Department of Emergency Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
Department of Medicine, Boston Children's Hospital, Boston, MA, USA.
Allergy. 2017 Nov;72(11):1796-1800. doi: 10.1111/all.13160. Epub 2017 Apr 12.
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 (P =.02) and hospital length-of-stay ≥3 days (P =.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).
新出现的证据表明，气道微生物群在病毒性细支气管炎发病机制中起着重要作用。然而，关于气道微生物群和 CCL5 在细支气管炎婴儿中的联合作用知之甚少。在这项对 2011-2014 年期间因细支气管炎住院的 1005 名婴儿（<1 岁）进行的多中心前瞻性队列研究中，我们观察到鼻咽气道 CCL5 水平和微生物群谱与重症监护使用（P =.02）和住院时间≥3 天（P =.03）风险之间存在统计学显著的相互作用。在 CCL5 水平较低的婴儿中，嗜血杆菌优势的微生物群谱与重症监护使用（比值比，3.20；95%置信区间，1.18-8.68；P=.02）和住院时间≥3 天（比值比，4.14；95%置信区间，2.08-8.24；P<.001）的风险较高相关，与莫拉菌优势的微生物群谱相比。相反，在 CCL5 水平较高的婴儿中，微生物群谱与这些严重程度结局之间没有显著关联（所有 P≥.10）。
