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Author Bisgaard, H.; Hermansen, M.N.; Buchvald, F.; Loland, L.; Halkjaer, L.B.; Bonnelykke, K.; Brasholt, M.; Heltberg, A.; Vissing, N.H.; Thorsen, S.V.; Stage, M.; Pipper, C.B. url  doi
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  Title Childhood asthma after bacterial colonization of the airway in neonates Type Journal Article
  Year (down) 2007 Publication The New England Journal of Medicine Abbreviated Journal N Engl J Med  
  Volume 357 Issue 15 Pages 1487-1495  
  Keywords Asthma/drug therapy/immunology/*microbiology; Bacterial Infections/*complications/immunology; Bronchodilator Agents/therapeutic use; Budesonide/therapeutic use; Child, Preschool; Cohort Studies; Female; Haemophilus influenzae/isolation & purification; Humans; Hypersensitivity/microbiology; Hypopharynx/*microbiology; Immunoglobulin E/blood; Infant; Infant, Newborn; Kaplan-Meier Estimate; Male; Moraxella (Branhamella) catarrhalis/isolation & purification; Neutrophils/physiology; Respiratory Sounds/*etiology; Respiratory Tract Infections/*complications; Risk Factors; Staphylococcus aureus/isolation & purification; Streptococcus pneumoniae/isolation & purification  
  Abstract BACKGROUND: Pathological features of the airway in young children with severe recurrent wheeze suggest an association between bacterial colonization and the initiating events of early asthma. We conducted a study to investigate a possible association between bacterial colonization of the hypopharynx in asymptomatic neonates and later development of recurrent wheeze, asthma, and allergy during the first 5 years of life. METHODS: The subjects were children from the Copenhagen Prospective Study on Asthma in Childhood birth cohort who were born to mothers with asthma. Aspirates from the hypopharyngeal region of asymptomatic 1-month-old infants were cultured for Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus. Wheeze was monitored prospectively on diary cards during the first 5 years of life. Blood eosinophil count and total IgE and specific IgE were measured at 4 years of age. Lung function was measured and asthma was diagnosed at 5 years of age. RESULTS: Hypopharyngeal samples were cultured from 321 neonates at 1 month of age. Twenty-one percent of the infants were colonized with S. pneumoniae, M. catarrhalis, H. influenzae, or a combination of these organisms; colonization with one or more of these organisms, but not colonization with S. aureus, was significantly associated with persistent wheeze (hazard ratio, 2.40; 95% confidence interval [CI], 1.45 to 3.99), acute severe exacerbation of wheeze (hazard ratio, 2.99; 95% CI, 1.66 to 5.39), and hospitalization for wheeze (hazard ratio, 3.85; 95% CI, 1.90 to 7.79). Blood eosinophil counts and total IgE at 4 years of age were significantly increased in children colonized neonatally with S. pneumoniae, M. catarrhalis, H. influenzae, or a combination of these organisms, but specific IgE was not significantly affected. The prevalence of asthma and the reversibility of airway resistance after beta2-agonist administration at 5 years of age were significantly increased in the children colonized neonatally with these organisms as compared with the children without such colonization (33% vs. 10% and 23% vs. 18%, respectively). CONCLUSIONS: Neonates colonized in the hypopharyngeal region with S. pneumoniae, H. influenzae, or M. catarrhalis, or with a combination of these organisms, are at increased risk for recurrent wheeze and asthma early in life.  
  Address Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Copenhagen. bisgaard@copsac.dk  
  Corporate Author Thesis  
  Impact Factor 55,873 First Author Bisgaard, H. Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Senior Author Pipper, C.B.  
  ISSN 0028-4793 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:17928596 Approved no  
  Call Number Serial 116  
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