Kristensen M, de Steenhuijsen Piters WAA, Wildenbeest J, van Houten MA, Zuurbier RP, Hasrat R, Arp K, Chu MLJN, Billard M, Heikkinen T, Cunningham S, Snape M, Drysdale SB, Thwaites RS, Martinon-Torres F, Pollard AJ, Openshaw PJM, Aerssen J, Binkowska J, Bont L, and Bogaert D
Respiratory syncytial virus (RSV) is the leading cause of infant respiratory infections and hospitalizations. To investigate the relationship between the respiratory microbiome and RSV infection, we sequence nasopharyngeal samples from a birth cohort and a pediatric case-control study (Respiratory Syncytial virus Consortium in Europe [RESCEU]). 1,537 samples are collected shortly after birth ("baseline"), during RSV infection and convalescence, and from healthy controls. We find a modest association between baseline microbiota and the severity of consecutive RSV infections. The respiratory microbiota during infection clearly differs between infants with RSV and controls. Haemophilus, Streptococcus, and Moraxella abundance are associated with severe disease and persistence of symptoms, whereas stepwise increasing abundance of Dolosigranulum and Corynebacterium is associated with milder disease and health. We conclude that the neonatal respiratory microbiota is only modestly associated with RSV severity during the first year of life. However, the respiratory microbiota at the time of infection is strongly associated with disease severity and residual symptoms., Competing Interests: Declaration of interests D.B. received funding from OM Pharma and GlaxoSmithKline. F.M.-T. declares that his institution received payment from GSK, Ablynx, Abbot, Seqirus, Sanofi, MSD, Merck, Pfizer, Roche, Regeneron, Janssen, MedImmune, Novavax, Novartis, and GSK for vaccine trials; F.M.-T. also reports receiving honoraria for lectures from Sanofi, MSD, Moderna, GSK, Biofabri, AstraZeneca, Novavax, Janssen, and Pfizer; payment of travel expenses and meeting fees from Pfizer, MSD, GSK, and Sanofi; and participation on data safety monitoring boards or advisory boards for Pfizer, GSK, Moderna, Sanofi, AstraZeneca, and Biofabri. J.W. has been an investigator for clinical trials sponsored by pharmaceutical companies including AstraZeneca, Merck, Pfizer, Sanofi, and Janssen with all funds paid to University Medical Center Utrecht (UMCU) and has participated in the advisory boards of Janssen and Sanofi with fees paid to UMCU., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)