TY - JOUR
T1 - Mycoplasma pneumoniae carriage in children with recurrent respiratory tract infections is associated with a less diverse and altered microbiota
AU - Koenen, Mischa H.
AU - de Groot, Ruben C.A.
AU - de Steenhuijsen Piters, Wouter A.A.
AU - Chu, Mei Ling J.N.
AU - Arp, Kayleigh
AU - Hasrat, Raïza
AU - de Bruijn, Ad C.J.M.
AU - Estevão, Silvia C.
AU - van der Vries, Erhard
AU - Langereis, Jeroen D.
AU - Boes, Marianne
AU - Bogaert, Debby
AU - van Rossum, Annemarie M.C.
AU - Unger, Wendy W.J.
AU - Verhagen, Lilly M.
N1 - Publisher Copyright:
© 2023 The Author(s)
PY - 2023/12
Y1 - 2023/12
N2 - Background: Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in school-aged children and can be preceded by asymptomatic carriage. However, its role in recurrent respiratory tract infections is unclear. We studied the prevalence of M.pneumoniae carriage in children with recurrent respiratory infections and identified associated factors. Methods: We tested M.pneumoniae carriage by qPCR in children with recurrent infections and their healthy family members in a cross-sectional study. Serum and mucosal total and M.pneumoniae-specific antibody levels were measured by ELISA and nasopharyngeal microbiota composition was characterized by 16S-rRNA sequencing. Findings: Prevalence of M.pneumoniae carriage was higher in children with recurrent infections (68%) than their family members without infections (47% in siblings and 27% in parents). M.pneumoniae carriage among family members appeared to be associated with transmission within the household, likely originating from the affected child. In logistic regression corrected for age and multiple comparisons, IgA (OR 0.16 [0.06–0.37]) and total IgG deficiency (OR 0.15 [0.02–0.74]) were less prevalent in M.pneumoniae carriers (n = 78) compared to non-carriers (n = 36). In multivariable analysis, the nasopharyngeal microbiota of M.pneumoniae carriers had lower alpha diversity (OR 0.27 [0.09–0.67]) and a higher abundance of Haemophilus influenzae (OR 45.01 [2.74–1608.11]) compared to non-carriers. Interpretation: M.pneumoniae carriage is highly prevalent in children with recurrent infections and carriers have a less diverse microbiota with an overrepresentation of disease-associated microbiota members compared to non-carriers. Given the high prevalence of M.pneumoniae carriage and the strong association with H. influenzae, we recommend appropriate antibiotic coverage of M.pneumoniae and H. influenzae in case of suspected pneumonia in children with recurrent respiratory tract infections or their family members.
AB - Background: Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in school-aged children and can be preceded by asymptomatic carriage. However, its role in recurrent respiratory tract infections is unclear. We studied the prevalence of M.pneumoniae carriage in children with recurrent respiratory infections and identified associated factors. Methods: We tested M.pneumoniae carriage by qPCR in children with recurrent infections and their healthy family members in a cross-sectional study. Serum and mucosal total and M.pneumoniae-specific antibody levels were measured by ELISA and nasopharyngeal microbiota composition was characterized by 16S-rRNA sequencing. Findings: Prevalence of M.pneumoniae carriage was higher in children with recurrent infections (68%) than their family members without infections (47% in siblings and 27% in parents). M.pneumoniae carriage among family members appeared to be associated with transmission within the household, likely originating from the affected child. In logistic regression corrected for age and multiple comparisons, IgA (OR 0.16 [0.06–0.37]) and total IgG deficiency (OR 0.15 [0.02–0.74]) were less prevalent in M.pneumoniae carriers (n = 78) compared to non-carriers (n = 36). In multivariable analysis, the nasopharyngeal microbiota of M.pneumoniae carriers had lower alpha diversity (OR 0.27 [0.09–0.67]) and a higher abundance of Haemophilus influenzae (OR 45.01 [2.74–1608.11]) compared to non-carriers. Interpretation: M.pneumoniae carriage is highly prevalent in children with recurrent infections and carriers have a less diverse microbiota with an overrepresentation of disease-associated microbiota members compared to non-carriers. Given the high prevalence of M.pneumoniae carriage and the strong association with H. influenzae, we recommend appropriate antibiotic coverage of M.pneumoniae and H. influenzae in case of suspected pneumonia in children with recurrent respiratory tract infections or their family members.
UR - http://www.scopus.com/inward/record.url?scp=85176418762&partnerID=8YFLogxK
U2 - 10.1016/j.ebiom.2023.104868
DO - 10.1016/j.ebiom.2023.104868
M3 - Article
C2 - 37950996
AN - SCOPUS:85176418762
SN - 2352-3964
VL - 98
JO - EBioMedicine
JF - EBioMedicine
M1 - 104868
ER -