Nasopharyngeal bacterial burden and antibiotics: Influence on inflammatory markers and disease severity in infants with respiratory syncytial virus bronchiolitis - 14/12/17
, Cesar Mella a, b, j , Santiago M. Lopez a, Nicole V. Brown c, Mark W. Hall b, Sue Hammond d, William Shiels e, Judith Groner f, Mario Marcon g, Octavio Ramilo a, h, Asuncion Mejias a, h, ⁎ Summary |
Objectives |
Animal studies suggest that RSV increases nasopharyngeal (NP) bacterial colonization facilitating bacterial infections. We investigated the influence of antibiotic treatment and colonization with potentially pathogenic bacteria on inflammatory markers and disease severity in RSV-infected in infants.
Methods |
Healthy young infants hospitalized with RSV bronchiolitis (n = 136) and age-matched healthy controls (n = 23) were enrolled and NP samples cultured for potentially pathogenic bacteria including: Gram-positive bacteria (GPB): Staphylococcus aureus, Streptococcus pneumoniae, β-hemolytic Streptococcus; and Gram-negative bacteria (GNB): Moraxella catarrhalis and Haemophilus influenzae. Clinical parameters and plasma IL-8, IL-6 and TNF-α concentrations were compared according to the bacterial class and antibiotic treatment.
Results |
Antibiotic treatment decreased by 10-fold NP bacterial recovery. Eighty-one percent of RSV infants who did not receive antibiotics before sample collection were colonized with pathogenic bacteria. Overall, GNB were identified in 21% of patients versus 4% of controls who were mostly colonized with GPB. Additionally, in RSV patients NP white blood cell counts (p = 0.026), and blood neutrophils (p = 0.02) were higher in those colonized with potentially pathogenic bacteria versus respiratory flora. RSV patients colonized with GNB had higher plasma IL-8 (p = 0.01) and IL-6 (p < 0.01) concentrations than controls, and required longer duration of oxygen (p = 0.049).
Conclusions |
Infants with RSV bronchiolitis colonized with potentially pathogenic bacteria had increased numbers of mucosal and systemic inflammatory cells. Specifically, colonization with GNB was associated with higher concentrations of proinflammatory cytokines and a trend towards increased disease severity.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Eighty one percent of infants hospitalized with RSV bronchiolitis were colonized with potentially pathogenic bacteria. |
• | Antibiotics were commonly used and associated with longer oxygen need and lobar consolidation in RSV-infected infants. |
• | Overall and Gram-negative (GNB) NP bacterial colonization was more common in RSV-infected infants vs. healthy controls. |
• | RSV-infected infants colonized with GNB had increased mucosal and blood neutrophil numbers, plasma IL-6 and IL-8 and duration of oxygen. |
Keywords : Nasopharyngeal bacterial colonization, Bronchiolitis, RSV, Disease severity, Gram-negative bacteria, Antibiotics
Plan
| ☆ | This work was presented in part at the European Society for Pediatric Infectious Diseases 30th Annual Meeting. Thessaloniki, Greece, May 8–12, 2012. |
Vol 71 - N° 4
P. 458-469 - octobre 2015 Retour au numéro
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