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Establishment of streptococci in the upper respiratory tract: longitudinal changes in the mouth and nasopharynx up to 2 years of age

E. KÖNÖNEN^*,, H. JOUSIMIES-SOMER^*, A. BRYK^*, T. KILPI and M. KILIAN

*Departments of Microbiology and Vaccines, National Public Health Institute, Helsinki, Finland and Department of Medical Microbiology & Immunology, University of Aarhus, Aarhus, Denmark

Corresponding author: Dr E. Könönen. Present address: Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, PO Box 24923, Safat 13110, Kuwait (e-mail: eija.kononen{at}hsc.kuniv.edu.kw).

Received 15 Oct. 2001; revised version received 23 March 2002; accepted 30 March 2002.

Abstract

As part of a series of longitudinal studies on the development of the indigenous microflora of the upper respiratory tract, the establishment of streptococci in the oral cavity and nasopharynx and IgA1 protease production by the early streptococcal flora was examined in 50 healthy Caucasian infants at the ages of 2, 6, 12, 18 and 24 months. In the oral cavity, streptococci were found in all infants on every sampling occasion, Streptococcus mitis biovar 1 being the main finding in each age group. S. salivarius and S. mitis biovar 2 reached their highest prevalence during the first year of life, whereas the prevalence of S. oralis and S. sanguis showed no significant increase before 12 months of age. Salivary streptococci mainly consisted of the above-mentioned species during the follow-up period. In contrast to the oral cavity, no stable colonisation pattern was observed for viridans streptococci in the nasopharynx. S. mitis biovar 1 and S. pneumoniae, a traditional respiratory pathogen, were the principal streptococcal species among nasopharyngeal isolates. IgA1 protease production by early streptococci was common in infancy. Among the oral streptococcal microflora, S. mitis biovar 1 (especially during the first year of life) and S. oralis and S. sanguis constituted the main species responsible for this enzyme activity. In the nasopharynx, IgA1 protease was produced by S. mitis biovar 1, S. oralis and S. pneumoniae. In conclusion, streptococcal colonisation differs in these two close habitats in the upper respiratory tract.

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