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1. Bacteria and viruses in the nasopharynx immediately prior to onset of acute lower respiratory infections in Indigenous Australian children

Author

Smith-Vaughan, HC, Binks, MJ, Beissbarth, J, Chang, AB, McCallum, GB, Mackay, IM, Morris, PS, Marsh, RL, Torzillo, PJ, Wurzel, DF, Grimwood, K, Nosworthy, E, Gaydon, JE, Leach, AJ, MacHunter, B, Chatfield, MD, Sloots, TP, Cheng, AC, Smith-Vaughan, HC, Binks, MJ, Beissbarth, J, Chang, AB, McCallum, GB, Mackay, IM, Morris, PS, Marsh, RL, Torzillo, PJ, Wurzel, DF, Grimwood, K, Nosworthy, E, Gaydon, JE, Leach, AJ, MacHunter, B, Chatfield, MD, Sloots, TP, and Cheng, AC

Abstract

Acute lower respiratory infection (ALRI) is a major cause of hospitalization for Indigenous children in remote regions of Australia. The associated microbiology remains unclear. Our aim was to determine whether the microbes present in the nasopharynx before an ALRI were associated with its onset. A retrospective case-control/crossover study among Indigenous children aged up to 2 years. ALRI cases identified by medical note review were eligible where nasopharyngeal swabs were available: (1) 0-21 days before ALRI onset (case); (2) 90-180 days before ALRI onset (same child controls); and (3) from time and age-matched children without ALRI (different child controls). PCR assays determined the presence and/or load of selected respiratory pathogens. Among 104 children (182 recorded ALRI episodes), 120 case-same child control and 170 case-different child control swab pairs were identified. Human adenoviruses (HAdV) were more prevalent in cases compared to same child controls (18 vs 7%; OR = 3.08, 95% CI 1.22-7.76, p = 0.017), but this association was not significant in cases versus different child controls (15 vs 10%; OR = 1.93, 95% CI 0.97-3.87 (p = 0.063). No other microbes were more prevalent in cases compared to controls. Streptococcus pneumoniae (74%), Haemophilus influenzae (75%) and Moraxella catarrhalis (88%) were commonly identified across all swabs. In a pediatric population with a high detection rate of nasopharyngeal microbes, HAdV was the only pathogen detected in the period before illness presentation that was significantly associated with ALRI onset. Detection of other potential ALRI pathogens was similar between cases and controls.

Published
2018

2. Bacteria and viruses in the nasopharynx immediately prior to onset of acute lower respiratory infections in Indigenous Australian children.

Author

Smith-Vaughan HC, Binks MJ, Beissbarth J, Chang AB, McCallum GB, Mackay IM, Morris PS, Marsh RL, Torzillo PJ, Wurzel DF, Grimwood K, Nosworthy E, Gaydon JE, Leach AJ, MacHunter B, Chatfield MD, Sloots TP, and Cheng AC

Subjects
Acute Disease epidemiology, Australia epidemiology, Bacteria classification, Bacteria genetics, Case-Control Studies, Child, Preschool, Cross-Over Studies, Female, Hospitalization, Humans, Infant, Male, Moraxella catarrhalis genetics, Moraxella catarrhalis isolation & purification, Native Hawaiian or Other Pacific Islander, Polymerase Chain Reaction, Prevalence, Respiratory Tract Infections epidemiology, Retrospective Studies, Streptococcus pneumoniae genetics, Streptococcus pneumoniae isolation & purification, Viruses genetics, Bacteria isolation & purification, Nasopharynx microbiology, Nasopharynx virology, Respiratory Tract Infections microbiology, Respiratory Tract Infections virology, Viruses isolation & purification
Abstract

Acute lower respiratory infection (ALRI) is a major cause of hospitalization for Indigenous children in remote regions of Australia. The associated microbiology remains unclear. Our aim was to determine whether the microbes present in the nasopharynx before an ALRI were associated with its onset. A retrospective case-control/crossover study among Indigenous children aged up to 2 years. ALRI cases identified by medical note review were eligible where nasopharyngeal swabs were available: (1) 0-21 days before ALRI onset (case); (2) 90-180 days before ALRI onset (same child controls); and (3) from time and age-matched children without ALRI (different child controls). PCR assays determined the presence and/or load of selected respiratory pathogens. Among 104 children (182 recorded ALRI episodes), 120 case-same child control and 170 case-different child control swab pairs were identified. Human adenoviruses (HAdV) were more prevalent in cases compared to same child controls (18 vs 7%; OR = 3.08, 95% CI 1.22-7.76, p = 0.017), but this association was not significant in cases versus different child controls (15 vs 10%; OR = 1.93, 95% CI 0.97-3.87 (p = 0.063). No other microbes were more prevalent in cases compared to controls. Streptococcus pneumoniae (74%), Haemophilus influenzae (75%) and Moraxella catarrhalis (88%) were commonly identified across all swabs. In a pediatric population with a high detection rate of nasopharyngeal microbes, HAdV was the only pathogen detected in the period before illness presentation that was significantly associated with ALRI onset. Detection of other potential ALRI pathogens was similar between cases and controls.

Published
2018
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