attention for under-5s in the USA [7]. This review will describe the evolution of the healthy NP microbiome, its relevance to disease of the lower airways, sinuses and middle ear, and propose further areas of investigation and evidence synthesis
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