Abstract
According to the literature, there is evidence of an association between the development of asthma and the microbiome. Here, this systematic review aimed to study the role of microbes in developing pediatric asthma. This systemic literature review was conducted comprehensively on the PubMed database between 2013 and June 2023 to explore the role of airway microbiome in developing pediatric asthma. The general search keywords used were: [(Asthma) AND (children)] AND (Airway microbiome). The inclusion criteria were sufficient details on the role of airway microbiome in developing pediatric asthma. Meanwhile, the exclusion criteria were studies discussing the role of airway microbiome in developing pediatric asthma in adults, case reports, letters, reviews, and studies published in languages other than English. Our search identified 34 articles obtained from the PubMed database. After the full-text inspection, only five studies met the inclusion criteria for the systematic review. The sample size of the study subjects was 679 children ranging from 0 to 16 years. The study designs included integrated clinical, systematic integrative, prospective observational, and cohort studies. Microorganisms were detected from the nasopharyngeal, nasal, bronchial airways, oropharynx, hypopharynx, and nostrils. Regarding the detected microbes, Staphylococcus aureus was detected in one study, Streptococcus in two studies, and Streptococcus pneumonia and Moraxella catarrhalis were found in two studies. The review concluded that bacterial infections, particularly those caused by Streptococcus pneumoniae, Haemophilus influenzae, M. catarrhalis, and viral infections (mainly rhinovirus and respiratory syncytial virus), have been associated with increased asthma development among children. Further studies are needed to understand microbial infection mechanisms for developing pediatric asthma.

Key words: Asthma, Pneumonia, Pediatrics, Microbes, Viral infections, Bacterial infections.