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 journalArticle

    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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    Smith-Vaughan, H., Binks, M., Beissbarth, J., Chang, A., Mccallum, G., Mackay, I. M., Morris, P., Marsh, R., Torzillo, P. J., Wurzel, D. F., Grimwood, K., Nosworthy, E., Gaydon, J. E., Leach, A., Machunter, B., Chatfield, M., Sloots, T. P., & Cheng, A. C. (2018). Bacteria and viruses in the nasopharynx immediately prior to onset of acute lower respiratory infections in Indigenous Australian children. European Journal of Clinical Microbiology and Infectious Diseases, 37(9), 1785–1794. https://doi.org/10.1007/s10096-018-3314-7