Increased Moraxella and Streptococcus species abundance after severe bronchiolitis is associated with recurrent wheezing - 05/02/20
, Pamela N. Luna, PhD b, Chad A. Shaw, PhD b, c, Kohei Hasegawa, MD, MPH d, Joseph F. Petrosino, PhD e, Pedro A. Piedra, MD f, g, Ashley F. Sullivan, MS, MPH d, Janice A. Espinola, MPH d, Christopher J. Stewart, PhD e, h, Carlos A. Camargo, MD, DrPH dAbstract |
Background |
The role of the airway microbiome in the development of recurrent wheezing and asthma remains uncertain, particularly in the high-risk group of infants hospitalized for bronchiolitis.
Objective |
We sought to examine the relation of the nasal microbiota at bronchiolitis-related hospitalization and 3 later points to the risk of recurrent wheezing by age 3 years.
Methods |
In 17 US centers researchers collected clinical data and nasal swabs from infants hospitalized for bronchiolitis. Trained parents collected nasal swabs 3 weeks after hospitalization and, when healthy, during the summer and 1 year after hospitalization. We applied 16S rRNA gene sequencing to all nasal swabs. We used joint modeling to examine the relation of longitudinal nasal microbiota abundances to the risk of recurrent wheezing.
Results |
Among 842 infants hospitalized for bronchiolitis, there was 88% follow-up at 3 years, and 31% had recurrent wheezing. The median age at enrollment was 3.2 months (interquartile range, 1.7-5.8 months). In joint modeling analyses adjusting for 16 covariates, including viral cause, a 10% increase in relative abundance of Moraxella or Streptococcus species 3 weeks after day 1 of hospitalization was associated with an increased risk of recurrent wheezing (hazard ratio [HR] of 1.38 and 95% high-density interval [HDI] of 1.11-1.85 and HR of 1.76 and 95% HDI of 1.13-3.19, respectively). Increased Streptococcus species abundance the summer after hospitalization was also associated with a greater risk of recurrent wheezing (HR, 1.76; 95% HDI, 1.15-3.27).
Conclusions |
Enrichment of Moraxella or Streptococcus species after bronchiolitis hospitalization was associated with recurrent wheezing by age 3 years, possibly providing new avenues to ameliorate the long-term respiratory outcomes of infants with severe bronchiolitis.
Le texte complet de cet article est disponible en PDF.Key words : Bronchiolitis, recurrent wheezing, Moraxella species, Streptococcus species, Haemophilus species, respiratory syncytial virus, rhinovirus, longitudinal studies, microbiome
Abbreviations used : HDI, HR, MARC-35, NPA, RSV
Plan
| This work was supported by grants U01 AI-087881, R01 AI-114552, R01 AI-108588, R01 AI-137091, and R01 AI-134940 from the National Institute of Allergy and Infectious Diseases and UG3/UH3 OD-023253 from the Office of the Director at the National Institutes of Health (Bethesda, Md). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. |
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| Disclosure of potential conflict of interest: J. F. Petrosino owns shares at Diversigen, a microbiome research company. P. A. Piedra provided bronchiolitis-related consultation for Gilead, Novavax, Ablynx, and Regeneron and received grant support from Novavax, Gilead, Regeneron, Janssen, and Ablynx. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 145 - N° 2
P. 518 - février 2020 Retour au numéro
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