Cargando…

Prognostic value of upper respiratory tract microbes in children presenting to primary care with respiratory infections: A prospective cohort study

BACKGROUND: The association between upper respiratory tract microbial positivity and illness prognosis in children is unclear. This impedes clinical decision-making and means the utility of upper respiratory tract microbial point-of-care tests remains unknown. We investigated for relationships betwe...

Descripción completa

Detalles Bibliográficos
Autores principales: McGeoch, Luke J., Thornton, Hannah V., Blair, Peter S., Christensen, Hannah, Turner, Nicholas L., Muir, Peter, Vipond, Barry, Redmond, Niamh M., Turnbull, Sophie, Hay, Alastair D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9098075/
https://www.ncbi.nlm.nih.gov/pubmed/35552562
http://dx.doi.org/10.1371/journal.pone.0268131
_version_ 1784706302296981504
author McGeoch, Luke J.
Thornton, Hannah V.
Blair, Peter S.
Christensen, Hannah
Turner, Nicholas L.
Muir, Peter
Vipond, Barry
Redmond, Niamh M.
Turnbull, Sophie
Hay, Alastair D.
author_facet McGeoch, Luke J.
Thornton, Hannah V.
Blair, Peter S.
Christensen, Hannah
Turner, Nicholas L.
Muir, Peter
Vipond, Barry
Redmond, Niamh M.
Turnbull, Sophie
Hay, Alastair D.
author_sort McGeoch, Luke J.
collection PubMed
description BACKGROUND: The association between upper respiratory tract microbial positivity and illness prognosis in children is unclear. This impedes clinical decision-making and means the utility of upper respiratory tract microbial point-of-care tests remains unknown. We investigated for relationships between pharyngeal microbes and symptom severity in children with suspected respiratory tract infection (RTI). METHODS: Baseline characteristics and pharyngeal swabs were collected from 2,296 children presenting to 58 general practices in Bristol, UK with acute cough and suspected RTI between 2011–2013. Post-consultation, parents recorded the severity of six RTI symptoms on a 0–6 scale daily for ≤28 days. We used multivariable hurdle regression, adjusting for clinical characteristics, antibiotics and other microbes, to investigate associations between respiratory microbes and mean symptom severity on days 2–4 post-presentation. RESULTS: Overall, 1,317 (57%) children with complete baseline, microbiological and symptom data were included. Baseline characteristics were similar in included participants and those lacking microbiological data. At least one virus was detected in 869 (66%) children, and at least one bacterium in 783 (60%). Compared to children with no virus detected (mean symptom severity score 1.52), adjusted mean symptom severity was 0.26 points higher in those testing positive for at least one virus (95% CI 0.15 to 0.38, p<0.001); and was also higher in those with detected Influenza B (0.44, 0.15 to 0.72, p = 0.003); RSV (0.41, 0.20 to 0.60, p<0.001); and Influenza A (0.25, -0.01 to 0.51, p = 0.059). Children positive for Enterovirus had a lower adjusted mean symptom severity (-0.24, -0.43 to -0.05, p = 0.013). Children with detected Bordetella pertussis (0.40, 0.00 to 0.79, p = 0.049) and those with detected Moraxella catarrhalis (-0.76, -1.06 to -0.45, p<0.001) respectively had higher and lower mean symptom severity compared to children without these bacteria. CONCLUSIONS: There is a potential role for upper respiratory tract microbiological point-of-care tests in determining the prognosis of childhood RTIs.
format Online
Article
Text
id pubmed-9098075
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-90980752022-05-13 Prognostic value of upper respiratory tract microbes in children presenting to primary care with respiratory infections: A prospective cohort study McGeoch, Luke J. Thornton, Hannah V. Blair, Peter S. Christensen, Hannah Turner, Nicholas L. Muir, Peter Vipond, Barry Redmond, Niamh M. Turnbull, Sophie Hay, Alastair D. PLoS One Research Article BACKGROUND: The association between upper respiratory tract microbial positivity and illness prognosis in children is unclear. This impedes clinical decision-making and means the utility of upper respiratory tract microbial point-of-care tests remains unknown. We investigated for relationships between pharyngeal microbes and symptom severity in children with suspected respiratory tract infection (RTI). METHODS: Baseline characteristics and pharyngeal swabs were collected from 2,296 children presenting to 58 general practices in Bristol, UK with acute cough and suspected RTI between 2011–2013. Post-consultation, parents recorded the severity of six RTI symptoms on a 0–6 scale daily for ≤28 days. We used multivariable hurdle regression, adjusting for clinical characteristics, antibiotics and other microbes, to investigate associations between respiratory microbes and mean symptom severity on days 2–4 post-presentation. RESULTS: Overall, 1,317 (57%) children with complete baseline, microbiological and symptom data were included. Baseline characteristics were similar in included participants and those lacking microbiological data. At least one virus was detected in 869 (66%) children, and at least one bacterium in 783 (60%). Compared to children with no virus detected (mean symptom severity score 1.52), adjusted mean symptom severity was 0.26 points higher in those testing positive for at least one virus (95% CI 0.15 to 0.38, p<0.001); and was also higher in those with detected Influenza B (0.44, 0.15 to 0.72, p = 0.003); RSV (0.41, 0.20 to 0.60, p<0.001); and Influenza A (0.25, -0.01 to 0.51, p = 0.059). Children positive for Enterovirus had a lower adjusted mean symptom severity (-0.24, -0.43 to -0.05, p = 0.013). Children with detected Bordetella pertussis (0.40, 0.00 to 0.79, p = 0.049) and those with detected Moraxella catarrhalis (-0.76, -1.06 to -0.45, p<0.001) respectively had higher and lower mean symptom severity compared to children without these bacteria. CONCLUSIONS: There is a potential role for upper respiratory tract microbiological point-of-care tests in determining the prognosis of childhood RTIs. Public Library of Science 2022-05-12 /pmc/articles/PMC9098075/ /pubmed/35552562 http://dx.doi.org/10.1371/journal.pone.0268131 Text en © 2022 McGeoch et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
McGeoch, Luke J.
Thornton, Hannah V.
Blair, Peter S.
Christensen, Hannah
Turner, Nicholas L.
Muir, Peter
Vipond, Barry
Redmond, Niamh M.
Turnbull, Sophie
Hay, Alastair D.
Prognostic value of upper respiratory tract microbes in children presenting to primary care with respiratory infections: A prospective cohort study
title Prognostic value of upper respiratory tract microbes in children presenting to primary care with respiratory infections: A prospective cohort study
title_full Prognostic value of upper respiratory tract microbes in children presenting to primary care with respiratory infections: A prospective cohort study
title_fullStr Prognostic value of upper respiratory tract microbes in children presenting to primary care with respiratory infections: A prospective cohort study
title_full_unstemmed Prognostic value of upper respiratory tract microbes in children presenting to primary care with respiratory infections: A prospective cohort study
title_short Prognostic value of upper respiratory tract microbes in children presenting to primary care with respiratory infections: A prospective cohort study
title_sort prognostic value of upper respiratory tract microbes in children presenting to primary care with respiratory infections: a prospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9098075/
https://www.ncbi.nlm.nih.gov/pubmed/35552562
http://dx.doi.org/10.1371/journal.pone.0268131
work_keys_str_mv AT mcgeochlukej prognosticvalueofupperrespiratorytractmicrobesinchildrenpresentingtoprimarycarewithrespiratoryinfectionsaprospectivecohortstudy
AT thorntonhannahv prognosticvalueofupperrespiratorytractmicrobesinchildrenpresentingtoprimarycarewithrespiratoryinfectionsaprospectivecohortstudy
AT blairpeters prognosticvalueofupperrespiratorytractmicrobesinchildrenpresentingtoprimarycarewithrespiratoryinfectionsaprospectivecohortstudy
AT christensenhannah prognosticvalueofupperrespiratorytractmicrobesinchildrenpresentingtoprimarycarewithrespiratoryinfectionsaprospectivecohortstudy
AT turnernicholasl prognosticvalueofupperrespiratorytractmicrobesinchildrenpresentingtoprimarycarewithrespiratoryinfectionsaprospectivecohortstudy
AT muirpeter prognosticvalueofupperrespiratorytractmicrobesinchildrenpresentingtoprimarycarewithrespiratoryinfectionsaprospectivecohortstudy
AT vipondbarry prognosticvalueofupperrespiratorytractmicrobesinchildrenpresentingtoprimarycarewithrespiratoryinfectionsaprospectivecohortstudy
AT redmondniamhm prognosticvalueofupperrespiratorytractmicrobesinchildrenpresentingtoprimarycarewithrespiratoryinfectionsaprospectivecohortstudy
AT turnbullsophie prognosticvalueofupperrespiratorytractmicrobesinchildrenpresentingtoprimarycarewithrespiratoryinfectionsaprospectivecohortstudy
AT hayalastaird prognosticvalueofupperrespiratorytractmicrobesinchildrenpresentingtoprimarycarewithrespiratoryinfectionsaprospectivecohortstudy