Baylor Contributes to Published Article in the Journal of Allergy and Clinical Immunology

Increased Moraxella and Streptococcus following severe bronchiolitis is associated with recurrent wheezing

Jonathan M Mansbach, Pamela N Luna, Chad A Shaw, Kohei Hasegawa, Joseph F Petrosino, Pedro A Piedra, Ashley F Sullivan, Janice A Espinola, Christopher J Stewart, Carlos A Camargo Jr

Published: November 15, 2019



The role of the airway microbiome in the development of recurrent wheezing and asthma remains uncertain, particularly in the high-risk group of infants hospitalized for bronchiolitis.


Examine the relation of nasal microbiota at bronchiolitis hospitalization and 3 later points to the risk of recurrent wheezing by age 3 years.


In 17 US centers, researchers collected clinical data and nasal swabs from infants hospitalized for bronchiolitis. Trained parents collected nasal swabs 3 weeks post-hospitalization and, when healthy, during summer and 1 year post-hospitalization. We applied 16S rRNA gene sequencing to all nasal swabs. We used joint modeling to examine the relation of longitudinal nasal microbiota abundances to risk of recurrent wheezing.

Measurements and Main Results

Among 842 infants hospitalized for bronchiolitis, there was 88% follow-up at 3 years and 31% developed recurrent wheezing. The median age at enrollment was 3.2 months (IQR, 1.7-5.8 months). In joint modeling analyses adjusting for 16 covariates, including viral etiology, a 10% increase in relative abundance of Moraxella or Streptococcus 3 weeks after day 1 of hospitalization was associated with an increased risk of recurrent wheezing (HR 1.38; 95% highest density interval [HDI] 1.11-1.85; and HR 1.76; 95%HDI 1.13-3.19, respectively). Increased Streptococcus the summer after hospitalization was also associated with a higher risk of recurrent wheezing (HR 1.76; 95%HDI 1.15-3.27).


Enrichment of Moraxella or Streptococcus after bronchiolitis hospitalization was associated with recurrent wheezing by age 3 years, possibly providing new avenues to ameliorate the long-term respiratory outcomes of infants with severe bronchiolitis.


Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. (2019)



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