Association of rhinovirus and potentially pathogenic bacterial detections in the first 3 months of life with subsequent wheezing in childhood
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Grimwood, Keith
Sly, Peter D
Lambert, Stephen B
Ware, Robert S
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Abstract
Objective: Airway interactions between viruses, especially rhinoviruses, and potentially pathogenic bacteria (PPB; Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis) in early infancy may increase the risk of subsequent wheezing and asthma. We evaluated the association between rhinovirus and PPB in the first 3 months of life and wheezing episodes before age 2 years and asthma at age 5–7 years. Methods: An Australian community-based birth cohort of healthy children involved parents collecting nasal swabs weekly and completing symptom diaries daily until age 2 years. In a follow-up subset, asthma diagnosis was assessed annually until age 7 years. Swabs were analyzed by real-time polymerase chain reaction assays. Children were included if they returned symptom diaries beyond age 3 months (wheeze) or were reviewed at age 5–7 years (asthma). Results: 1440 swabs were returned by 146 children in the first 3 months of life. Wheeze and asthma outcomes were recorded for 146 and 84 children, respectively. Each additional week of rhinovirus detection increased the incidence of wheezing before age 2 years by 1.16 times (95% confidence interval [CI]: 0.99–1.35). There were no significant associations between bacteria and wheeze. Each additional week with H. influenzae increased the odds of asthma at age 5–7 years by 135% (odds ratio: 2.35, 95% CI: 0.99–5.58). No significant interaction was observed between rhinovirus and PPB for wheezing or asthma. Conclusion: Early life rhinovirus infection was associated with wheezing before age 2 years and H. influenzae with asthma by age 5–7 years. Microbes may play an etiologic role in wheezing and asthma, warranting further study.
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Pediatric Pulmonology
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© 2023 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Subject
Medical bacteriology
Respiratory diseases
Cardiovascular medicine and haematology
Paediatrics
Rhinovirus
asthma
children
respiratory bacteria
wheeze
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Takashima, MD; Grimwood, K; Sly, PD; Lambert, SB; Ware, RS, Association of rhinovirus and potentially pathogenic bacterial detections in the first 3 months of life with subsequent wheezing in childhood, Pediatric Pulmonology, 2023