Microbial and clinical factors are related to recurrence of symptoms after childhood lower respiratory tract infection
- Emma M. de Koff1,2,
- Wing Ho Man1,3,
- Marlies A. van Houten1,4,
- Arine M. Vlieger5,
- Mei Ling J.N. Chu2,
- Elisabeth A.M. Sanders2,6 and
- Debby Bogaert2,7⇑
- 1Spaarne Academy, Spaarne Gasthuis, Hoofddorp and Haarlem, Netherlands
- 2Department of Paediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital and University Medical Centre Utrecht, Utrecht, Netherlands
- 3Department of Paediatrics, Willem-Alexander Children's Hospital and Leiden University Medical Centre, Leiden, Netherlands
- 4Department of Paediatrics, Spaarne Gasthuis, Hoofddorp and Haarlem, Netherlands
- 5Department of Paediatrics, St Antonius Ziekenhuis, Nieuwegein, Netherlands
- 6Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
- 7Medical Research Council and University of Edinburgh Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Prof. Dr. Debby Bogaert, MRC Center for Inflammation Research, University of Ediburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK. E-mail: d.bogaert{at}ed.ac.uk
Abstract
Childhood lower respiratory tract infections (LRTI) are associated with dysbiosis of the nasopharyngeal microbiota, and persistent dysbiosis following the LRTI may in turn be related to recurrent or chronic respiratory problems.
Therefore, we aimed to investigate microbial and clinical predictors of early recurrence of respiratory symptoms as well as recovery of the microbial community following hospital admission for LRTI in children.
To this end, we collected clinical data and characterised the nasopharyngeal microbiota of 154 children (4 weeks–5 years old) hospitalised for a LRTI (bronchiolitis, pneumonia, wheezing illness, or mixed infection) at admission and 4–8 weeks later. Data were compared to 307 age-, gender- and time-matched healthy controls.
During follow-up, 66% of cases experienced recurrence of (mild) respiratory symptoms. In cases with recurrence of symptoms during follow-up, we found distinct nasopharyngeal microbiota at hospital admission, with higher levels of Haemophilus influenzae/haemolyticus, Prevotella oris and other gram-negatives and lower levels of Corynebacterium pseudodiphtheriticum/propinquum and Dolosigranulum pigrum compared to healthy controls. Furthermore, in cases with recurrence of respiratory symptoms, recovery of the microbiota was also diminished. Especially in cases with wheezing illness we observed a high rate of recurrence of respiratory symptoms, as well as diminished microbiota recovery at follow-up.
Together, our results suggest a link between the nasopharyngeal microbiota composition during LRTI and early recurrence of respiratory symptoms, as well as diminished microbiota recovery after 4–8 weeks. Future studies should investigate whether (speed of) ecological recovery following childhood LRTI is associated with long-term respiratory problems.
Footnotes
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Conflict of Interest: Drs. de Koff has nothing to disclose.
Conflict of Interest: Dr. Man has nothing to disclose.
Conflict of Interest: Dr. van Houten has nothing to disclose.
Conflict of Interest: Dr. Vlieger has nothing to disclose.
Conflict of Interest: Mrs. Chu has nothing to disclose.
Conflict of Interest: Dr. Sanders has nothing to disclose.
Conflict of Interest: Dr. Bogaert has nothing to disclose.
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- Received December 15, 2020.
- Accepted February 17, 2021.
- Copyright ©The authors 2021
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