The effect of prone posture on nasal temperature in children in relation to induction of staphylococcal toxins implicated in sudden infant death syndrome

• Published in: FEMS immunology and medical microbiology Vol. 25; no. 1-2; pp. 109 - 113
• Main Authors: Molony, Neil, Blackwell, C. Caroline, Busuttil, Anthony
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.08.1999; Blackwell; Oxford University Press
• Subjects: Ambient temperature; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Body Temperature; Child; Child, Preschool; Children; Controlled conditions; Cot death; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Enterotoxins - biosynthesis; Humans; Infant; Infant, Newborn; Infants; Intensive care medicine; Medical sciences; Nose - physiology; Posture; Prone Position; Prone sleeping position; Respiratory tract; SIDS; Sleep; Staphylococcal toxin; Staphylococcus aureus - metabolism; Sudden Infant Death - etiology; Sudden infant death syndrome; Surface temperature; Temperature requirements; Toxins; Sudden infant death syndrome; Prone sleeping position; Cot death; Staphylococcal toxin; Human; Pathogenesis; Position; Sudden death; Body temperature; Infant; Nasopharynx; Toxin; Sleep; Etiology; Risk factor; Bacteria; Micrococcales; Micrococcaceae; Staphylococcus aureus
• ISSN: 0928-8244; 1574-695X; 2049-632X
• DOI: 10.1111/j.1574-695X.1999.tb01333.x

Abstract The incidence of sudden infant death syndrome (SIDS) has declined in response to campaigns discouraging the prone sleeping position. Recent work suggests some SIDS death may be in response to bacterial toxins produced in the upper airway. A minimal temperature of 37°C is required for induction of the pyrogenic toxins of Staphylococcus aureus identified in many SIDS infants. This aim of this study was to test the hypothesis that the prone position raises the temperature of the upper airways in children. A pilot study of 10 children (aged 3–8) and a main study of 30 children were carried out. Nasal septal temperatures were measured with an infra-red thermometer with the subjects in upright and prone positions under controlled conditions of ambient temperature and humidity. In both the pilot study and main study, nasal temperatures in the prone position were significantly higher (P<0.01) Five subjects' prone readings were 37°C or higher. These findings suggest that lying prone raises the upper airway surface temperature towards that required for toxin production. This could be one means by which the prone sleeping position contributes to the risk of SIDS.