ORIGINAL ARTICLE RESPIRATORY INFECTIONS Microbial and clinical factors are related to recurrence of symptoms after childhood lower respiratory tract infection Emma M. de Koff 1,2, Wing Ho Man1,3, Marlies A. van Houten1,4, Arine M. Vlieger5, Mei Ling J.N. Chu2, Elisabeth A.M. Sanders2,6 and Debby Bogaert2,7 Affiliations: 1Spaarne Academy, Spaarne Gasthuis, Hoofddorp and Haarlem, The Netherlands. 2Dept of Paediatric Immunology and Infectious Diseases, Wilhelmina Children’s Hospital and University Medical Centre Utrecht, Utrecht, The Netherlands. 3Dept of Paediatrics, Willem-Alexander Children’s Hospital and Leiden University Medical Centre, Leiden, The Netherlands. 4Dept of Paediatrics, Spaarne Gasthuis, Hoofddorp and Haarlem, The Netherlands. 5Dept of Paediatrics, St Antonius Ziekenhuis, Nieuwegein, The Netherlands. 6Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. 7Medical Research Council and University of Edinburgh Centre for Inflammation Research, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK. Correspondence: Debby Bogaert, MRC Center for Inflammation Research, University of Ediburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK. E-mail:
[email protected] ABSTRACT Childhood lower respiratory tract infections (LRTI) are associated with dysbiosis of the nasopharyngeal microbiota, and persistent dysbiosis following the LRTI may in turn be related to recurrent or chronic respiratory problems. Therefore, we aimed to investigate microbial and clinical predictors of early recurrence of respiratory symptoms as well as recovery of the microbial community following hospital admission for LRTI in children. To this end, we collected clinical data and characterised the nasopharyngeal microbiota of 154 children (4 weeks–5 years old) hospitalised for a LRTI (bronchiolitis, pneumonia, wheezing illness or mixed infection) at admission and 4–8 weeks later.