Abstract
Acute viral wheeze in children is a major cause of hospitalisation and a major risk factor for the development of asthma. However, the role of the respiratory tract microbiome in the development of acute wheeze is unclear. To investigate whether severe wheezing episodes in children are associated with bacterial dysbiosis in the respiratory tract, oropharyngeal swabs were collected from 109 children with acute wheezing attending the only tertiary paediatric hospital in Perth, Australia. The bacterial community from these samples was explored using next generation sequencing and compared to samples from 75 non-wheezing controls. No significant difference in bacterial diversity was observed between samples from those with wheeze and healthy controls. Within the wheezing group, attendance at kindergarten or preschool was however, associated with increased bacterial diversity. Rhinovirus (RV) infection did not have a significant effect on bacterial community composition. A significant difference in bacterial richness was observed between children with RV-A and RV-C infection, however this is likely due to the differences in age group between the patient cohorts. The bacterial community within the oropharynx was found to be diverse and heterogeneous. Age and attendance at day care or kindergarten were important factors in driving bacterial diversity. However, wheeze and viral infection were not found to significantly relate to the bacterial community. Bacterial airway microbiome is highly variable in early life and its role in wheeze remains less clear than viral influences.
Highlights
Respiratory infections are a significant cause of morbidity in young children, with over half of hospitalisations in children under 5 years of age being related to respiratory disease [1]
Acute wheeze is the most common reason for children to present to hospital with between 80–90% of these cases being attributed to viral infection [7, 8]
While a number of respiratory viruses have been implicated in wheeze the most common are respiratory syncytial virus (RSV) and rhinovirus (RV)[9]
Summary
Respiratory infections are a significant cause of morbidity in young children, with over half of hospitalisations in children under 5 years of age being related to respiratory disease [1]. In infants aged less than one year RSV infections predominate, but after this RV is viewed as an important risk factor for acute wheeze [10]. The influence of the respiratory tract bacterial community in the context of wheeze is still being established Recent studies in this area have implicated organisms such as Moraxella catarrhalis, Haemophilus influenzae and Staphylococcus aureus in increased rates of wheeze [11, 12]. It has been suggested this may be due to immune modulation by these organisms, in infants resulting in increased risk of asthma development in later life [13]
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