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Am J Respir Crit Care Med. 2017 Dec 15;196(12):1582-1590. doi: 10.1164/rccm.201703-0554OC.

Maturation of the Infant Respiratory Microbiota, Environmental Drivers, and Health Consequences. A Prospective Cohort Study.

Author information

1
1 Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, the Netherlands.
2
2 Spaarne Gasthuis Academy, Hoofddorp, the Netherlands.
3
3 Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands.
4
4 Medical Research Council/University of Edinburgh Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
5
5 Microbiology and Systems Biology Group, Netherlands Organisation for Applied Scientific Research, Zeist, the Netherlands.
6
6 Department of Obstetrics and Gynaecology, Spaarne Gasthuis, Hoofddorp, the Netherlands.
7
7 Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; and.
8
8 Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands.

Abstract

RATIONALE:

Perinatal and postnatal influences are presumed important drivers of the early-life respiratory microbiota composition. We hypothesized that the respiratory microbiota composition and development in infancy is affecting microbiota stability and thereby resistance against respiratory tract infections (RTIs) over time.

OBJECTIVES:

To investigate common environmental drivers, including birth mode, feeding type, antibiotic exposure, and crowding conditions, in relation to respiratory tract microbiota maturation and stability, and consecutive risk of RTIs over the first year of life.

METHODS:

In a prospectively followed cohort of 112 infants, we characterized the nasopharyngeal microbiota longitudinally from birth on (11 consecutive sample moments and the maximum three RTI samples per subject; in total, nā€‰=ā€‰1,121 samples) by 16S-rRNA gene amplicon sequencing.

MEASUREMENTS AND MAIN RESULTS:

Using a microbiota-based machine-learning algorithm, we found that children experiencing a higher number of RTIs in the first year of life already demonstrate an aberrant microbial developmental trajectory from the first month of life on as compared with the reference group (0-2 RTIs/yr). The altered microbiota maturation process coincided with decreased microbial community stability, prolonged reduction of Corynebacterium and Dolosigranulum, enrichment of Moraxella very early in life, followed by later enrichment of Neisseria and Prevotella spp. Independent drivers of these aberrant developmental trajectories of respiratory microbiota members were mode of delivery, infant feeding, crowding, and recent antibiotic use.

CONCLUSIONS:

Our results suggest that environmental drivers impact microbiota development and, consequently, resistance against development of RTIs. This supports the idea that microbiota form the mediator between early-life environmental risk factors for and susceptibility to RTIs over the first year of life.

KEYWORDS:

development; nasopharynx; respiratory microbiota; respiratory tract infections; risk factors

PMID:
28665684
DOI:
10.1164/rccm.201703-0554OC
[Indexed for MEDLINE]

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