Bacteria in RSV-infected children: A systematic review and meta-analysis in the context of recent microbiome research
Notice bibliographique
Résumé
INTRODUCTION: Recent evidence highlights the role of respiratory microbial community imbalances as a potential driver of acute respiratory infections (ARIs). This paradigm shift emphasizes the need to investigate the etiology of ARIs within the broader context of respiratory microbial ecosystems. This systematic review examines bacterial species detected in children <5 years with respiratory syncytial virus (RSV) infection, evaluates factors influencing their proportions, and assesses their impact on clinical features, including symptoms, radiological findings, biomarkers, pathogenesis, immune responses, infection severity, and healthcare resource utilization. METHODS: This study followed a registered protocol in the PROSPERO database (CRD42024545522). Eligible studies included those investigating children <5 years with RSV-associated ARIs that assessed bacterial presence using any diagnostic method in any setting. A comprehensive search was conducted across eight databases for studies published between January 1, 1996, and April 4, 2025. Two independent reviewers assessed the quality of the included studies using a standardized evaluation form. Study-level and pooled proportions were estimated using random-effects models. Meta-regression analysis was performed based on demographic and clinical factors. We compared clinical outcomes between RSV-monoinfected children and those with RSV-bacterial co-detection using study-level estimates (odds ratios, standardized mean differences, or median differences). RESULTS: A total of 125 studies conducted across all six WHO regions met the eligibility criteria and were included in the analysis. The review identified over 60 bacterial species associated with RSV infections, with three dominant pathogens, Moraxella catarrhalis (21.7% [11.2-34.3]), Haemophilus influenzae (17.5% [10.6-25.6]), and Streptococcus pneumoniae (18.0% [12.3-24.4]). The aggregated proportion of detecting at least one bacterium in RSV-infected children was 28.9% [24.7-33.3]. Bacterial prevalence was significantly higher in low- and middle-income countries and varied by sample type, with the highest proportions observed in upper and lower respiratory tract samples. Bordetella pertussis showed the highest prevalence in children aged 0-11 months compared to older age groups. Bacterial co-detection in RSV-infected children was associated with significantly increased risks of specific symptoms, e.g., fever; elevated levels of biomarkers, e.g., C-reactive protein (CRP); and poor outcomes including higher mortality rates, pediatric intensive care unit admissions, prolonged hospital stays, increased severity scores, greater antibiotic use, and heightened respiratory support requirements, including oxygen, invasive and non-invasive ventilation, and prolonged mechanical ventilation. CONCLUSION: The findings of this review highlight the substantial diversity of respiratory bacteria in RSV-infected children, with M. catarrhalis, H. influenzae, and S. pneumoniae being the most frequently detected species. Respiratory bacterial co-detection in RSV-infected children is associated with distinct clinical symptoms, radiological findings, specific biomarkers, increased disease severity, and higher healthcare resource use. These findings collectively emphasize the importance of integrating microbiome-preserving strategies, precision diagnostics, and innovative prevention and therapeutic measures to optimize care and outcomes for children with RSV-associated ARIs.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,016 | 0,037 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,001 |
| Méta-épidémiologie (sens large) | 0,019 | 0,029 |
| Bibliométrie | 0,012 | 0,013 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».