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Nasopharyngeal isolates and their clinical impact on young children with asthma: a pilot study
Ahmed R Alsuwaidi1, Alia M Alkalbani2, Afaf Alblooshi1
1Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates, alsuwaidia@uaeu.ac.ae.
Insights
Respiratory infections in children with asthma are linked to pathogens like rhinovirus. Identifying these microbes can help manage symptoms and reduce airway resistance, especially during winter.
Area of Science:
- Pediatric Respiratory Medicine
- Infectious Diseases
- Asthma Research
Background:
- Respiratory infections significantly impact childhood asthma development and exacerbation.
- Viral pathogens, including rhinovirus and respiratory syncytial virus, are implicated in asthma.
- Understanding nasopharyngeal colonization is crucial for managing pediatric respiratory illnesses.
Purpose of the Study:
- To determine the prevalence of respiratory pathogens in children with asthma.
- To investigate the contribution of these pathogens to respiratory symptoms and airway resistance.
- To analyze pathogen colonization during the winter season in asthmatic children.
Main Methods:
- Nasopharyngeal specimens collected from asthmatic children and controls (December 2016-March 2017).
- Multiplex real-time PCR used to test for 19 viruses and 7 bacteria.
- Assessed respiratory symptoms and airway resistance using validated questionnaires and forced-oscillation technique.
Main Results:
- Common isolates in both groups included Streptococcus pneumoniae, Haemophilus influenzae, and rhinovirus.
- Asthmatic patients frequently had multiple pathogen isolates, with variations during the study.
- Mild common cold symptoms correlated with significantly higher airway resistance (5 Hz z-score, P=0.025).
Conclusions:
- Multiple respiratory pathogens are frequently isolated from children with asthma.
- These pathogens appear to contribute to asthma symptoms and increased airway resistance.
- Reducing exposure to respiratory pathogens may benefit children with asthma, particularly in winter.
Introduction:
Respiratory infections have significant effects on childhood asthma. Viral respiratory infections, such as rhinovirus and respiratory syncytial virus are likely to be important in the development and exacerbation of asthma. In this study, we investigated the nasopharyngeal colonization in children with asthma to determine the prevalence of pathogens and their contribution to respiratory symptoms and airway resistance during winter.
Methods:
From December 2016 to March 2017, 50 nasopharyngeal specimens were collected from 18 patients (age, 5.0±1.1 years) with asthma and 9 specimens from 9 control children (age, 4.9±1.0 years). Samples were tested for 19 viruses and 7 bacteria, using multiplex real-time PCR. Respiratory disease markers included the Global Asthma Network Questionnaire, the Common-Cold Questionnaire, the Global Initiative for Asthma assessment of asthma control, and the airway resistance at 5 Hz by forced-oscillation technique.
Results:
The most commonly isolated organisms in both groups (patients and controls) were Streptococcus pneumoniae, Haemophilus influenzae, and rhinovirus. Most patients had multiple isolates (median, 3.5; range, 1-5), which changed during the study period. Types of isolates were 4 bacteria (S. pneumoniae, H. influenzae, Bordetella pertussis, and Bordetella parapertussis) and 6 viruses (rhinovirus, enterovirus, metapneumovirus, adenovirus, coronaviruses, and parainfluenza viruses). Similar isolates, including influenza A-H3 virus and bocavirus, were detected in the controls. Of the 9 patients with "wheezing disturbing sleep ≥1 per week", 6 had rhinovirus, 2 coronaviruses, and 1 no detectable viruses. Patients with mild common cold symptoms had significantly higher airway resistance at 5 Hz z-score (P=0.025).
Conclusion:
Multiple respiratory pathogens were isolated from many patients with asthma, which appeared to contribute to disease symptoms and airway resistance. Minimizing children's exposure to respiratory pathogens might be beneficial, especially during winter.
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