The respiratory microbiome is linked to the severity of RSV infections and the persistence of symptoms in children
Maartje Kristensen, Wouter A. A. de Steenhuijsen Piters, Joanne Wildenbeest, Marlies A. van Houten, Roy Zuurbier, Raïza Hasrat, Kayleigh Arp, Mei Ling J. N. Chu, Marie Billard, Terho Heikkinen, Steve Cunningham, Matthew D. Snape, Simon B. Drysdale, Ryan S. Thwaites, Federico Martinón‐Torres, Andrew J. Pollard, Peter Openshaw, Jeroen Aerssen, Justyna Binkowska, Louis Bont, Debby Bogaert
Abstract
Respiratory syncytial virus (RSV) is the leading cause of infant respiratory infections and hospitalizations. To investigate the relationship between the respiratory microbiome and RSV infection, we sequence nasopharyngeal samples from a birth cohort and a pediatric case-control study (Respiratory Syncytial virus Consortium in Europe [RESCEU]). 1,537 samples are collected shortly after birth (“baseline”), during RSV infection and convalescence, and from healthy controls. We find a modest association between baseline microbiota and the severity of consecutive RSV infections. The respiratory microbiota during infection clearly differs between infants with RSV and controls. Haemophilus , Streptococcus , and Moraxella abundance are associated with severe disease and persistence of symptoms, whereas stepwise increasing abundance of Dolosigranulum and Corynebacterium is associated with milder disease and health. We conclude that the neonatal respiratory microbiota is only modestly associated with RSV severity during the first year of life. However, the respiratory microbiota at the time of infection is strongly associated with disease severity and residual symptoms. • The neonatal respiratory microbiota is only modestly associated with RSV severity • Respiratory microbiota during RSV infection differs between RSV cases and controls • Haemophilus , Streptococcus , and Moraxella are linked to severe disease • Dolosigranulum and Corynebacterium are associated with milder disease and health In this study, Kristensen et al. investigate the link between the respiratory microbiome and RSV severity. Although the neonatal respiratory microbiota is only modestly associated with RSV severity during the first year of life, the respiratory microbiota during RSV infection is strongly associated with disease severity and persistence of symptoms.