TY - JOUR T1 - Microbial and clinical factors are related to recurrence of symptoms after childhood lower respiratory tract infection JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00939-2020 SP - 00939-2020 AU - Emma M. de Koff AU - Wing Ho Man AU - Marlies A. van Houten AU - Arine M. Vlieger AU - Mei Ling J.N. Chu AU - Elisabeth A.M. Sanders AU - Debby Bogaert Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/early/2021/02/18/23120541.00939-2020.abstract N2 - 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.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.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. ER -