title: The relationship between nasopharyngeal CCL5 and microbiota on disease severity among infants with bronchiolitis.
abstract: Emerging evidence suggests that the airway microbiota plays an important role in viral bronchiolitis pathobiology. However, little is known about the combined role of airway microbiota and CCL5 in infants with bronchiolitis. In this multicenter prospective cohort study of 1005 infants (age <1 year) hospitalized for bronchiolitis during 2011-2014, we observed statistically significant interactions between nasopharyngeal airway CCL5 levels and microbiota profiles with regard to the risk of both intensive care use (Pinteraction=.02) and hospital length-of-stay ≥3 days (Pinteraction=.03). Among infants with lower CCL5 levels, the Haemophilus-dominant microbiota profile was associated with a higher risk of intensive care use (OR, 3.20; 95%CI, 1.18-8.68; P=.02) and hospital length-of-stay ≥3 days (OR, 4.14; 95%CI, 2.08-8.24; P<.001) compared to the Moraxella-dominant profile. Conversely, among those with higher CCL5 levels, there were no significant associations between the microbiota profiles and these severity outcomes (all P≥.10).
authors.affiliation: Department of Emergency Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: K
authors.identifier: http://orcid.org/0000-0002-5739-7999
authors.initials: K
authors.lastname: Hasegawa
authors.affiliation: Department of Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Mansbach
authors.affiliation: Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: N J
authors.initials: NJ
authors.lastname: Ajami
authors.affiliation: Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: J F
authors.initials: JF
authors.lastname: Petrosino
authors.affiliation: Division of Emergency Medicine, Department of Pediatrics, Children's National Health System, Washington, DC, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Freishtat
authors.affiliation: Division of Emergency Medicine, Department of Pediatrics, Children's National Health System, Washington, DC, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Teach
authors.affiliation: Department of Molecular Virology and Microbiology and Pediatrics, Baylor College of Medicine, Houston, TX, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Piedra
authors.affiliation: Department of Emergency Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Camargo
mesh_terms: D001988:Bronchiolitis / Q000209:etiology / Q000473:pathology*; D018946:Chemokine CCL5; D006190:Haemophilus; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D007902:Length of Stay; D064307:Microbiota; D009016:Moraxella; D009305:Nasopharynx / Q000737:chemistry* / Q000382:microbiology
chemical_list: C483024:CCL5 protein, human; D018946:Chemokine CCL5
keywords: CCL5/RANTES; airway; bronchiolitis; microbiota; severity