Nasopharyngeal bacterial colonization during the first wheezing episode is associated with longer duration of hospitalization and higher risk of relapse in young children

Jartti, Tuomas; Kuneinen, Susanna; Lehtinen, Pasi; Peltola, Ville; Vuorinen, Tytti; Leinonen, Maija; Ruuskanen, Olli

doi:10.1007/s10096-010-1075-z

Cited by 22 publications

(26 citation statements)

References 42 publications

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“…Lower airway colonization with these organisms was also associated with higher blood eosinophil counts and total IgE levels, but not specific IgE levels, at 4 years and with bronchodilator reversibility and development of asthma at 5 years. In a study of children under 3 years hospitalized for viral-induced wheezing, 60% demonstrated nasopharyngeal (NP) colonization with Streptococcus pneumoniae , Moraxella catarrhalis , or Haemophilus influenzae , and this was associated with increased risk of recurrent wheezing episodes during the following year 14 . Importantly, antibiotic use may select for these organisms 12 .…”

Section: Microbial Exposurementioning

confidence: 99%

Environmental determinants of allergy and asthma in early life

Burbank¹,

Sood²,

Kesic

et al. 2017

Journal of Allergy and Clinical Immunology

252

177

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Allergic disease prevalence has significantly increased in recent decades. Primary prevention efforts are being guided by the study of the exposome, or collective environmental exposures beginning during the prenatal period, to identify modifiable factors that impact allergic disease risk. In this review, we explore the evidence supporting a relationship between key components of the external exposome in the prenatal and early-life periods and their impact on atopy development, focused on microbial, allergen, and air pollution exposures. The abundance and diversity of microbial exposures during the first months and years of life have been linked with risk of allergic sensitization and disease. Indoor environmental allergen exposure during early life may also impact disease development, depending on the allergen type, dose, and timing of exposure. Recent evidence supports the role of ambient air pollution in allergic disease inception. The lack of clarity in the literature surrounding the relationship between environment and atopy reflects the complex interplay between cumulative environmental factors and genetic susceptibility, such that no one factor dictates disease development in all individuals. Understanding the impact of the summation of environmental exposures throughout a child's development is needed to identify cost-effective interventions that reduce atopy risk in children.

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Section: Microbial Exposurementioning

confidence: 99%

Environmental determinants of allergy and asthma in early life

Burbank¹,

Sood²,

Kesic

et al. 2017

Journal of Allergy and Clinical Immunology

252

177

View full text Add to dashboard Cite

show abstract

“…A post-hoc analysis in a cohort of children younger than 3 years of age hospitalized for their first viral induced wheezing episode (viral swab positive in 93% of participants) showed that 60% of these children had positive NP culture for Streptococcus pneumoniae, Haemophilus influenzae , or Moraxella catarrhalis . In addition, children with bacterial colonization of the upper airway had longer durations of hospitalization and were more likely to develop recurrent wheezing in the year following the initial wheezing compared to children without evidence for bacterial colonization 33 .…”

Section: Airway Bacterial Colonization and Exacerbation Of Early Chilmentioning

confidence: 99%

The relationships between environmental bacterial exposure, airway bacterial colonization, and asthma

Beigelman

Weinstock

Bacharier

2014

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of this review Recent application of advanced culture-independent molecular techniques for identification of microorganisms has contributed to our knowledge on the role of early life microbial exposure and colonization in health and disease. The purpose of this review is to present the current perspectives regarding the role of microbial exposure and airway bacterial colonization on the development and the activity of asthma. Recent findings Recent findings continue to support the protective role of early life diverse microbial exposure against the development of atopic disease. However, airway bacterial colonization early in life serves as a risk factor for the development of asthma. Culture-independent molecular techniques for identification of microorganisms have challenged the traditional paradigm that the lower airway is a sterile compartment. Asthmatics, compared to non-asthmatics appear to have a different lung microbiome composition and some of these differences might contribute to asthma activity, severity, and corticosteroid response. Summary Bacterial presence in the airway appears to influence the inception and may affect the activity of asthma. Complex interactions between different types and routes of bacterial exposures, the airway and the immune system early in life may determine whether these exposures augment or reduce the risk of asthma development.

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“…In addition, we were not able to demonstrate any synergy between viral infections and PNC colonization, or, more specifically, between RSV infection and PNC colonization, in relation to later outcome. In a previous Finnish study, nasopharyngeal bacterial colonization, documented on positive cultures for S. pneumoniae , H. influenzae and M. catarrhalis , during the first wheezing episode in children younger than 3 years of age was associated with a longer duration of hospitalization and higher risk of relapses of wheezing within 2 months after hospitalization . In addition, a recent study demonstrated the capability of S. pneumoniae to contribute to the severity of respiratory tract illnesses during rhinovirus infection, including asthma exacerbations .…”

Section: Discussionmentioning

confidence: 77%

“…Previous studies on PNC colonization during wheezing in children have suggested that S. pneumoniae may not be an innocent bystander during the respiratory infection . The aim of the present study was therefore to evaluate whether PNC colonization during the first wheezing episode in early childhood is a determinant of subsequent wheezing or later asthma, atopy and lung function in childhood, adolescence or adulthood.…”

mentioning

confidence: 93%

“…In addition, wheezing children with respiratory bacteria colonization at the time of the wheezing episode have a prolonged hospitalization time, increased prevalence of recurrent wheezing within 2 months after discharge, and the greatest burden of illness symptoms . Pneumococcal (PNC) colonization, however, was not associated with increased risk of wheezing 1 year after the initial wheezing episode in a previous Finnish study …”

mentioning

confidence: 99%

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