title: Association of nasopharyngeal microbiota profiles with bronchiolitis severity in infants hospitalised for bronchiolitis.
abstract: Little is known about the relationship between the specific airway microbiota composition and severity of bronchiolitis. We aimed to identify nasopharyngeal microbiota profiles and link these profiles to acute severity in infants hospitalised for bronchiolitis.We conducted a multicentre prospective cohort study of 1005 infants (age <1 year) hospitalised for bronchiolitis over three winters, 2011-2014. By applying a 16S rRNA gene sequence and clustering approach to the nasopharyngeal aspirates collected within 24 h of hospitalisation, we determined nasopharyngeal microbiota profiles and their association with bronchiolitis severity. The primary outcome was intensive care use, i.e. admission to an intensive care unit or use of mechanical ventilation.We identified four nasopharyngeal microbiota profiles: three profiles were dominated by one of Haemophilus, Moraxella or Streptococcus, while the fourth profile had the highest bacterial richness. The rate of intensive care use was highest in infants with a Haemophilus-dominant profile and lowest in those with a Moraxella-dominant profile (20.2% versus 12.3%; unadjusted OR 1.81, 95% CI 1.07-3.11, p=0.03). After adjusting for 11 patient-level confounders, the rate remained significantly higher in infants with Haemophilus-dominant profiles (OR 1.98, 95% CI 1.08-3.62, p=0.03). These findings were externally validated in a separate cohort of 307 children hospitalised for bronchiolitis.
authors: Dept of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA khasegawa1@partners.org.
authors: Kohei
authors: 0000-0002-5739-7999
authors: K
authors: Hasegawa
authors: Dept of Medicine, Boston Children's Hospital, Boston, MA, USA.
authors: Jonathan M
authors: JM
authors: Mansbach
authors: Alkek Center for Metagenomics and Microbiome Research, Dept of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
authors: Nadim J
authors: NJ
authors: Ajami
authors: Dept of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors: Janice A
authors: JA
authors: Espinola
authors: Dept of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.
authors: David M
authors: DM
authors: Henke
authors: Alkek Center for Metagenomics and Microbiome Research, Dept of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
authors: Joseph F
authors: JF
authors: Petrosino
authors: Dept of Molecular Virology and Microbiology and Pediatrics, Baylor College of Medicine, Houston, TX, USA.
authors: Pedro A
authors: PA
authors: Piedra
authors: Dept of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.
authors: Chad A
authors: CA
authors: Shaw
authors: Dept of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors: Ashley F
authors: AF
authors: Sullivan
authors: Dept of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors: Carlos A
authors: CA
authors: Camargo
mesh_terms: D001988:Bronchiolitis / Q000382:microbiology*; D003422:Critical Care; D005260:Female; D006190:Haemophilus; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D064307:Microbiota; D009016:Moraxella; D009305:Nasopharynx / Q000382:microbiology*; D016017:Odds Ratio; D018720:Prevotella; D011446:Prospective Studies; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012720:Severity of Illness Index; D013210:Staphylococcus; D013291:Streptococcus; D016896:Treatment Outcome; D014481:United States
chemical_list: D012336:RNA, Ribosomal, 16S