Early respiratory viral infections in infants with cystic fibrosis

Ashley R. Deschamp, Joseph E. Hatch, James E. Slaven, Netsanet Gebregziabher, Gregory Storch, Graham L. Hall, Stephen Stick, Sarath Ranganathan, Thomas W. Ferkol, Stephanie Davis

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalJournal of Cystic Fibrosis
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

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Virus Diseases
Cystic Fibrosis
Respiratory Tract Infections
Viruses
Anti-Bacterial Agents
Inflammation
Paramyxoviridae Infections
Rhinovirus
Coronavirus
Multiplex Polymerase Chain Reaction
Microbiota
Bronchoalveolar Lavage Fluid
Bronchoscopy
Bronchoalveolar Lavage
Ambulatory Care
Observational Studies
Neutrophils
Newborn Infant
Prospective Studies
Morbidity

Keywords

  • Bacteria
  • Cystic fibrosis
  • Inflammation
  • Pathogens
  • Viruses

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

Deschamp, A. R., Hatch, J. E., Slaven, J. E., Gebregziabher, N., Storch, G., Hall, G. L., ... Davis, S. (2019). Early respiratory viral infections in infants with cystic fibrosis. Journal of Cystic Fibrosis. https://doi.org/10.1016/j.jcf.2019.02.004

Early respiratory viral infections in infants with cystic fibrosis. / Deschamp, Ashley R.; Hatch, Joseph E.; Slaven, James E.; Gebregziabher, Netsanet; Storch, Gregory; Hall, Graham L.; Stick, Stephen; Ranganathan, Sarath; Ferkol, Thomas W.; Davis, Stephanie.

In: Journal of Cystic Fibrosis, 01.01.2019.

Research output: Contribution to journalArticle

Deschamp, AR, Hatch, JE, Slaven, JE, Gebregziabher, N, Storch, G, Hall, GL, Stick, S, Ranganathan, S, Ferkol, TW & Davis, S 2019, 'Early respiratory viral infections in infants with cystic fibrosis', Journal of Cystic Fibrosis. https://doi.org/10.1016/j.jcf.2019.02.004
Deschamp AR, Hatch JE, Slaven JE, Gebregziabher N, Storch G, Hall GL et al. Early respiratory viral infections in infants with cystic fibrosis. Journal of Cystic Fibrosis. 2019 Jan 1. https://doi.org/10.1016/j.jcf.2019.02.004
Deschamp, Ashley R. ; Hatch, Joseph E. ; Slaven, James E. ; Gebregziabher, Netsanet ; Storch, Gregory ; Hall, Graham L. ; Stick, Stephen ; Ranganathan, Sarath ; Ferkol, Thomas W. ; Davis, Stephanie. / Early respiratory viral infections in infants with cystic fibrosis. In: Journal of Cystic Fibrosis. 2019.
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