Is the Improvement of CF Patients, Hospitalized for Pulmonary Exacerbation, Correlated to a Decrease in Bacterial Load?

Deschaght, Pieter; Schelstraete, Petra; Simaey, Leen Van; Vanderkercken, Marleen; Raman, A.; Mahieu, L.; Daele, S. Van; Baets, Frans De; Vaneechoutte, Mario

doi:10.1371/journal.pone.0079010

Cited by 29 publications

(43 citation statements)

References 35 publications

(29 reference statements)

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“…Some studies find little change (Fodor et al, 2012;Deschaght et al, 2013;Price et al, 2013), while others are finding fluctuations in anaerobic microbial abundance (Carmody et al, 2013;Deschaght et al, 2013;Twomey et al, 2013;Zemanick et al, 2013). The WinCF system demonstrated that obligate anaerobes are abundant prior to exacerbation and actively fermenting.…”

Section: Resultsmentioning

confidence: 99%

A Winogradsky-based culture system shows an association between microbial fermentation and cystic fibrosis exacerbation

et al. 2014

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There is a poor understanding of how the physiology of polymicrobial communities in cystic fibrosis (CF) lungs contributes to pulmonary exacerbations and lung function decline. In this study, a microbial culture system based on the principles of the Winogradsky column (WinCF system) was developed to study the physiology of CF microbes. The system used glass capillary tubes filled with artificial sputum medium to mimic a clogged airway bronchiole. Chemical indicators were added to observe microbial physiology within the tubes. Characterization of sputum samples from seven patients showed variation in pH, respiration, biofilm formation and gas production, indicating that the physiology of CF microbial communities varied among patients. Incubation of homogenized tissues from an explant CF lung mirrored responses of a Pseudomonas aeruginosa pure culture, supporting evidence that end-stage lungs are dominated by this pathogen. Longitudinal sputum samples taken through two exacerbation events in a single patient showed that a two-unit drop in pH and a 30% increase in gas production occurred in the tubes prior to exacerbation, which was reversed with antibiotic treatment. Microbial community profiles obtained through amplification and sequencing of the 16S rRNA gene showed that fermentative anaerobes became more abundant during exacerbation and were then reduced during treatment where P. aeruginosa became the dominant bacterium. Results from the WinCF experiments support the model where two functionally different CF microbial communities exist, the persistent Climax Community and the acute Attack Community. Fermentative anaerobes are hypothesized to be the core members of the Attack Community and production of acidic and gaseous products from fermentation may drive developing exacerbations. Treatment targeting the Attack Community may better resolve exacerbations and resulting lung damage.

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Section: Resultsmentioning

confidence: 99%

A Winogradsky-based culture system shows an association between microbial fermentation and cystic fibrosis exacerbation

et al. 2014

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“…2007/503). Study was performed in accordance with approved national and international guidelines; written informed consent was obtained from all the patients > 18 years or from the parents and children older than 12 years, as previously reported [16,17]. …”

Section: Methodsmentioning

confidence: 99%

“…aeruginosa [1], and received the same antimicrobial treatment: Tazocin ® (Piperacillin/Tazobactam 4000mg/500mg) by intravenous administration during 15 days. Sputum samples were collected as previously reported [16,17]. …”

Section: Methodsmentioning

confidence: 99%

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Effects of Propidium Monoazide (PMA) Treatment on Mycobiome and Bacteriome Analysis of Cystic Fibrosis Airways during Exacerbation

et al. 2016

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Introduction and PurposePropidium monoazide (PMA)-pretreatment has increasingly been applied to remove the bias from dead or damaged cell artefacts, which could impact the microbiota analysis by high-throughput sequencing. Our study aimed to determine whether a PMA-pretreatment coupled with high-throughput sequencing analysis provides a different picture of the airway mycobiome and bacteriome.Results and DiscussionWe compared deep-sequencing data of mycobiota and microbiota of 15 sputum samples from 5 cystic fibrosis (CF) patients with and without prior PMA-treatment of the DNA-extracts. PMA-pretreatment had no significant effect on the entire and abundant bacterial community (genera expressed as operational taxonomic units (OTUs) with a relative abundance greater than or equal to 1%), but caused a significant difference in the intermediate community (less than 1%) when analyzing the alpha biodiversity Simpson index (p = 0.03). Regarding PMA impact on the airway mycobiota evaluated for the first time here; no significant differences in alpha diversity indexes between PMA-treated and untreated samples were observed. Regarding beta diversity analysis, the intermediate communities also differed more dramatically than the total and abundant ones when studying both mycobiome and bacteriome. Our results showed that only the intermediate (or low abundance) population diversity is impacted by PMA-treatment, and therefore that abundant taxa are mostly viable during acute exacerbation in CF. Given such a cumbersome protocol (PMA-pretreatment coupled with high-throughput sequencing), we discuss its potential interest within the follow-up of CF patients. Further studies using PMA-pretreatment are warranted to improve our “omic” knowledge of the CF airways.

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“…A number of research groups have studied the microbiota changes that occur around exacerbations. 61, 62 The use of antibiotics is associated with mortality benefits when treating severe exacerbations in both CF and COPD, however their use would seemingly disrupt a healthy diversity in the lower lung fields. This question has been addressed by Price and others who tracked CF patients during treatment of an exacerbation and monitored the relative amounts of individual species and the change in diversity over the course of a single exacerbation.…”

Section: The Lower Airways As An Ecosystemmentioning

confidence: 99%

Understanding Persistent Bacterial Lung Infections

Pragman

Berger

Williams

2016

Clinical Pulmonary Medicine

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The infections found in chronic obstructive pulmonary disease, cystic fibrosis, and bronchiectasis share a number of clinical similarities, the most striking of which is bacterial persistence despite the use of antibiotics. These infections have been clinically described using culture-based methods usually performed on sputum samples, and treatment has been directed towards the bacteria found in this manner. Unfortunately the clinical response to antibiotics is frequently not predictable based on these cultures, and the role of these cultured organisms in disease progression has been debated. The past 20 years have seen a revolution in the techniques used to describe bacterial populations and their growth patterns. These techniques have revealed these persistent lung infections are vastly more complicated than described by traditional, and still widely relied upon, sputum cultures. A better understanding of the initiation and evolution of these infections, and better clinical tools to describe them, will dramatically alter the way patients are cared for. While clinical tests to more accurately describe these infections are not yet available, the better appreciation of these infections afforded by current science should enlighten practitioners as to the care of their patients with these diseases.

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Is the Improvement of CF Patients, Hospitalized for Pulmonary Exacerbation, Correlated to a Decrease in Bacterial Load?

Cited by 29 publications

References 35 publications

A Winogradsky-based culture system shows an association between microbial fermentation and cystic fibrosis exacerbation

A Winogradsky-based culture system shows an association between microbial fermentation and cystic fibrosis exacerbation

Effects of Propidium Monoazide (PMA) Treatment on Mycobiome and Bacteriome Analysis of Cystic Fibrosis Airways during Exacerbation

Understanding Persistent Bacterial Lung Infections

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