Nasal Airway Microbiota Profile and Severe Bronchiolitis in Infants A Case-control Study

• Type of Material: Article
• Authors: Kohei Hasegawa, Harvard Medical School; Rachel Linnemann, Emory University; Jonathan M. Mansbach, Boston Childrens Hospital; Nadim J. Ajami, Baylor College of Medicine; Janice A. Espinola, Harvard Medical School; Joseph F. Petrosino, Baylor College of Medicine; Pedro A. Piedra, Baylor College of Medicine; Michelle D. Stevenson, University of Louisville; Ashley F. Sullivan, Harvard Medical School; Amy D. Thompson, Alfred I. duPont Hospital for Children; Carlos A. Camargo, Harvard Medical School
• Language: English
• Date: 2017-11-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Copyright © 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
• Final Published Version (URL): http://dx.doi.org/10.1097/INF.0000000000001500
• Title of Journal or Parent Work: Pediatric Infectious Disease Journal
• ISSN: 0891-3668
• Volume: 36
• Issue: 11
• Start Page: 1044
• End Page: 1051
• Grant/Funding Information: This study was supported by the grants U01 AI-087881, R01 AI-114552, R01 AI-108588, and R21 HL-129909 from the National Institutes of Health (Bethesda, MD).; The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
• Keywords: ASTHMA; Corynebacterium; microbiota; hospitalization; Life Sciences & Biomedicine; Infectious Diseases; RHINOVIRUS INFECTION; Dolosigranulum; SYMPTOMS; bronchiolitis; COLONIZATION; Science & Technology; RESPIRATORY SYNCYTIAL VIRUS; NASOPHARYNGEAL MICROBIOTA; cluster; airway; Staphylococcus; Moraxella; DISEASE; PATHOGENIC BACTERIA; Immunology; CHILDREN; respiratory infection; INFLAMMATION; Pediatrics
• Research Categories: Biology, Virology; Biology, Microbiology

Abstract

Background: Little is known about the relationship of airway microbiota with bronchiolitis in infants. We aimed to identify nasal airway microbiota profiles and to determine their association with the likelihood of bronchiolitis in infants. Methods: A case-control study was conducted. As a part of a multicenter prospective study, we collected nasal airway samples from 40 infants hospitalized with bronchiolitis. We concurrently enrolled 110 age-matched healthy controls. By applying 16S ribosomal RNA gene sequencing and an unbiased clustering approach to these 150 nasal samples, we identified microbiota profiles and determined the association of microbiota profiles with likelihood of bronchiolitis. Results: Overall, the median age was 3 months and 56% were male. Unbiased clustering of airway microbiota identified 4 distinct profiles: Moraxella-dominant profile (37%), Corynebacterium/Dolosigranulum-dominant profile (27%), Staphylococcus-dominant profile (15%) and mixed profile (20%). Proportion of bronchiolitis was lowest in infants with Moraxella-dominant profile (14%) and highest in those with Staphylococcus-dominant profile (57%), corresponding to an odds ratio of 7.80 (95% confidence interval, 2.64-24.9; P < 0.001). In the multivariable model, the association between Staphylococcus-dominant profile and greater likelihood of bronchiolitis persisted (odds ratio for comparison with Moraxella-dominant profile, 5.16; 95% confidence interval, 1.26-22.9; P = 0.03). By contrast, Corynebacterium/Dolosigranulum-dominant profile group had low proportion of infants with bronchiolitis (17%); the likelihood of bronchiolitis in this group did not significantly differ from those with Moraxella-dominant profile in both unadjusted and adjusted analyses. Conclusions: In this case-control study, we identified 4 distinct nasal airway microbiota profiles in infants. Moraxella-dominant and Corynebacterium/Dolosigranulum-dominant profiles were associated with low likelihood of bronchiolitis, while Staphylococcus-dominant profile was associated with high likelihood of bronchiolitis.