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O087 - SYNERGISM BETWEEN RESPIRATORY VIRUSES AND PNEUMOCOCCUS: A POTENTIAL ROLE FOR THE UPPER RESPIRATORY MICROBIOME? (ID 266)
Respiratory viruses predispose to infections caused by pneumococcus. Although this viral-pneumococcal synergism was first recognized during the 1918 influenza pandemic, most subsequent studies have focused on the effect of respiratory viruses on host pneumococcal immunity. The respiratory microbiome is a complementary and potentially modifiable mechanism by which respiratory viruses may promote pneumococcal colonization.
We conducted a longitudinal study of mother-infant pairs (n=266) in Gaborone, Botswana. We collected infant nasopharyngeal swabs every 1-2 months during the first year of life and tested these samples (n=1,901) for pneumococcus (lytA gene) and respiratory viruses (Table 1) by PCR. We used 16S ribosomal RNA gene sequencing to evaluate associations between respiratory virus infection and the relative abundances of bacterial genera within the nasopharyngeal microbiome.
Pneumococcus was identified more frequently (68% vs. 43%; p<0.0001) and at higher colonization density (7.2 vs. 6.7 log copies/mL; p<0.0001) in samples with one or more respiratory viruses than in samples without respiratory viruses. In multivariable analyses, respiratory virus detection was associated with a 46% higher hazard of pneumococcal colonization (Cox proportional hazards model; HR: 1.46, 95% CI: 1.01-2.19). Respiratory virus infection was associated with losses of genera containing key bacterial commensals (Corynebacterium, Lactobacillus) and enrichment of the nasopharyngeal microbiome by Streptococcus and other genera containing common bacterial pathobionts (Figure 1).
Respiratory viruses contribute to population-level trends in pneumococcal colonization during infancy. Our data provide new insights into the dynamic interactions that exist between respiratory viruses, the nasopharyngeal microbiome, and pneumococcus within the upper respiratory tract.