The nasopharyngeal bacterial flora in the sudden infant death syndrome.

The nasopharyngeal bacterial flora in babies who had died of the sudden infant death syndrome (SIDS) (n = 46) and in healthy infants aged 2 weeks to 6 months (n = 46) is described. Of those who had died, 41.3% carried Staphylococcus aureus (95% confidence limits: 27.3-55.3%) compared with 28.3% of healthy infants (95% confidence limits: 15.3-41.3%). The isolation rate of streptococci was 78.3% in cases (95% confidence limits: 66.4-90.2%) and 32.6% in healthy infants (95% confidence limits: 19.1-46.1%) (significant difference P less than 0.0001). Enterobacteria were isolated from 45.6% of cases (95% confidence limits: 31.2-60%) but only 2.2% of healthy infants (95% confidence limits 0-6.4%) (significant difference, P less than 0.0001). These results indicate a disordered nasopharyngeal flora in SIDS. They also provide baseline data for investigating the hypothesis that common bacterial toxins are involved in the pathogenesis of SIDS.