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Itzhak Brook, MD, MSc; Alan E. Gober, MD

Arch Otolaryngol Head Neck Surg. 2005;131:509-512.

Objective  To study the frequency of isolation of potential pathogens and interfering bacteria in the posterior nasopharynx of otitis media–prone (OMP) children and their smoking and nonsmoking parents to possibly explain why active and passive exposure to smoking is associated with carriage of potentially pathogenic bacteria and an increased risk of respiratory tract infection in both adults and children.

Setting  Outpatient clinic.

Participants  Twenty OMP children and their smoking parents (smoking group) and 20 OMP children and their nonsmoking parents (nonsmoking group).

Interventions  Posterior nasopharynx cultures were taken from 20 OMP children and their smoking parents and 20 OMP children and their nonsmoking parents.

Main Outcome Measure  Potential pathogens and aerobic and anaerobic bacteria with interfering capabilities against these organisms were identified.

Results  Fourteen potential pathogens were isolated from smoking parents, and 17 were recovered from their children. Concordance in isolation of a pathogen between a parent and child was noted in 11 instances. Three potential pathogens were isolated from nonsmoking parents (P<.001 compared with the parents and children in the smoking group and children in the nonsmoking group), and 16 were recovered from their children. Bacterial interference by normal flora isolates against potential pathogens was noted in 58 instances in smoking parents and in 55 instances in their children (P<.05). Bacterial interference was noted in 129 instances in nonsmoking parents (P<.05 compared with the parents and children in the smoking group and children in the nonsmoking group) and in 55 instances in their children.

Conclusions  A high recovery rate of potential pathogens and a low number of interfering organisms were observed in OMP children. This was not related to their parents’ smoking habits. The posterior nasopharynx flora of smoking parents contained more potential pathogens similar to the ones recovered from OMP children and fewer interfering organisms than nonsmoking parents.

Author Affiliations: Department of Pediatrics, Georgetown University School of Medicine, Washington, DC.