Abstract
BackgroundCompetitive interactions among bacteria in the respiratory tract microbiota influence which species can colonize and potentially contribute to pathogenesis of community-acquired pneumonia (CAP). However, understanding of the role of respiratory tract microbiota in the clinical course of pediatric CAP is limited.MethodsWe sought to compare microbiota profiles in induced sputum and nasopharyngeal/oropharyngeal (NP/OP) samples from children and to identify microbiota profiles associated with CAP severity. We used 16S ribosomal RNA sequencing and several measures of microbiota profiles, including principal component analysis (PCA), to describe the respiratory microbiota in 383 children, 6 months to <18 years, hospitalized with CAP. We examined associations between induced sputum and NP/OP microbiota profiles and CAP severity (hospital length of stay and intensive care unit admission) using logistic regression.ResultsRelative abundance of bacterial taxa differed in induced sputum and NP/OP samples. In children 6 months to < 5 years, the sputum PCA factor with high relative abundance of Actinomyces, Veillonella, Rothia, and Lactobacillales was associated with decreased odds of length of stay ≥ 4 days [adjusted odds ratio (aOR) 0.69; 95 % confidence interval (CI) 0.48–0.99]. The sputum factor with high relative abundance of Haemophilus and Pasteurellaceae was associated with increased odds of intensive care unit admission [aOR 1.52; 95 % CI 1.02–2.26]. In children 5 to < 18 years, the sputum factor with high relative abundance of Porphyromonadaceae, Bacteriodales, Lactobacillales, and Prevotella was associated with increased odds of length of stay ≥ 4 days [aOR 1.52; 95 % CI 1.02–2.26]. Taxa in NP/OP samples were not associated with CAP severity.ConclusionCertain taxa in the respiratory microbiota, which were detected in induced sputum samples, are associated with the clinical course of CAP.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1670-4) contains supplementary material, which is available to authorized users.
Highlights
Competitive interactions among bacteria in the respiratory tract microbiota influence which species can colonize and potentially contribute to pathogenesis of community-acquired pneumonia (CAP)
We sought to 1) use 16S ribosomal RNA microbial profiling to determine whether microbiota profiles differ between induced sputum and NP/OP samples from children hospitalized with CAP, and 2) identify microbiota profiles associated with CAP severity as measured by length of hospital stay (LOS) and intensive care unit (ICU) admission
A history of asthma/reactive airway disease and ICU admission were more frequent in children 5 to < 18 years compared to children 6 months to < 5 years of age
Summary
Competitive interactions among bacteria in the respiratory tract microbiota influence which species can colonize and potentially contribute to pathogenesis of community-acquired pneumonia (CAP). Respiratory virus infection may lead to the overgrowth of select bacteria in the upper respiratory tract microbiota, facilitate transition of bacteria into the lower airways, or promote enhanced replication of bacteria already present in the lower airways [1, 15,16,17,18].
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