Department of Respiratory Medicine, Children's Hospital, Chongqing Medical University, Chongqing, PR China.
Clin Microbiol Infect. 2010 Sep;16(9):1399-404. doi: 10.1111/j.1469-0691.2009.03147.x.
It is reported that bacterial colonization of the airway in neonates affects the likelihood and severity of subsequent wheezing in childhood. This study aimed to explore the impact of bacterial colonization on the severity of virus-induced wheezing, and accompanying airway inflammation. Nasopharyngeal aspirates (NPAs) from 68 hospitalized children with bronchiolitis and 85 children with recurrent wheezing were obtained. Eleven common respiratory viruses were sought by PCR and/or direct fluorescence assay. Bacteria were isolated from NPAs by routine culture methods. Cell numbers and concentrations of cytokines/chemokines in the NPAs were measured, and nucleated cells were characterized. The frequency of bacterial colonization in children with recurrent wheezing was significantly higher than in children with an initial attack of bronchiolitis. Bacterial colonization accompanying virus infection had no effect on clinical manifestations, duration of hospitalization, concentrations of cytokines/chemokines (except interleukin-10 (IL-10)) or cellularity in the children with bronchiolitis; however, among the children with recurrent wheezing, those who had coexistent non-invasive bacterial colonization and virus infection presented more frequent cyanosis, longer duration of hospitalization, a higher concentration of IL-10 and a higher percentage of neutrophils in NPAs than those with virus infection but without bacterial colonization. Bacterial colonization was common in children with virus-induced wheezing, particularly in the situation of recurrent wheezing. To some extent, bacterial colonization accompanying virus infection may contribute to the severity of the wheezing because of its impact on airway inflammation.
据报道，新生儿气道细菌定植会影响随后儿童期喘息的可能性和严重程度。本研究旨在探讨细菌定植对病毒诱导喘息严重程度以及伴随的气道炎症的影响。收集了 68 例毛细支气管炎住院患儿和 85 例复发性喘息患儿的鼻咽抽吸物（NPA）。通过 PCR 和/或直接荧光检测寻找 11 种常见呼吸道病毒。通过常规培养方法从 NPA 中分离细菌。测量 NPA 中细胞数量和细胞因子/趋化因子的浓度，并对有核细胞进行特征描述。复发性喘息患儿的细菌定植频率明显高于毛细支气管炎初发患儿。病毒感染时伴随的细菌定植对毛细支气管炎患儿的临床表现、住院时间、细胞因子/趋化因子浓度（除白细胞介素-10（IL-10）外）或细胞数无影响；然而，在复发性喘息患儿中，与病毒感染但无细菌定植的患儿相比，合并非侵袭性细菌定植和病毒感染的患儿出现发绀更频繁、住院时间更长、NPA 中 IL-10 浓度更高、中性粒细胞百分比更高。病毒诱导喘息的患儿中细菌定植很常见，尤其是在复发性喘息的情况下。在某种程度上，病毒感染时伴随的细菌定植可能会加重喘息的严重程度，因为它会影响气道炎症。
