Nasopharyngeal Lactobacillus Is Associated With Childhood Wheezing Illnesses Following Acute Respiratory Syncytial Virus Infection in Infancy
- Early-life acute respiratory infection (ARI) with respiratory syncytial virus (RSV) has been strongly associated with the development of childhood wheezing illnesses, but the pathways underlying this association are poorly understood.
- To examine the role of the nasopharyngeal microbiome in the development of childhood wheezing illnesses following RSV ARI in infancy.
- We conducted a nested cohort study of 118 previously healthy, term infants with confirmed RSV ARI by RT-PCR. We used next-generation sequencing of the V4 region of the 16S rRNA gene to characterize the nasopharyngeal microbiome during RSV ARI. Our main outcome of interest was 2-year subsequent wheeze.
- One hundred thirteen (95.8%) of the 118 infants had 2-year outcome data. Of these, 46 (40.7%) had parental report of subsequent wheeze.
- There was no association between the overall taxonomic composition, diversity, and richness of the nasopharyngeal microbiome during RSV ARI with the development of subsequent wheeze.
- However, the nasopharyngeal detection and abundance of Lactobacillus was consistently higher in infants who did not develop this outcome.
- Lactobacillus also ranked first among the different genera in a model distinguishing infants with and without subsequent wheeze.
- The nasopharyngeal detection and increased abundance of Lactobacillus during RSV ARI in infancy are associated with a reduced risk of childhood wheezing illnesses at age 2 years.