| Popis: |
Background: Lower respiratory tract infections (LRTI) are a leading cause of morbidity in children. A clear causative pathogen is commonly not found. Aims and objectives: We investigated whether the respiratory microbiome and virome could explain acute LRTI in children. Methods: We conducted a case-control study including 154 children ( Results: Viruses were commonly present in cases and controls irrespective of disease phenotype: RSV (49% vs 4%) and hMPV (6% vs 1.7%) were overrepresented in cases, and HRV was overrepresented in controls (50% vs 67%, all p Haemophilus spp., Streptococcus pneumoniae , Prevotella , and other oral species in cases, and Moraxella , Corynebacterium , and Dolosigranulum overrepresented in controls. Only by combining data on viruses, bacteria, and host characteristics using random forest analyses, we could classify cases and controls with high certainty (AUC>0.85). Conclusions: Our data suggest that LRTI pathogenesis is driven by interactions between respiratory viruses, and potentially pathogenic bacteria in the absence of potentially protective commensals, resulting in overgrowth of pro-inflammatory bacteria. These data underline that the complex interactions between the environment, the host and its microbiota should be studied in an integrated manner to further elucidate the LRTI pathogenesis in children. |
