The microbiota in bronchoalveolar lavage from young children with chronic lung disease includes taxa present in both the oropharynx and nasopharynx.
The microbiota in bronchoalveolar lavage from young children with chronic lung disease includes taxa present in both the oropharynx and nasopharynx.
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DOI：
10.1186/s40168-016-0182-1
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发表时间：
2016-07-07
期刊：
影响因子：
15.5
通讯作者：
Smith-Vaughan HC
中科院分区：
文献类型：
--
作者：
Marsh RL;Kaestli M;Chang AB;Binks MJ;Pope CE;Hoffman LR;Smith-Vaughan HC
需要全身麻醉的侵入性方法需要对没有咳痰的幼儿的肺微生物群进行取样。这对儿童气道微生物群的纵向研究提出了重大挑战。非侵入性上呼吸道取样是监测气道微生物群的一种替代方法；然而，描述这些结果与幼儿肺部微生物群之间关系的数据有限。在这项研究中，我们比较了幼儿上呼吸道和下呼吸道的微生物群，以确定非侵入性上呼吸道取样程序是否提供了可靠的肺微生物群测量或临床定义的差异。采用16S rRNA基因测序方法对78名有或无肺部疾病的儿童（中位年龄2.2岁）的口咽（OP）拭子、鼻咽（NP）拭子和支气管肺泡灌洗液（BAL）中的微生物群进行了表征。排列多变量方差分析（peromova）检测到BAL与OP拭子（p = 0.0001, Pseudo-F = 12.2, df = 1）和NP拭子（p = 0.0001, Pseudo-F = 21.9, df = 1）的微生物群差异显著，NP和BAL的微生物群差异大于OP和BAL，其Pseudo-F值较高。OP和NP联合数据（上呼吸道）中的微生物群提供了更全面的BAL微生物群代表，但上呼吸道和BAL微生物群之间仍然存在显著差异，尽管Pseudo-F相当小（PERMANOVA p = 0.0001; Pseudo-F = 4.9, df = 1）。尽管存在总体差异，但在69%的儿童中，配对的BAL和上呼吸道（OP和NP）微生物群相似度为50%。此外，主坐标的典型分析（CAP分析）发现，在分析BAL（特征值>0.8，错分类率26.5%）或OP和NP联合数据（特征值>0.8，错分类率12.2%）时，临床定义组的微生物群之间存在显著差异。在本研究中，上呼吸道取样为大多数儿童提供了不完善但可靠的BAL微生物群代表。我们建议，当需要对没有咳痰的幼儿进行非侵入性上呼吸道取样以评估气道微生物群时，同时包括OP和NP标本。CAP分析的结果表明，下呼吸道和上呼吸道微生物群谱可以区分慢性化脓性肺病儿童和持续性细菌性支气管炎儿童；然而，需要进一步的研究来证实这一观察结果。本文的在线版本（doi:10.1186/s40168-016-0182-1）包含补充材料，可供授权用户使用。
Invasive methods requiring general anaesthesia are needed to sample the lung microbiota in young children who do not expectorate. This poses substantial challenges to longitudinal study of paediatric airway microbiota. Non-invasive upper airway sampling is an alternative method for monitoring airway microbiota; however, there are limited data describing the relationship of such results with lung microbiota in young children. In this study, we compared the upper and lower airway microbiota in young children to determine whether non-invasive upper airway sampling procedures provide a reliable measure of either lung microbiota or clinically defined differences. The microbiota in oropharyngeal (OP) swabs, nasopharyngeal (NP) swabs and bronchoalveolar lavage (BAL) from 78 children (median age 2.2 years) with and without lung disease were characterised using 16S rRNA gene sequencing. Permutational multivariate analysis of variance (PERMANOVA) detected significant differences between the microbiota in BAL and those in both OP swabs (p = 0.0001, Pseudo-F = 12.2, df = 1) and NP swabs (p = 0.0001; Pseudo-F = 21.9, df = 1) with the NP and BAL microbiota more different than the OP and BAL, as indicated by a higher Pseudo-F value. The microbiota in combined OP and NP data (upper airways) provided a more comprehensive representation of BAL microbiota, but significant differences between the upper airway and BAL microbiota remained, albeit with a considerably smaller Pseudo-F (PERMANOVA p = 0.0001; Pseudo-F = 4.9, df = 1). Despite this overall difference, paired BAL and upper airway (OP and NP) microbiota were >50 % similar among 69 % of children. Furthermore, canonical analysis of principal coordinates (CAP analysis) detected significant differences between the microbiota from clinically defined groups when analysing either BAL (eigenvalues >0.8; misclassification rate 26.5 %) or the combined OP and NP data (eigenvalues >0.8; misclassification rate 12.2 %). Upper airway sampling provided an imperfect, but reliable, representation of the BAL microbiota for most children in this study. We recommend inclusion of both OP and NP specimens when non-invasive upper airway sampling is needed to assess airway microbiota in young children who do not expectorate. The results of the CAP analysis suggest lower and upper airway microbiota profiles may differentiate children with chronic suppurative lung disease from those with persistent bacterial bronchitis; however, further research is needed to confirm this observation. The online version of this article (doi:10.1186/s40168-016-0182-1) contains supplementary material, which is available to authorized users.