Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland.
Thorax. 2019 Jun;74(6):592-599. doi: 10.1136/thoraxjnl-2018-212629. Epub 2019 May 10.
Emerging evidence shows that airway microbiota may modulate local immune responses, thereby contributing to the susceptibility and severity of acute respiratory infections (ARIs). However, there are little data on the longitudinal relationships between airway microbiota and susceptibility to ARIs in children.
We aimed to investigate the association of early nasal microbiota and the subsequent risk of ARIs during the first years of life.
In this prospective population-based birth-cohort study in Finland, we followed 839 healthy infants for ARIs from birth to age 24 months. Nasal microbiota was tested using 16S rRNA gene sequencing at age 2 months. We applied an unsupervised clustering approach to identify early nasal microbiota profiles, and examined the association of profiles with the rate of ARIs during age 2-24 months.
We identified five nasal microbiota profiles dominated by , , , and , respectively. Incidence rate of ARIs was highest in children with an early -dominant profile and lowest in those with a -dominant profile (738 vs 552/100 children years; unadjusted incidence rate ratio (IRR), 1.34; 95% CI 1.16 to 1.54; p < 0.001). After adjusting for nine potential confounders, the -dominant profile-ARI association persisted (adjusted IRR (aIRR), 1.19; 95% CI 1.04 to 1.37; p = 0.01). Similarly, the incidence rate of lower respiratory tract infections (a subset of all ARIs) was significantly higher in children with an early -dominant profile (aIRR, 2.79; 95% CI 1.04 to 8.09; p = 0.04).
-dominant nasal microbiota profile in early infancy was associated with an increased rate of ARIs during the first 2 years of life.
新出现的证据表明，气道微生物群可能调节局部免疫反应，从而导致急性呼吸道感染（ARI）的易感性和严重程度。然而，关于气道微生物群与儿童 ARI 易感性之间的纵向关系的数据很少。
我们旨在研究早期鼻腔微生物群与生命头 2 年期间发生 ARI 的风险之间的关联。
在芬兰进行的这项前瞻性基于人群的出生队列研究中，我们对 839 名健康婴儿从出生到 24 月龄期间的 ARI 进行了随访。在 2 月龄时使用 16S rRNA 基因测序检测鼻腔微生物群。我们应用无监督聚类方法来识别早期鼻腔微生物群谱，并研究谱与 2-24 月龄期间 ARI 发生率的关系。
我们确定了五种鼻腔微生物群谱，分别由 、 、 、 和 主导。以早期 -主导谱为主的儿童 ARI 发生率最高，以 -主导谱为主的儿童 ARI 发生率最低（738 比 552/100 儿童年；未调整发病率比（IRR），1.34；95%CI 1.16 至 1.54；p < 0.001）。在调整了 9 个潜在混杂因素后，-主导谱-ARI 关联仍然存在（调整后的 IRR（aIRR），1.19；95%CI 1.04 至 1.37；p = 0.01）。同样，早期 -主导谱的儿童下呼吸道感染（所有 ARI 的一个亚组）的发生率显著更高（aIRR，2.79；95%CI 1.04 至 8.09；p = 0.04）。
生命早期鼻腔微生物群以 -主导谱与生命头 2 年期间 ARI 发生率增加有关。
