Airway bacterial community composition in persons with advanced cystic fibrosis lung disease.
Airway bacterial community composition in persons with advanced cystic fibrosis lung disease.
复制标题
晚期囊性纤维化肺病患者的气道细菌群落组成。
DOI：
10.1016/j.jcf.2023.01.001
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
LiPuma,JohnJ
中科院分区：
文献类型：
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作者：
Thornton,ChristinaS;Carmody,LisaA;Kalikin,LindaM;Opron,Kristopher;Caverly,LindsayJ;LiPuma,JohnJ
背景囊性纤维化（pwCF）患者肺部疾病的进展与气道细菌群落多样性的减少有关。然而，低多样性群落在晚期 CF 肺病中出现的频率以及它们与临床结果的关系尚不清楚。方法我们对细菌 16S 核糖体 RNA 基因的一个区域进行了测序，以表征 190 个患有晚期 CF 肺病（FEV1≤40% 预测值）的 pwCF 痰液中的细菌群落，特别关注优势属的患病率和相对丰度。我们评估了群落多样性与临床结果之间的关系。结果尽管 190 例患有晚期肺病的 pwCF 中大多数气道细菌群落的特点是多样性低且占优势属，但相当少数 (40%) 则不然。优势属的缺失、甲氧西林敏感金黄色葡萄球菌的存在以及细菌丰富度的增加与肺功能呈正相关。优势属的较高相对丰度和更多的抗菌药物使用与肺功能呈负相关。与那些没有低多样性群落和优势属的 PwCF 相比，具有低多样性群落和优势属的 PwCF 的无肺移植生存率较低（中位生存期分别为 1.6 年和 2.9 年）。 结论 相当一部分患有晚期肺病的 PwCF 不具有以低多样性和优势属为特征的气道细菌群落，这些个体的生存率更高。了解低多样性气道群落的前因及其对肺部疾病轨迹可能产生的影响可能为改进管理策略提供途径。
BackgroundThe progression of lung disease in people with cystic fibrosis (pwCF) has been associated with a decrease in the diversity of airway bacterial communities. How often low diversity communities occur in advanced CF lung disease and how they may be associated with clinical outcomes is not clear, however.MethodsWe sequenced a region of the bacterial 16S ribosomal RNA gene to characterize bacterial communities in sputum from 190 pwCF with advanced lung disease (FEV1≤40% predicted), with particular attention to the prevalence and relative abundance of dominant genera. We evaluated relationships between community diversity and clinical outcomes.ResultsAlthough most of the 190 pwCF with advanced lung disease had airway bacterial communities characterized by low diversity with a dominant genus, a considerable minority (40%) did not. The absence of a dominant genus, presence of methicillin-susceptibleStaphylococcus aureus, and greater bacterial richness positively correlated with lung function. Higher relative abundance of the dominant genus and greater antimicrobial use negatively correlated with lung function. PwCF with a low diversity community and dominant genus had reduced lung transplant-free survival compared to those without (median survival of 1.6 vs 2.9 years).ConclusionsA considerable proportion of pwCF with advanced lung disease do not have airway bacterial communities characterized by low diversity and a dominant genus and these individuals had better survival. An understanding of the antecedents of low diversity airway communities– and the impact these may have on lung disease trajectory - may provide avenues for improved management strategies.