Association of bacteria and viruses with wheezy episodes in young children: prospective birth cohort study

Hans Bisgaard, Mette Northman Hermansen, Klaus Bønnelykke, Jakob Stokholm, Florent Baty, Nanna Lassen Skytt, Julia Aniscenko, Tatiana Kebadze, Sebastian L Johnston, Hans Bisgaard, Mette Northman Hermansen, Klaus Bønnelykke, Jakob Stokholm, Florent Baty, Nanna Lassen Skytt, Julia Aniscenko, Tatiana Kebadze, Sebastian L Johnston

Abstract

Objective: To study the association between wheezy symptoms in young children and the presence of bacteria in the airways.

Design: Birth cohort study.

Setting: Clinical research unit in Copenhagen.

Participants: Children of asthmatic mothers, from age 4 weeks to 3 years, with planned visits and acute admissions to the research clinic.

Main outcome measure: Frequency of bacteria and virus carriage in airway aspirates during wheezy episodes and at planned visits without respiratory symptoms.

Results: 984 samples (361 children) were analysed for bacteria, 844 (299 children) for viruses, and 696 (277 children) for both viruses and bacteria. Wheezy episodes were associated with both bacterial infection (odds ratio 2.9, 95% confidence interval 1.9 to 4.3; P<0.001) and virus infection (2.8, 1.7 to 4.4; P<0.001). The associations of bacteria and viruses were independent of each other.

Conclusion: Acute wheezy episodes in young children were significantly associated with bacterial infections similar to but independent of the association with virus infections.

Conflict of interest statement

All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any company for the submitted work; no financial relationships with any companies that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4787945/bin/bish757864.f1_default.jpg
Association of viruses and bacteria with wheezy episodes in young children

References

    1. Kocevar VS, Bisgaard H, Jonsson L, Valovirta E, Kristensen F, Yin DD, et al. Variations in pediatric asthma hospitalization rates and costs between and within Nordic countries. Chest 2004;125:1680-4.
    1. Bush A. Practice imperfect—treatment for wheezing in preschoolers. N Engl J Med 2009;360:409-10.
    1. Kusel MM, de Klerk NH, Holt PG, Kebadze T, Johnston SL, Sly PD. Role of respiratory viruses in acute upper and lower respiratory tract illness in the first year of life: a birth cohort study. Pediatr Infect Dis J 2006;25:680-6.
    1. Lemanske RF Jr, Jackson DJ, Gangnon RE, Evans MD, Li Z, Shult PA, et al. Rhinovirus illnesses during infancy predict subsequent childhood wheezing. J Allergy Clin Immunol 2005;116:571-7.
    1. Johnston SL, Pattemore PK, Sanderson G, Smith S, Lampe F, Josephs L, et al. Community study of role of viral infections in exacerbations of asthma in 9-11 year old children. BMJ 1995;310:1225-9.
    1. Global Strategy for Asthma Management and Prevention. No 02-3659. 2005. NIH publication.
    1. Oommen A, Lambert PC, Grigg J. Efficacy of a short course of parent-initiated oral prednisolone for viral wheeze in children aged 1-5 years: randomised controlled trial. Lancet 2003;362:1433-8.
    1. Ducharme FM, Lemire C, Noya FJ, Davis GM, Alos N, Leblond H, et al. Preemptive use of high-dose fluticasone for virus-induced wheezing in young children. N Engl J Med 2009;360:339-53.
    1. Panickar J, Lakhanpaul M, Lambert PC, Kenia P, Stephenson T, Smyth A, et al. Oral prednisolone for preschool children with acute virus-induced wheezing. N Engl J Med 2009;360:329-38.
    1. Bisgaard H, Szefler S. Prevalence of asthma-like symptoms in young children. Pediatr Pulmonol 2007;42:723-8.
    1. Bisgaard H. The Copenhagen Prospective Study on Asthma in Childhood (COPSAC): design, rationale, and baseline data from a longitudinal birth cohort study. Ann Allergy Asthma Immunol 2004;93:381-9.
    1. Bisgaard H, Hermansen MN, Loland L, Halkjaer LB, Buchvald F. Intermittent inhaled corticosteroids in infants with episodic wheezing. N Engl J Med 2006;354:1998-2005.
    1. Bisgaard H, Hermansen MN, Buchvald F, Loland L, Halkjaer LB, Bonnelykke K, et al. Childhood asthma after bacterial colonization of the airway in neonates. N Engl J Med 2007;357:1487-95.
    1. Murray PR. Manual of clinical microbiology. 8th ed. ASM Press; 2003.
    1. Lund B, Edlund C, Rynnel-Dagoo B, Lundgren Y, Sterner J, Nord CE. Ecological effects on the oro- and nasopharyngeal microflora in children after treatment of acute otitis media with cefuroxime axetil or amoxycillin-clavulanate as suspensions. Clin Microbiol Infect 2001;7:230-7.
    1. Kusel MM, de Klerk NH, Kebadze T, Vohma V, Holt PG, Johnston SL, et al. Early-life respiratory viral infections, atopic sensitization, and risk of subsequent development of persistent asthma. J Allergy Clin Immunol 2007;119:1105-10.
    1. Aniansson G, Alm B, Andersson B, Larsson P, Nylen O, Peterson H, et al. Nasopharyngeal colonization during the first year of life. J Infect Dis 1992;165 (suppl 1):S38-42.
    1. Watson K, Carville K, Bowman J, Jacoby P, Riley TV, Leach AJ, et al. Upper respiratory tract bacterial carriage in Aboriginal and non-Aboriginal children in a semi-arid area of Western Australia. Pediatr Infect Dis J 2006;25:782-90.
    1. Harrison LM, Morris JA, Telford DR, Brown SM, Jones K. The nasopharyngeal bacterial flora in infancy: effects of age, gender, season, viral upper respiratory tract infection and sleeping position. FEMS Immunol Med Microbiol 1999;25:19-28.
    1. Peacock SJ, Justice A, Griffiths D, de Silva GD, Kantzanou MN, Crook D, et al. Determinants of acquisition and carriage of Staphylococcus aureus in infancy. J Clin Microbiol 2003;41:5718-25.
    1. Bisgaard H, Simpson A, Palmer CN, Bonnelykke K, McLean I, Mukhopadhyay S, et al. Gene-environment interaction in the onset of eczema in infancy: filaggrin loss-of-function mutations enhanced by neonatal cat exposure. PLoS Med 2008;5:e131.
    1. Andersen ZJ, Loft S, Ketzel M, Stage M, Scheike T, Mette MN, et al. Ambient air pollution triggers wheezing aymptoms in infants. Thorax 2008;63:710-6.
    1. Johnston SL, Blasi F, Black PN, Martin RJ, Farrell DJ, Nieman RB. The effect of telithromycin in acute exacerbations of asthma. N Engl J Med 2006;354:1589-600.
    1. Tahan F, Ozcan A, Koc N. Clarithromycin in the treatment of RSV bronchiolitis: a double-blind, randomised, placebo-controlled trial. Eur Respir J 2007;29:91-7.
    1. Fonseca-Aten M, Okada PJ, Bowlware KL, Chavez-Bueno S, Mejias A, Rios AM, et al. Effect of clarithromycin on cytokines and chemokines in children with an acute exacerbation of recurrent wheezing: a double-blind, randomized, placebo-controlled trial. Ann Allergy Asthma Immunol 2006;97:457-63.
    1. Hahn DL, Plane MB, Mahdi OS, Byrne GI. Secondary outcomes of a pilot randomized trial of azithromycin treatment for asthma. PLoS Clin Trials 2006;1:e11.
    1. Johnston SL. Macrolide antibiotics and asthma treatment. J Allergy Clin Immunol 2006;117:1233-6.
    1. Talbot TR, Hartert TV, Mitchel E, Halasa NB, Arbogast PG, Poehling KA, et al. Asthma as a risk factor for invasive pneumococcal disease. N Engl J Med 2005;352:2082-90.
    1. Contoli M, Message SD, Laza-Stanca V, Edwards MR, Wark PA, Bartlett NW, et al. Role of deficient type III interferon-lambda production in asthma exacerbations. Nat Med 2006;12:1023-6.

Source: PubMed

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