The association between anterior nares and nasopharyngeal microbiota in infants hospitalized for bronchiolitis

Luna, Pamela N.; Hasegawa, Kohei; Ajami, Nadim J.; Espinola, Janice A.; Henke, David; Petrosino, Joseph F.; Piedra, Pedro A.; Sullivan, Ashley F.; Camargo, Carlos A.; Shaw, Chad A.; Mansbach, Jonathan M.

doi:10.1186/s40168-017-0385-0

Cited by 59 publications

(73 citation statements)

References 55 publications

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“…Furthermore, compared to healthcare worker‐collected NPS from children during ARI episodes, we have observed similar yields by PCR of H. influenzae , and higher yields of S. pneumoniae and M. catarrhalis , from parent‐collected anterior nasal swabs mailed into the laboratory (Lambert, unpublished RESPECT data; http://clinicaltrials.gov: NCT00966069). In addition, a recent 16S rDNA sequencing study in hospitalized infants with bronchiolitis found good within‐individual correlations between Haemophilus and Moraxella in nasopharyngeal aspirate and mailed nasal swab specimens . Finally, while the oropharynx rather than nasopharynx has been suggested as the optimal sampling site for H. influenzae , this observation may be biased by inadequate differentiation between H. influenzae and H. haemolyticus , the latter being common in the oropharynx …”

Section: Discussionmentioning

confidence: 99%

Nasal swab bacteriology by PCR during the first 24‐months of life: A prospective birth cohort study

Palmu

Ware

Lambert

et al. 2019

Pediatric Pulmonology

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Background Most respiratory bacterial carriage studies in children are based on cross‐sectional samples or longitudinal studies with infrequent sampling points. The prospective Observational Research in Childhood Infectious Diseases birth cohort study intensively evaluated the community‐based epidemiology of respiratory viruses and bacteria during the first 2‐years of life. Here we report the bacteriologic findings. Methods Pregnant women in Brisbane, Australia were recruited between September 2010 and October 2012, and their healthy newborn children were followed for the first 2‐years of life. Parents kept a daily symptom diary for the study child, collected a weekly anterior nose swab and completed an illness burden diary when their child met pre‐defined illness criteria. Specimens were tested for respiratory bacteria by real‐time polymerase chain reaction (PCR) assays and those containing human genomic DNA, deemed as high‐quality, were analyzed. Results Altogether 8100 high‐quality nasal swab specimens from 158 enrolled children were analyzed. Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae were detected in 42.4%, 38.9%, and 14.8% of these samples, respectively. Concomitant detection of bacteria was common. In contrast, Bordetella pertussis, B. parapertussis, Mycoplasma pneumoniae, Chlamydia pneumoniae, and Simkania negevensis were rarely identified. The prevalence of the three major bacteria was higher with increasing age and in the winter and spring months. Siblings and childcare attendance were the other risk factors identified. Conclusions We confirmed the feasibility of frequent nasal swabbing by parents for studying bacterial colonization. PCR detected the major respiratory tract bacteria with expected high frequencies, but atypical bacteria were found rarely in this cohort.

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Section: Discussionmentioning

confidence: 99%

Nasal swab bacteriology by PCR during the first 24‐months of life: A prospective birth cohort study

Palmu

Ware

Lambert

et al. 2019

Pediatric Pulmonology

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“…All site researchers collected nasopharyngeal aspirates (NPAs) within 24 hours of hospitalization by using the same equipment (eg, sample traps and suction catheters from Medline Industries [Mundelein, Ill]) and a standardized protocol, as previously described. 15…”

Section: Nasopharyngeal Aspirate Collectionmentioning

confidence: 99%

“…Within 24 hours of hospitalization, site teams collected an index nasal swab from both anterior nares by using a single nylon pediatric FLOQSwab (Copan, Brescia, Italy). 15 This swab was collected either before the NPA collection or more than 2 hours after the NPA collection. During hospitalization, site teams taught parents how to collect the nasal swab sample.…”

Section: Nasal Swab Collectionmentioning

confidence: 99%

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Increased Moraxella and Streptococcus species abundance after severe bronchiolitis is associated with recurrent wheezing

Mansbach

Luna

Shaw

et al. 2020

Journal of Allergy and Clinical Immunology

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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% highdensity 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,. 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. (J Allergy Clin Immunol 2020;145:518-27.)

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“…Future research could focus on which child with bronchiolitis is likely to relapse and require hospitalization (or re‐hospitalization) and will require greater use of health‐care resources . We only explored biomarkers along the inflammatory and apoptotic pathways in our study, but the anterior nares may also contain microbial risk markers that may prove useful in bronchiolitis . These should be explored in the search for an objective predictive tool in bronchiolitis.…”

Section: Discussionmentioning

confidence: 99%

Nasal high‐mobility group box 1 and caspase in bronchiolitis

Chong

Lai

Castillo

et al. 2018

Pediatric Pulmonology

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Objective Nasal biomarkers have potential to add objectivity to the clinical assessment of the child with bronchiolitis. We aim to study, if nasal caspase and high‐mobility group box 1 protein (HMGB1) levels differ between patients who were hospitalized and those discharged from the emergency department (ED), among patients with bronchiolitis. Methods Using an observational cross‐sectional study design, we recruited patients younger than 24 months presenting to the ED from September 1, 2015 to May 31, 2017 with a diagnosis of acute bronchiolitis. We described the patients’ clinical severity measured by the modified respiratory index score (RIS), and performed standardized collection and analysis of nasal caspase and HMGB1 levels. Results Among 85 patients recruited, the median age was 5.0 months (interquartile range, IQR 3.3‐7.2) and the median modified RIS score was 3 (IQR 2‐4). Hospitalized patients had a 2.4‐fold higher HMGB1 level than patients who were discharged from the ED (2.558 μg/mL [IQR 1.038‐5.125] vs 1.056 μg/mL [IQR 0.409‐2.395], P = 0.0013). There was no difference in median caspase level between hospitalized and discharged patients. The Area Under the Receiver Operating Characteristics curve predicting hospitalization was 0.7021 for HMGB1 compared to 0.5709 for RIS in this bronchiolitis cohort. Conclusions Our study findings show that nasal HMGB1 levels significantly differentiate between young children with bronchiolitis who were hospitalized compared to those fit for discharge. This exploratory study holds potential for future research on nasal HMGB1 for severity stratification in young children with acute bronchiolitis.

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The association between anterior nares and nasopharyngeal microbiota in infants hospitalized for bronchiolitis

Cited by 59 publications

References 55 publications

Nasal swab bacteriology by PCR during the first 24‐months of life: A prospective birth cohort study

Nasal swab bacteriology by PCR during the first 24‐months of life: A prospective birth cohort study

Increased Moraxella and Streptococcus species abundance after severe bronchiolitis is associated with recurrent wheezing

Nasal high‐mobility group box 1 and caspase in bronchiolitis

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