Ponsford M, Price C, Farewell D, et al. - Given an increased risk of respiratory tract infections among patients with primary antibody deficiency (PAD), researchers sought to report on the symptomatic and microbial burden of upper airway infection in adults with PAD relative to age-matched controls. They conducted a prospective 12-month observational study consisting of a daily upper and lower airway symptom score alongside molecular detection of 19 pathogen targets nasal swab collected fortnightly. Recruitment of 44 patients and 42 controls (including 34 household pairs) was done; these provided over 22,500 days of symptom scores and 1,496 nasal swabs. Observations revealed that despite frequent use of prophylactic antibiotics and individualised IgRT dosing, cases had recurrent chronic upper respiratory infection and symptoms from a restricted pathogen subset. PAD patients had raised odds ratio (OR) for pathogen detection, especially viral, specifically human rhinovirus HRV, and parainfluenza. In addition, patients with PAD more frequently had H. influenzae and S. pneumonia. Following were independent risk factors for viral detection: young child exposure, IgM deficiency, and presence of bronchiectasis. A lower risk of bacterial detection by PCR was noted in correlation with using prophylactic antibiotics