@article{a3ef1bf62b5d4ce6936bcd4e844f5032,
title = "Early respiratory viral infections in infants with cystic fibrosis",
abstract = "Background: Viral infections contribute to morbidity in cystic fibrosis (CF), but the impact of respiratory viruses on the development of airway disease is poorly understood. Methods: Infants with CF identified by newborn screening were enrolled prior to 4 months of age to participate in a prospective observational study at 4 centers. Clinical data were collected at clinic visits and weekly phone calls. Multiplex PCR assays were performed on nasopharyngeal swabs to detect respiratory viruses during routine visits and when symptomatic. Participants underwent bronchoscopy with bronchoalveolar lavage (BAL) and a subset underwent pulmonary function testing. We present findings through 8.5 months of life. Results: Seventy infants were enrolled, mean age 3.1 ± 0.8 months. Rhinovirus was the most prevalent virus (66%), followed by parainfluenza (19%), and coronavirus (16%). Participants had a median of 1.5 viral positive swabs (range 0–10). Past viral infection was associated with elevated neutrophil concentrations and bacterial isolates in BAL fluid, including recovery of classic CF bacterial pathogens. When antibiotics were prescribed for respiratory-related indications, viruses were identified in 52% of those instances. Conclusions: Early viral infections were associated with greater neutrophilic inflammation and bacterial pathogens. Early viral infections appear to contribute to initiation of lower airway inflammation in infants with CF. Antibiotics were commonly prescribed in the setting of a viral infection. Future investigations examining longitudinal relationships between viral infections, airway microbiome, and antibiotic use will allow us to elucidate the interplay between these factors in young children with CF.",
keywords = "Bacteria, Cystic fibrosis, Inflammation, Pathogens, Viruses",
author = "Deschamp, {Ashley R.} and Hatch, {Joseph E.} and Slaven, {James E.} and Netsanet Gebregziabher and Gregory Storch and Hall, {Graham L.} and Stephen Stick and Sarath Ranganathan and Ferkol, {Thomas W.} and Davis, {Stephanie D.}",
note = "Funding Information: The authors were supported by the National Institutes of Health (NIH) grants, HL116211 (SDD, TWF, SR), National Health and Medical Research Council award, NHMRC1043768 , NHMRC1000896 (SMS), NHMRCAPP1025550 (GLH), the Cystic Fibrosis Foundation Fellowship Training Grant (ARD), the Indiana Physician Scientist Award (Eli Lilly) (SDD), and the Royal Children's Hospital Cystic Fibrosis Research Trust (SR). The views expressed do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices, or organizations imply endorsement by the U.S government. There are no previous publications with any overlapping information presented in this report. Portions of this work have been presented in abstract form at the North American Cystic Fibrosis Conference and American Thoracic Society conference in 2015. This work is not and will not be submitted to any other journal while under consideration. Neither author has an actual or perceived conflict of interest concerning the information presented in the paper. None of the authors received honoraria or grant to write the manuscript. All authors listed on the manuscript have reviewed and approved the content of the submission, and take full responsibility for the information provided. Appendix A Funding Information: The authors would like to thank the families who participated and the research coordinators who collected data and cared for the infants including Miriam Davis, Jane Quante, Nadeene Clarke, Rachel Foong, and Alana Harper. They would like to thank the personnel from the Washington University Virology Laboratory at St. Louis Children's Hospital for their expertise and contributions. The authors were supported by the National Institutes of Health (NIH) grants, HL116211 (SDD, TWF, SR), National Health and Medical Research Council award, NHMRC1043768, NHMRC1000896 (SMS), NHMRCAPP1025550 (GLH), the Cystic Fibrosis Foundation Fellowship Training Grant (ARD), the Indiana Physician Scientist Award (Eli Lilly) (SDD), and the Royal Children's Hospital Cystic Fibrosis Research Trust (SR). The views expressed do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices, or organizations imply endorsement by the U.S government. There are no previous publications with any overlapping information presented in this report. Portions of this work have been presented in abstract form at the North American Cystic Fibrosis Conference and American Thoracic Society conference in 2015. This work is not and will not be submitted to any other journal while under consideration. Neither author has an actual or perceived conflict of interest concerning the information presented in the paper. None of the authors received honoraria or grant to write the manuscript. All authors listed on the manuscript have reviewed and approved the content of the submission, and take full responsibility for the information provided. Publisher Copyright: {\textcopyright} 2019",
year = "2019",
month = nov,
doi = "10.1016/j.jcf.2019.02.004",
language = "English",
volume = "18",
pages = "844--850",
journal = "Journal of Cystic Fibrosis",
issn = "1569-1993",
number = "6",
}