Lung Microbiota and Bacterial Abundance in Patients with Bronchiectasis when Clinically Stable and during Exacerbation
Lung Microbiota and Bacterial Abundance in Patients with Bronchiectasis when Clinically Stable and during Exacerbation
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DOI：
10.1164/rccm.201210-1937oc
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发表时间：
2013-05-15
影响因子：
24.7
通讯作者：
Elborn, J. Stuart
中科院分区：
文献类型：
--
作者：
Tunney, Michael M.;Einarsson, Gisli G.;Elborn, J. Stuart
基本原理：感染性呼吸道疾病中细菌种群的表征将提供对肺微生物群、疾病发病机制和治疗outcomes.Objectives之间关系的更好理解：全面定义支气管扩张患者病情稳定和加重期间的肺微生物群组成。细菌丰度和社区组成进行了分析，采用厌氧培养和16 S rDNA焦磷酸sequencing. Measures和主要结果：在临床稳定的患者，需氧菌和厌氧菌检测40 40（100%）和33 40（83%）痰标本，分别。培养的优势微生物为铜绿假单胞菌（n = 10例患者）、流感嗜血杆菌（n = 12）、普雷沃菌（n = 18）和韦荣球菌（n = 13）。焦磷酸测序产生了超过150，000个序列，代表113个不同的微生物分类群;观察到的大多数群落丰富度是由于在临床稳定患者和急性发作患者中以低丰度存在的分类群，具有相似的门分布模式。急性加重治疗后，总负荷（P = 0.925）、有氧负荷（P = 0.917）或无氧负荷（P = 0.683）均无变化，社区组成仅发生有限变化。通过培养和焦磷酸测序检测细菌的一致性对于需氧菌如铜绿假单胞菌（Kappa = 0.84）是好的，但对于包括厌氧菌的其他属较差。缺乏一致性主要是由于细菌被检测到焦磷酸测序，而不是culture.Conclusions：一个复杂的微生物群是存在于支气管扩张症患者的肺部，并保持稳定，通过治疗病情加重，这表明微生物群组成的变化不占病情加重。
Rationale: Characterization of bacterial populations in infectious respiratory diseases will provide improved understanding of the relationship between the lung microbiota, disease pathogenesis, and treatment outcomes.Objectives: To comprehensively define lung microbiota composition during stable disease and exacerbation in patients with bronchiectasis.Methods: Sputum was collected from patients when clinically stable and before and after completion of antibiotic treatment of exacer-bations. Bacterial abundance and community composition were analyzed using anaerobic culture and 16S rDNA pyrosequencing.Measurements and Main Results: In clinically stable patients, aerobic and anaerobic bacteria were detected in 40 of 40 (100%) and 33 of 40 (83%) sputum samples, respectively. The dominant organisms cultured were Pseudomonas aeruginosa (n = 10 patients), Haemophilus influenzae (n = 12), Prevotella (n = 18), and Veillonella (n = 13). Pyrosequencing generated more than 150,000 sequences, representing 113 distinct microbial taxa; the majority of observed community richness resulted from taxa present in low abundance with similar patterns of phyla distribution in clinically stable patients and patients at the onset of exacerbation. After treatment of exacerbation, there was no change in total (P = 0.925), aerobic (P = 0.917), or anaerobic (P = 0.683) load and only a limited shift in community composition. Agreement for detection of bacteria by culture and pyrosequencing was good for aerobic bacteria such as P. aeruginosa (kappa = 0.84) but poorer for other genera including anaerobes. Lack of agreement was largely due to bacteria being detected by pyrosequencing but not by culture.Conclusions: A complex microbiota is present in the lungs of patients with bronchiectasis and remains stable through treatment of exacerbations, suggesting that changes in microbiota composition do not account for exacerbations.