Reduced Bacterial Colony Count of Anaerobic Bacteria Is Associated with a Worsening in Lung Clearance Index and Inflammation in Cystic Fibrosis

O’Neill, Katherine; Bradley, J.M.; Johnston, E.; McGrath, Stephanie; McIlreavey, Leanne; Rowan, Stephen; Reid, Alastair; Bradbury, Ian; Einarsson, G.G.; Elborn, J. Stuart; Tunney, Michael

doi:10.1371/journal.pone.0126980

Cited by 51 publications

(58 citation statements)

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“…The relative abundance of some recognized pathogens showed positive relationships with some HRCT and clinical measures, whereas negative relationships were seen between the abundance of anaerobic organisms, HRCT and clinical measures. Such organisms have previously been associated with milder lung disease in CF . Results from this study in BE suggest a similar picture.…”

Section: Discussionsupporting

confidence: 79%

Composition of airway bacterial community correlates with chest HRCT in adults with bronchiectasis

et al. 2019

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Background and objective In bronchiectasis (BE) not caused by cystic fibrosis, chronic, polymicrobial airway infection contributes to the underlying pathogenesis of disease. There is little information on whether bacterial community composition relates to clinical status. We determined the relationship between bacterial community composition, chest high‐resolution computed tomography (HRCT) scores and clinical markers in BE. Methods A subgroup of BE patients from a previous cross‐sectional study were analysed. Spontaneously expectorated sputum was analysed using culture‐independent sequencing on the Roche 454‐FLX platform covering the V1–V3 region of the 16S rRNA marker gene. Chest HRCT scans, multiple breath washout, spirometry and blood inflammatory markers were collected. Spearman's rank (r) correlation coefficient was used to assess relationships. Results Data from 21 patients were analysed (mean (SD) age: 64.0 (7.7); female : male 14:7; mean (SD) forced expiratory volume in 1 s (FEV1): 76.5 (17.2)). All bacterial community composition metrics (bacterial richness, diversity, evenness and dominance) correlated with percentage BE score, with more severe HRCT abnormality relating to lower bacterial richness, evenness and diversity (range r = −0.47 to −0.66; P < 0.05). Inflammation (C‐reactive protein and white cell count) was greater in patients with lower diversity and richness (range r = −0.44 to −0.47; P < 0.05). Bacterial community characteristics did not correlate with lung function. Conclusion This is the first study to indicate a relationship between bacterial community characteristics by 16S rRNA marker gene sequencing, structural damage as determined by chest HRCT and clinical measures in BE. The association between loss of diversity and chest HRCT severity suggests that bacterial dominance with pathogenic bacteria may contribute to disease pathology.

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Section: Discussionsupporting

confidence: 79%

Composition of airway bacterial community correlates with chest HRCT in adults with bronchiectasis

et al. 2019

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“…It is worth emphasizing that there are several reports in which the relationship between LCI outcomes and pulmonary infections was investigated . Many studies already describe the difference in LCI results in CF patients with and without P. aeruginosa infection …”

Section: Discussionmentioning

confidence: 99%

Change in lung clearance index with microbiological status in children with cystic fibrosis

Walicka‐Serzysko¹,

Postek²,

Milczewska³

et al. 2019

Pediatric Pulmonology

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The impact of infections caused by bacteria, especially Gram‐negative, on the progression of lung disease in cystic fibrosis is well established. Decline in pulmonary function commence already at early age. In this group of patients, the lung clearance index seems to be a better marker than FEV1 allowing non‐invasive monitoring of changes in small airways. The aim of this study was to investigate the association between the microbiological status and LCI derived from multiple breath washout (MBW) technique as well as FEV1 and FVC in children suffering from cystic fibrosis. Over the 1‐year recruitment period, 136 CF patients aged 5‐18 with: Staphylococcus aureus (n‐27), Pseudomonas aeruginosa (first time (n‐27), intermittent (n‐9), and chronic (34) infection), Aspergillus fumigatus (n‐6) and without pathogenic flora (n‐33) were included in the study. Patients had performed a spirometry and MBW test during the visit at outpatient clinic. The study showed that the lung clearance index in patients infected with Aspergillus fumigatus was significantly higher (P < 0.05) than in those with normal throat flora. There was also statistically significant differences in the lung clearance index obtained in subjects with chronic Pseudomonas aeruginosa infection and those with first Pseudomonas aeruginosa infection (P < 0.05). Furthermore, significant statistical differences (P < 0.05) were observed between the groups of patients with chronic Pseudomonas aeruginosa infection FEV1 > 70% and FEV1 < 70%. In conclusion, LCI was associated with microbiological status of CF patients. Chronic lung infections, especially Aspergillus fumigatus and Pseudomonas aeruginosa, were associated with increased LCI. Early eradication of pathological flora positively affects the maintenance of lower LCI.

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“…Streptococcus , Prevotella , Veillonella , and Neisseria are the most common and abundant genera in the lower airways in young CF patients as well as in healthy people [17, 20, 22, 53, 55]. A high intra-individual variation in the structure of the microbiome was highlighted in different studies, mostly because the lung is a heterogeneous niche and does not possess a homogeneous microbiome [56–59].…”

Section: Reviewmentioning

confidence: 99%

“…The same pattern is likely to occur with the emerging atypical CF pathogens like S. maltophilia and A. xylosoxidans , non-tuberculous mycobacteria, and fungi [5]. High dominance of one species correlates with a decrease in diversity, anaerobe load, and lung function [10, 55, 62]. …”

Section: Reviewmentioning

confidence: 99%

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Acquisition and adaptation of the airway microbiota in the early life of cystic fibrosis patients

Boutin

Dalpke

2017

Mol Cell Pediatr

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Cystic fibrosis (CF) is a genetic disease in which bacterial infections of the airways play a major role in the long-term clinical outcome. In recent years, a number of next-generation sequencing (NGS)-based studies aimed at deciphering the structure and composition of the airways’ microbiota. It was shown that the nasal cavity of CF patients displays dysbiosis early in life indicating a failure in the first establishment of a healthy microbiota. In contrast, within the conducting and lower airways, the establishment occurs normally first, but is sensitive to future dysbiosis including chronic infections with classical pathogens in later life. The objective of this mini-review is to give an update on the current knowledge about the development of the microbiota in the early life of CF patients. Microbial acquisition in the human airways can be described by the island model: Microbes found in the lower airways of CF patients represent “islands” that are at first populated from the upper airways reflecting the “mainland.” Colonization can be modeled following the neutral theory in which the most abundant bacteria in the mainland are also frequently found in the lower airways initially. At later times, however, the colonization process of the lower airways segregates by active selection of specific microbes. Future research should focus on those processes of microbial and host interactions to understand how microbial communities are shaped on short- and long-term scales. We point out what therapeutic consequences arise from the microbiome data obtained within ecological framework models.

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Reduced Bacterial Colony Count of Anaerobic Bacteria Is Associated with a Worsening in Lung Clearance Index and Inflammation in Cystic Fibrosis

Cited by 51 publications

References 34 publications

Composition of airway bacterial community correlates with chest HRCT in adults with bronchiectasis

Composition of airway bacterial community correlates with chest HRCT in adults with bronchiectasis

Change in lung clearance index with microbiological status in children with cystic fibrosis

Acquisition and adaptation of the airway microbiota in the early life of cystic fibrosis patients

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