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Increased Moraxella and Streptococcus species abundance after severe bronchiolitis is associated with recurrent
Jonathan M Mansbach1, Pamela N Luna2, Chad A Shaw3
1Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
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.
Insights
The airway microbiome, specifically Moraxella and Streptococcus species, after bronchiolitis hospitalization in infants is linked to recurrent wheezing. This finding may help improve long-term respiratory health outcomes.
Area of Science:
- Microbiology
- Pediatric Pulmonology
- Respiratory Health
Background:
- The role of the airway microbiome in infant respiratory illnesses like asthma is not fully understood.
- Infants hospitalized for bronchiolitis are at high risk for developing recurrent wheezing and asthma.
Purpose of the Study:
- To investigate the association between nasal microbiota composition during and after bronchiolitis hospitalization and the risk of recurrent wheezing by age 3.
- To identify specific microbial patterns that may predict long-term respiratory outcomes in high-risk infants.
Main Methods:
- 16S rRNA gene sequencing was used to analyze nasal swabs from 842 infants hospitalized for bronchiolitis.
- Nasal swabs were collected at hospitalization, 3 weeks post-hospitalization, during summer, and 1 year after hospitalization.
- Joint modeling was employed to assess the relationship between longitudinal nasal microbiota and recurrent wheezing risk, adjusting for 16 covariates.
Main Results:
- 31% of infants experienced recurrent wheezing by age 3.
- Increased abundance of Moraxella or Streptococcus species 3 weeks post-hospitalization was associated with a higher risk of recurrent wheezing (HR 1.38-1.76).
- Elevated Streptococcus species abundance in the summer post-hospitalization also correlated with increased recurrent wheezing risk (HR 1.76).
Conclusions:
- Enrichment of Moraxella or Streptococcus species following bronchiolitis hospitalization is linked to recurrent wheezing in early childhood.
- These findings suggest potential microbial targets for interventions to improve respiratory outcomes in infants with severe bronchiolitis.
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