Background

Early life acute respiratory infection (ARI) with respiratory syncytial virus (RSV) has been strongly associated with the development of childhood wheezing illnesses, but the pathways underlying this association are poorly understood.

Objective

To examine the role of the nasopharyngeal microbiome in the development of childhood wheezing illnesses following RSV ARI in infancy.

Methods

We conducted a nested cohort study of 118 previously healthy, term infants with confirmed RSV ARI by RT-PCR. We used next-generation sequencing of the V4 region of the 16S ribosomal RNA gene to characterize the nasopharyngeal microbiome during RSV ARI. Our main outcome of interest was 2-year subsequent wheeze.

Results

Of the 118 infants, 113 (95.8%) had 2-year outcome data. Of these, 46 (40.7%) had parental report of subsequent wheeze. There was no association between the overall taxonomic composition, diversity, and richness of the nasopharyngeal microbiome during RSV ARI with the development of subsequent wheeze. However, the nasopharyngeal detection and abundance of Lactobacillus was consistently higher in infants who did not develop this outcome. Lactobacillus also ranked first among the different genera in a model distinguishing infants with and without subsequent wheeze.

Conclusions

The nasopharyngeal detection and increased abundance of Lactobacillus during RSV ARI in infancy are associated with a reduced risk of childhood wheezing illnesses at age 2 years.

中文翻译：

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婴幼儿急性呼吸道合胞病毒感染后，鼻咽乳杆菌与儿童患喘息性疾病的风险降低相关

背景

早期呼吸道合胞病毒（RSV）引起的急性呼吸道感染（ARI）与儿童喘息性疾病的发展密切相关，但对该关联的潜在途径了解甚少。

客观的

审查鼻咽微生物组在婴儿期RSV ARI后儿童喘息性疾病发展中的作用。

方法

我们通过RT-PCR对118名先前健康，足月婴儿的确诊为RSV ARI的婴儿进行了嵌套队列研究。我们使用了16S核糖体RNA基因V4区域的下一代测序来表征RSV ARI期间的鼻咽微生物组。我们感兴趣的主要结果是2年后的喘息。

结果

在118名婴儿中，有113名（95.8％）具有2年结局数据。其中有46（40.7％）人的父母有其后喘息的报告。RSV ARI期间鼻咽微生物组的总体分类学组成，多样性和丰富性与随后的喘息发作之间没有关联。然而，未出现这种结果的婴儿的鼻咽检测和乳杆菌丰度始终较高。在区分有或没有随后喘鸣的婴儿的模型中，乳酸杆菌在不同属中也排名第一。

结论

在婴儿期进行RSV ARI期间，鼻咽检测和乳杆菌丰度增加与2岁时儿童喘息性疾病的风险降低有关。