Kirsten M Kloepfer1, Wai Ming Lee2, Tressa E Pappas2, Theresa J Kang2, Rose F Vrtis3, Michael D Evans4, Ronald E Gangnon4, Yury A Bochkov2, Daniel J Jackson5, Robert F Lemanske5, James E Gern5. 1. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Ind. Electronic address: kloepfer@iu.edu. 2. Department of Pediatrics, University of Wisconsin-Madison, Madison, Wis. 3. Department of Medicine, University of Wisconsin-Madison, Madison, Wis. 4. Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis. 5. Department of Pediatrics, University of Wisconsin-Madison, Madison, Wis; Department of Medicine, University of Wisconsin-Madison, Madison, Wis.
Abstract
BACKGROUND: Detection of either viral or bacterial pathogens is associated with wheezing in children; however, the influence of both bacteria and viruses on illness symptoms has not been described. OBJECTIVE: We evaluated bacterial detection during the peak rhinovirus season in children with and without asthma to determine whether an association exists between bacterial infection and the severity of rhinovirus-induced illnesses. METHODS: Three hundred eight children (166 with asthma and 142 without asthma) aged 4 to 12 years provided 5 consecutive weekly nasal samples during September and scored cold and asthma symptoms daily. Viral diagnostics and quantitative PCR for Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were performed on all nasal samples. RESULTS: Detection rates were 53%, 17%, and 11% for H influenzae, S pneumoniae, and M catarrhalis, respectively, with detection of rhinovirus increasing the risk of detecting bacteria within the same sample (odds ratio [OR], 2.0; 95% CI, 1.4-2.7; P < .0001) or the following week (OR, 1.6; 95% CI, 1.1-2.4; P = .02). In the absence of rhinovirus, S pneumoniae was associated with increased cold symptoms (mean, 2.7 [95% CI, 2.0-3.5] vs 1.8 [95% CI, 1.5-2.2]; P = .006) and moderate asthma exacerbations (18% [95% CI, 12% to 27%] vs 9.2% [95% CI, 6.7% to 12%]; P = .006). In the presence of rhinovirus, S pneumoniae was associated with increased moderate asthma exacerbations (22% [95% CI, 16% to 29%] vs 15% [95% CI, 11% to 20%]; P = .01). Furthermore, M catarrhalis detected alongside rhinovirus increased the likelihood of experiencing cold symptoms, asthma symptoms, or both compared with isolated detection of rhinovirus (OR, 2.0 [95% CI, 1.0-4.1]; P = .04). Regardless of rhinovirus status, H influenzae was not associated with respiratory symptoms. CONCLUSION: Rhinovirus infection enhances detection of specific bacterial pathogens in children with and without asthma. Furthermore, these findings suggest that M catarrhalis and S pneumoniae contribute to the severity of respiratory tract illnesses, including asthma exacerbations.
BACKGROUND: Detection of either viral or bacterial pathogens is associated with wheezing in children; however, the influence of both bacteria and viruses on illness symptoms has not been described. OBJECTIVE: We evaluated bacterial detection during the peak rhinovirus season in children with and without asthma to determine whether an association exists between bacterial infection and the severity of rhinovirus-induced illnesses. METHODS: Three hundred eight children (166 with asthma and 142 without asthma) aged 4 to 12 years provided 5 consecutive weekly nasal samples during September and scored cold and asthma symptoms daily. Viral diagnostics and quantitative PCR for Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were performed on all nasal samples. RESULTS: Detection rates were 53%, 17%, and 11% for H influenzae, S pneumoniae, and M catarrhalis, respectively, with detection of rhinovirus increasing the risk of detecting bacteria within the same sample (odds ratio [OR], 2.0; 95% CI, 1.4-2.7; P < .0001) or the following week (OR, 1.6; 95% CI, 1.1-2.4; P = .02). In the absence of rhinovirus, S pneumoniae was associated with increased cold symptoms (mean, 2.7 [95% CI, 2.0-3.5] vs 1.8 [95% CI, 1.5-2.2]; P = .006) and moderate asthma exacerbations (18% [95% CI, 12% to 27%] vs 9.2% [95% CI, 6.7% to 12%]; P = .006). In the presence of rhinovirus, S pneumoniae was associated with increased moderate asthma exacerbations (22% [95% CI, 16% to 29%] vs 15% [95% CI, 11% to 20%]; P = .01). Furthermore, M catarrhalis detected alongside rhinovirus increased the likelihood of experiencing cold symptoms, asthma symptoms, or both compared with isolated detection of rhinovirus (OR, 2.0 [95% CI, 1.0-4.1]; P = .04). Regardless of rhinovirus status, H influenzae was not associated with respiratory symptoms. CONCLUSION:Rhinovirus infection enhances detection of specific bacterial pathogens in children with and without asthma. Furthermore, these findings suggest that M catarrhalis and S pneumoniae contribute to the severity of respiratory tract illnesses, including asthma exacerbations.
Authors: Yvonne J Huang; Craig E Nelson; Eoin L Brodie; Todd Z Desantis; Marshall S Baek; Jane Liu; Tanja Woyke; Martin Allgaier; Jim Bristow; Jeanine P Wiener-Kronish; E Rand Sutherland; Tonya S King; Nikolina Icitovic; Richard J Martin; William J Calhoun; Mario Castro; Loren C Denlinger; Emily Dimango; Monica Kraft; Stephen P Peters; Stephen I Wasserman; Michael E Wechsler; Homer A Boushey; Susan V Lynch Journal: J Allergy Clin Immunol Date: 2010-12-30 Impact factor: 10.793
Authors: Emily S Charlson; Kyle Bittinger; Andrew R Haas; Ayannah S Fitzgerald; Ian Frank; Anjana Yadav; Frederic D Bushman; Ronald G Collman Journal: Am J Respir Crit Care Med Date: 2011-06-16 Impact factor: 21.405
Authors: Kirsten M Kloepfer; Jaime P Olenec; Wai Ming Lee; Guiyan Liu; Rose F Vrtis; Kathy A Roberg; Michael D Evans; Ronald E Gangnon; Robert F Lemanske; James E Gern Journal: Am J Respir Crit Care Med Date: 2012-02-23 Impact factor: 21.405
Authors: Jaime P Olenec; Woo Kyung Kim; Wai-Ming Lee; Fue Vang; Tressa E Pappas; Lisa E P Salazar; Michael D Evans; Jack Bork; Kathleen Roberg; Robert F Lemanske; James E Gern Journal: J Allergy Clin Immunol Date: 2010-04-14 Impact factor: 10.793
Authors: Hans Bisgaard; Mette Northman Hermansen; Klaus Bønnelykke; Jakob Stokholm; Florent Baty; Nanna Lassen Skytt; Julia Aniscenko; Tatiana Kebadze; Sebastian L Johnston Journal: BMJ Date: 2010-10-04
Authors: Kirsty R Short; Patrick C Reading; Lorena E Brown; John Pedersen; Brad Gilbertson; Emma R Job; Kathryn M Edenborough; Marrit N Habets; Aldert Zomer; Peter W M Hermans; Dimitri A Diavatopoulos; Odilia L Wijburg Journal: Infect Immun Date: 2013-01-14 Impact factor: 3.441
Authors: Iris De Schutter; Alexandra Dreesman; Oriane Soetens; Marc De Waele; Françoise Crokaert; Jan Verhaegen; Denis Piérard; Anne Malfroot Journal: BMC Pediatr Date: 2012-06-22 Impact factor: 2.125
Authors: Guma M K Abdeldaim; Kristoffer Strålin; Jens Korsgaard; Jonas Blomberg; Christina Welinder-Olsson; Björn Herrmann Journal: BMC Microbiol Date: 2010-12-03 Impact factor: 3.605
Authors: Paul Andres Cardenas; Philip J Cooper; Michael J Cox; Martha Chico; Carlos Arias; Miriam F Moffatt; William Osmond Cookson Journal: PLoS One Date: 2012-10-05 Impact factor: 3.240
Authors: Amy S Feldman; Yuan He; Martin L Moore; Marc B Hershenson; Tina V Hartert Journal: Am J Respir Crit Care Med Date: 2015-01-01 Impact factor: 21.405
Authors: Jason E Lang; Janet T Holbrook; Edward B Mougey; Christine Y Wei; Robert A Wise; W Gerald Teague; John J Lima Journal: Ann Am Thorac Soc Date: 2015-06
Authors: Richard Hewitt; Hugo Farne; Andrew Ritchie; Emma Luke; Sebastian L Johnston; Patrick Mallia Journal: Ther Adv Respir Dis Date: 2015-11-26 Impact factor: 4.031
Authors: Leonard B Bacharier; Theresa W Guilbert; David T Mauger; Susan Boehmer; Avraham Beigelman; Anne M Fitzpatrick; Daniel J Jackson; Sachin N Baxi; Mindy Benson; Carey-Ann D Burnham; Michael Cabana; Mario Castro; James F Chmiel; Ronina Covar; Michael Daines; Jonathan M Gaffin; Deborah Ann Gentile; Fernando Holguin; Elliot Israel; H William Kelly; Stephen C Lazarus; Robert F Lemanske; Ngoc Ly; Kelley Meade; Wayne Morgan; James Moy; Tod Olin; Stephen P Peters; Wanda Phipatanakul; Jacqueline A Pongracic; Hengameh H Raissy; Kristie Ross; William J Sheehan; Christine Sorkness; Stanley J Szefler; W Gerald Teague; Shannon Thyne; Fernando D Martinez Journal: JAMA Date: 2015-11-17 Impact factor: 56.272