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

Heidi Smith-Vaughan, Michael Binks, Jemima Beissbarth, Anne Chang, Gabrielle Mccallum, Ian M Mackay, Peter Morris, Robyn Marsh, Paul J. Torzillo, Danielle F. Wurzel, Keith Grimwood, Elizabeth Nosworthy, Jane E. Gaydon, Amanda Leach, Barbara Machunter, Mark Chatfield, Theo P Sloots, Allen C. Cheng

Research output: Contribution to journalArticleResearchpeer-review

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.
Original languageEnglish
Pages (from-to)1785–1794
Number of pages10
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Volume37
Issue number9
Early online date29 Jun 2018
DOIs
Publication statusPublished - 2018

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Nasopharynx
Respiratory Tract Infections
Viruses
Bacteria
Human Adenoviruses
Moraxella (Branhamella) catarrhalis
Haemophilus influenzae
Streptococcus pneumoniae
Microbiology
Cross-Over Studies
Case-Control Studies
Hospitalization
Pediatrics
Polymerase Chain Reaction

Cite this

Smith-Vaughan, Heidi ; Binks, Michael ; Beissbarth, Jemima ; Chang, Anne ; Mccallum, Gabrielle ; Mackay, Ian M ; Morris, Peter ; Marsh, Robyn ; Torzillo, Paul J. ; Wurzel, Danielle F. ; Grimwood, Keith ; Nosworthy, Elizabeth ; Gaydon, Jane E. ; Leach, Amanda ; Machunter, Barbara ; Chatfield, Mark ; Sloots, Theo P ; Cheng, Allen C. / Bacteria and viruses in the nasopharynx immediately prior to onset of acute lower respiratory infections in Indigenous Australian children. In: European Journal of Clinical Microbiology and Infectious Diseases. 2018 ; Vol. 37, No. 9. pp. 1785–1794.
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title = "Bacteria and viruses in the nasopharynx immediately prior to onset of acute lower respiratory infections in Indigenous Australian children",
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.",
author = "Heidi Smith-Vaughan and Michael Binks and Jemima Beissbarth and Anne Chang and Gabrielle Mccallum and Mackay, {Ian M} and Peter Morris and Robyn Marsh and Torzillo, {Paul J.} and Wurzel, {Danielle F.} and Keith Grimwood and Elizabeth Nosworthy and Gaydon, {Jane E.} and Amanda Leach and Barbara Machunter and Mark Chatfield and Sloots, {Theo P} and Cheng, {Allen C.}",
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Bacteria and viruses in the nasopharynx immediately prior to onset of acute lower respiratory infections in Indigenous Australian children. / Smith-Vaughan, Heidi; Binks, Michael; Beissbarth, Jemima; Chang, Anne; Mccallum, Gabrielle; Mackay, Ian M; Morris, Peter; Marsh, Robyn; Torzillo, Paul J.; Wurzel, Danielle F.; Grimwood, Keith; Nosworthy, Elizabeth; Gaydon, Jane E. ; Leach, Amanda; Machunter, Barbara; Chatfield, Mark; Sloots, Theo P; Cheng, Allen C.

In: European Journal of Clinical Microbiology and Infectious Diseases, Vol. 37, No. 9, 2018, p. 1785–1794.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Bacteria and viruses in the nasopharynx immediately prior to onset of acute lower respiratory infections in Indigenous Australian children

AU - Smith-Vaughan, Heidi

AU - Binks, Michael

AU - Beissbarth, Jemima

AU - Chang, Anne

AU - Mccallum, Gabrielle

AU - Mackay, Ian M

AU - Morris, Peter

AU - Marsh, Robyn

AU - Torzillo, Paul J.

AU - Wurzel, Danielle F.

AU - Grimwood, Keith

AU - Nosworthy, Elizabeth

AU - Gaydon, Jane E.

AU - Leach, Amanda

AU - Machunter, Barbara

AU - Chatfield, Mark

AU - Sloots, Theo P

AU - Cheng, Allen C.

PY - 2018

Y1 - 2018

N2 - 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.

AB - 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.

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U2 - 10.1007/s10096-018-3314-7

DO - 10.1007/s10096-018-3314-7

M3 - Article

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SN - 0934-9723

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ER -