Postmortem Nasopharyngeal Microbiome Analysis of Zambian Infants With and Without Respiratory Syncytial Virus Disease: A Nested Case Control Study
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Jessica McClintock1, Aubrey R Odom-Mabey2, Nitsueh Kebere2
1From the Division of Infectious Disease, Center for Data Science, Rutgers New Jersey Medical School, Newark, New Jersey.
Insights
The nasopharyngeal microbiome of infants with respiratory syncytial virus (RSV) infection shows distinct differences, with higher Moraxella and lower Gemella and Staphylococcus abundance, potentially linking to RSV mortality.
Area of Science:
- Microbiology
- Pediatrics
- Infectious Diseases
Background:
- Respiratory syncytial virus (RSV) is a leading cause of infant respiratory infections, especially in developing nations.
- Infant nasopharyngeal (NP) microbiome alterations are linked to RSV severity, but studies often exclude developing countries.
- Previous research focused on clinical settings, limiting understanding in diverse populations.
Purpose of the Study:
- To investigate NP microbiome differences in deceased infants with and without RSV in Zambia.
- To explore the association between specific microbial profiles and RSV-associated mortality.
- To expand understanding of the NP microbiome's role in infant RSV outcomes in a developing country context.
Main Methods:
- A nested case-control study using postmortem NP samples from deceased infants.
- Comparison of NP microbiome profiles between RSV+ (n=50) and RSV- (n=50) infants using 16S ribosomal DNA sequencing.
- Infants were part of the Zambia Pertussis and RSV Infant Mortality Estimation (ZPRIME) study, with deaths occurring in the community or shortly after hospital admission.
Main Results:
- The NP microbiome of RSV+ infants showed significantly higher abundance of Moraxella compared to RSV- infants.
- Conversely, Gemella and Staphylococcus were less abundant in the NP microbiome of RSV+ infants.
- These findings indicate specific microbial shifts associated with RSV infection in infants.
Conclusions:
- The observed NP microbiome alterations in RSV+ infants align with previous research.
- Changes in Moraxella, Gemella, and Staphylococcus abundance appear specific to RSV infection.
- These microbial differences may be associated with mortality in infants due to RSV.
Background:
Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and lower respiratory tract infections in children in their first year of life, disproportionately affecting infants in developing countries. Previous studies have found that the nasopharyngeal (NP) microbiome of infants with RSV infection has specific characteristics that correlate with disease severity, including lower biodiversity, perturbations of the microbiota and differences in relative abundance. These studies have focused on infants seen in clinical or hospital settings, predominantly in developed countries.
Methods:
We conducted a nested case control study within a random sample of 50 deceased RSV+ infants with age at death ranging from 4 days to 6 months and 50 matched deceased RSV- infants who were all previously enrolled in the Zambia Pertussis and RSV Infant Mortality Estimation (ZPRIME) study. All infants died within the community or within 48 hours of facility admittance. As part of the ZPRIME study procedures, all decedents underwent one-time, postmortem NP sampling. The current analysis explored the differences between the NP microbiome profiles of RSV+ and RSV- decedents using the 16S ribosomal DNA sequencing.
Results:
We found that Moraxella was more abundant in the NP microbiome of RSV+ decedents than in the RSV- decedents. Additionally, Gemella and Staphylococcus were less abundant in RSV+ decedents than in the RSV- decedents.
Conclusions:
These results support previously reported findings of the association between the NP microbiome and RSV and suggest that changes in the abundance of these microbes are likely specific to RSV and may correlate with mortality associated with the disease.
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