The disorders of respiratory tract microbiota in children with respiratory diseases (literary review)

O.S. Koreniuk


The article presents the data of national and foreign literature about microbiocenosis of human body under normal and pathological conditions. Stages of respiratory tract colonization by microflora in different periods of childhood are considered. The information of numerous studies on lung microbiota is presented in comparison with the microbiocenosis of the upper respiratory tract. Experimental data confirming the presence of microflora in the lungs of a healthy person and a direct correlation between the microbiota of the upper and lower respiratory tracts are provided. One of the most important factors determining the state of the microbiota of the lung is microaspiration. The value of microbiocenosis of open cavities for the formation of mucosal immunity is shown. The scientific concept about the algorithm of functioning of colonization resistance of the mucous membranes is outlined. We considered the method to evaluate nasopharynx microbiocenosis and the degree of dysbiosis. Particular attention is paid to the microbiota of the upper and lower respiratory tract in children with repeated respiratory diseases, as well as in children with recurrent and chronic respiratory diseases. It is shown that the identification of the pathogen in the culture from the upper and lower respiratory ways does not necessarily indicate its role as a causative agent of acute bronchopulmonary disease. The evaluation of dysbiosis severity is needed. However, long persistence of the infectious agent in patients with acute bronchopulmonary diseases can lead to an imbalance of immune reactivity and the formation of a chronic bronchopulmonary inflammatory process. Increased airway colonization in patients with chronic respiratory diseases is an important risk factor contributing to the development of exacerbations. It is noted that monitoring of etiologically significant microorganisms in patients with acute and chronic bronchopulmonary pathology is necessary for the improvement of pathogenetic treatment and prevention of chronic conditions.


microbiocenosis; respiratory diseases; children; review


Zverev VV, Boichenko MN, editors. Meditsinskaia mikrobiologiia, virusologiia i immunologiia: uchebnik. Tom 1 [Medical microbiology, virology and immunology: a textbook. Volume 1]. Moscow: GEOTAR-Media; 2010. 448p. (in Russian).

Metelskaya VA, Alyoshkin VA, Voropaeva EA, et al. Colonization resistance and immunological reactivity of children's oropharyngeal mucosa in health and bronchopulmonary pathology. Vestnik Rossiiskoi akademii meditsinskikh nauk. 2010;(7):10-15. (in Russian).

Bosch AATM, Levin E, van Houten MA, et al. Development of upper respiratory tract microbiota in infancy is affected by mode of delivery. EBioMedicine. 2016 Jul;9:336-345. doi: 10.1016/j.ebiom.2016.05.031.

Hilty M, Burke C, Pedro H, et al. Disordered microbial communities in asthmatic airways. PLoS One. 2010 Jan 5;5(1):e8578. doi: 10.1371/journal.pone.0008578.

Charlson ES, Bittinger K, Haas AR, et al. Topographical continuity of bacterial populations in the healthy human respiratory tract. Am J Respir Crit Care Med. 2011 Oct 15;184(8):957-63. doi: 10.1164/rccm.201104-0655OC.

Gleeson K, Eggli DF, Maxwell SL. Quantitative aspiration during sleep in normal subjects. Chest. 1997 May;111(5):1266-72.

Bassis CM, Erb-Downward JR, Dickson RP, et al. Analysis of the upper respiratory tract microbiotas as the source of the lung and gastric microbiotas in healthy individuals. MBio. 2015 Mar 3;6(2):e00037. doi: 10.1128/mBio.00037-15.

Korenjuk OS. Efficiency of healthy food in the regimen of regurgitation syndrome in infants. Medychnyj forum. 2014;(2):93-99. (in Ukrainian).

Ilchenko SI, Duka ED, Zhukova LA. Microaspiration Syndrome in Pediatric Practice: Modern Features and Role in Bronchial Obstruction Syndrome Formation. Zdorov'e rebenka. 2016;(75):90-94. doi: 10.22141/2224-0551.7.75.2016.86731. (in Russian).

Bryskina EYu, Bryskin VS. Questions of diagnostics of microaspiration of the gastrointestinal content in children receiving respiratory therapy in the neonatal period. Eurasian Union of Scientists. 2014;(7-3):24-26. (in Russian).

Charlson ES, Bittinger K, Chen J, et al. Assessing bacterial populations in the lung by replicate analysis of samples from the upper and lower respiratory tracts. PLoS One. 2012;7(9):e42786. doi: 10.1371/journal.pone.0042786.

Goddard AF, Staudinger BJ, Dowd SE, et al. Direct sampling of cystic fibrosis lungs indicates that DNA-based analyses of upper-airway specimens can misrepresent lung microbiota. Proc Natl Acad Sci U S A. 2012 Aug 21;109(34):13769-74. doi: 10.1073/pnas.1107435109.

Madan JC, Koestler DC, Stanton BA, et al. Serial analysis of the gut and respiratory microbiome in cystic fibrosis in infancy: interaction between intestinal and respiratory tracts and impact of nutritional exposures. MBio. 2012 Aug 21;3(4). pii: e00251-12. doi: 10.1128/mBio.00251-12.

Morris A, Beck JM, Schloss PD, et al. Comparison of the respiratory microbiome in healthy nonsmokers and smokers. Am J Respir Crit Care Med. 2013 May 15;187(10):1067-75. doi: 10.1164/rccm.201210-1913OC.

Pragman AA, Kim HB, Reilly CS, Wendt C, Isaacson RE. The lung microbiome in moderate and severe chronic obstructive pulmonary disease. PLoS One. 2012;7(10):e47305. doi: 10.1371/journal.pone.0047305.

Sze MA, Dimitriu PA, Hayashi S, et al. The lung tissue microbiome in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012 May 15;185(10):1073-80. doi: 10.1164/rccm.201111-2075OC.

Huang YJ, Nelson CE, Brodie EL, et al. Airway microbiota and bronchial hyperresponsiveness in patients with suboptimally controlled asthma. J Allergy Clin Immunol. 2011 Feb;127(2):372-381.e1-3. doi: 10.1016/j.jaci.2010.10.048.

Karaulov AV, Afanasyev SS, Aleshkin VA, et al. Microflora, colonization mucosal resistance and mucosal immunity. Immunologia. 2015;36(5):290-295. (in Russian).

Karaulov AV, Aleshkin VA, Voropaeva EA, et al. Colonization resistance indicators of oropharynx mucous membrane as objective criteria of mucosal immunity at bronchitis in children. Immunologia. 2012;33(5):255-259. (in Russian).

Abaturov AE. Molecular mechanisms of non-specific protection of respiratory tract: recognition of pathogen-associated molecular structures. Zdorov'e rebenka. 2006;(2):14-18. (in Russian).

Huang YJ, Lynch SV. The emerging relationship between the airway microbiota and chronic respiratory disease: clinical implications. Expert Rev Respir Med. 2011 Dec;5(6):809-21. doi: 10.1586/ers.11.76.

Huffnagle GB, Dickson RP. The bacterial microbiota in inflammatory lung diseases. Clin Immunol. 2015 Aug;159(2):177-82. doi: 10.1016/j.clim.2015.05.022.

Regev-Yochay G, Trzcinski K, Thompson CM, Malley R, Lipsitch M. Interference between streptococcus pneumoniae and staphylococcus aureus: In vitro hydrogen peroxide-mediated killing by Streptococcus pneumoniae. J Bacteriol. 2006 Jul;188(13):4996-5001. doi: 10.1128/JB.00317-06.

Pericone CD, Overweg K, Hermans PWM, Weiser JN. Inhibitory and bactericidal effects of hydrogen peroxide production by streptococcus pneumoniae on other inhabitants of the upper respiratory tract. Infect Immun. 2000 Jul;68(7):3990-7.

Margolis E, Yates A, Levin B. The ecology of nasal colonization of streptococcus pneumoniae, haemophilus influenzae and staphylococcus aureus: the role of competition and interactions with host's immune response. BMC Microbiol. 2010 Feb 23;10:59. doi: 10.1186/1471-2180-10-59.

Blaser MJ, Falkow S. What are the consequences of the disappearing human microbiota? Nat Rev Microbiol. 2009 Dec;7(12):887-94. doi: 10.1038/nrmicro2245.

Brook I, Gober AE. Increased recovery of Moraxella catarrhalis and Haemophilus influenzae in association with group A β-haemolytic streptococci in healthy children and those with pharyngo-tonsillitis. J Med Microbiol. 2006 Aug;55(Pt 8):989-92. doi: 10.1099/jmm.0.46325-0.

Tano K, Olofsson C, Grahn-Håkansson E, Holm SE. In vitro inhibition of S. pneumoniae, nontypable H. influenzae and M. catarrhalis by alpha-hemolytic streptococci from healthy children. Int J Pediatr Otorhinolaryngol. 1999 Jan 25;47(1):49-56.

Tano K, Hellström S. Bacterial adherence to pharyngeal cells: in vitro studies with alpha-haemolytic streptococci and haemophilus influenzae. Acta Otolaryngol. 2002 Oct;122(7):745-51.

Karaulov AV, Metelskaya VA, Aleshkin VA, et al. Adhesion of indigene and opportunistic microorganisms by cells of nasopharyngeal and buccal epithelium as an indicator of respiratory tract resistance in children with pneumonia and bronchitis.International journal of immunopathology, allergology, infectology. 2010;(3):37-46. (in Russian).

Afanasyev SS, Aleshkin VA, Voropayeva EA, et al. Microbiocenoses of open cavities and mucosal immunity. Effektivnaia farmakoterapiia. 2013;(27):6-11. (in Russian).

Berezhnyj VV. Immunocorrection of repeated episodes of respiratory tract infection in children. Zdorov`ja Ukrai'ny. Pediatrija. 2013;(27):32-33. (in Ukrainian).

Kamasheva GT, Belukhina EG, Sharipova GK, Karipollin BK. Characterization of the microbiocenosis of the upper respiratory tract in sickly children in the city of Semey. Nauka i zdravookhranenie. 2011;(1):69-71. (in Russian).

Snegireva NIu. Narusheniia mikrobiotsenoza i funktsional'nye izmeneniia organov dykhaniia u detei s retsidiviruiushchimi respiratornymi infektsiiami i podkhody k korrektsii. Diss. kand. med. nauk [Disturbances of microbiocenosis and functional changes in respiratory organs in children with recurrent respiratory infections and approaches to correction. PhD diss.]. Ivanovo; 2009. 123 p. (in Russian).

Metelskaya VA. Kharakteristika kolonizatsionnoi rezistentnosti slizistykh obolochek dykhatel'nogo trakta pri bronkhitakh u detei. Diss. kand. biol. Nauk [Characteristics of colonization resistance of the mucous membranes of the respiratory tract in bronchitis in children. PhD diss.]. Moscow; 2013. 119 p. (in Russian).

Lupal'tsova OS. Features of the microflora of the respiratory tract in children with respiratory pathology. In: Proceeding of the IV Scientific and Practical Conference of Students and Young Scientists on Modern Aspects of Infectious Pathology. 2014 Oct 13-15; Astrakhan, Russian Federation. Astrakhan; 2014. 94-99 pp. (in Russian).

Malanicheva TG, Ziatdinova NV. Perfection methods of treatment of reccurent bronchites at often painful children with an allowance of microbiocoenosis of nasopharynxes. Practical Medicine. 2009;(39):114-115. (in Russian).

Samatova EV. Microbiocenosis characteristics of the low respiratory tract at chronic infectious-inflammatory pulmonary diseases in children and antibiotic resistance of basic pathogens. Vestnik Ural'skoi Meditsinskoi Akademicheskoi Nauki. 2012;(38):45-50. (in Russian).

Kholodok GN. Mikrobiologicheskie i patogeneticheskie aspekty vnebol'nichnykh pnevmonii u detei. Diss. dokt. med. nauk [Microbiological and pathogenetic aspects of community-acquired pneumonia in children. Dr. med. sci. diss.]. Moscow; 2012. 41p. (in Russian).

Wills-Karp M, Santeliz J, Karp CL. The germless theory of allergic disease: revisiting the hygiene hypothesis. Nat Rev Immunol. 2001 Oct;1(1):69-75. doi: 10.1038/35095579.

Huang YJ, Nelson CE, Brodie EL, et al. Airway microbiota and bronchial hyperresponsiveness in patients with suboptimally controlled asthma. The Journal of allergy and clinical immunology. J Allergy Clin Immunol. 2011 Feb;127(2):372-381.e1-3. doi: 10.1016/j.jaci.2010.10.048.

Mckeever TM, Lewis SA, Smith C, et al. Early exposure to infections and antibiotics and the incidence of allergic disease: a birth cohort study with the West Midlands General Practice Research Database. J Allergy Clin Immunol. 2002 Jan;109(1):43-50.

Wjst M, Hoelscher B, Frye C, Wichmann HE, Dold S, Heinrich J. Early antibiotic treatment and later asthma. Eur J Med Res. 2001 Jun 28;6(6):263-71.

Droste JH, Wieringa MH, Weyler JJ, Nelen VJ, Vermeire PA, Van Bever HP. Does the use of antibiotics in early childhood increase the risk of asthma and allergic disease? Clin Exp Allergy. 2000 Nov;30(11):1547-53.

Bottcher MF, Nordin EK, Sandin A, Midtvedt T, Bjorksten B. Microflora-associated characteristics in faeces from allergic and nonallergic infants. Clin Exp Allergy. 2000 Nov;30(11):1590-6.

Kalliomaki M, Kirjavainen P, Eerola E, Kero P, Salminen S, Isolauri E. Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. J Allergy Clin Immunol. 2001 Jan;107(1):129-34. doi: 10.1067/mai.2001.111237.

Bjorksten B, Sepp E, Julge K, Voor T, Mikelsaar M. Allergy development and the intestinal microflora during the first year of life. J Allergy Clin Immunol. 2001 Oct;108(4):516-20. doi: 10.1067/mai.2001.118130.

Kirjavainen PV, Arvola T, Salminen SJ, Isolauri E. Aberrant composition of gut microbiota of allergic infants: a target of bifidobacterial therapy at weaning? Gut. 2002 Jul;51(1):51-5.

Noverr MC, Falkowski NR, Mcdonald RA, Mckenzie AN, Huffnagle GB. Development of allergic airway disease in mice following antibiotic therapy and fungal microbiota increase: role of host genetics, antigen, and interleukin-13. Infect Immun. 2005 Jan;73(1):30-8. doi: 10.1128/IAI.73.1.30-38.2005.

Noverr MC, Noggle RM, Toews GB, Huffnagle GB. Role of antibiotics and fungal microbiota in driving pulmonary allergic responses. Infect Immun. 2004 Sep;72(9):4996-5003. doi: 10.1128/IAI.72.9.4996-5003.2004.

Herbst T, Sichelstiel A, Schar C, et al. Dysregulation of allergic airway inflammation in the absence of microbial colonization. Am J Respir Crit Care Med. 2011 Jul 15;184(2):198-205. doi: 10.1164/rccm.201010-1574OC.

Copyright (c) 2018 CHILD`S HEALTH

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


© Publishing House Zaslavsky, 1997-2020


   Seo анализ сайта