Assessment of stability and fluctuations of cultured lower airway bacterial communities in people with cystic fibrosis.
Adolescent
Adult
Anti-Bacterial Agents
/ therapeutic use
Biota
/ drug effects
Child
Colony Count, Microbial
/ methods
Cystic Fibrosis
/ diagnosis
Disease Progression
Female
Humans
Lung
/ microbiology
Male
Microbiota
/ drug effects
Patient Acuity
Prognosis
Sputum
/ microbiology
Symptom Assessment
/ methods
Symptom Flare Up
Bacterial density
Bacterial ecology
Extended-quantitative culture
Sputum
Journal
Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society
ISSN: 1873-5010
Titre abrégé: J Cyst Fibros
Pays: Netherlands
ID NLM: 101128966
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
21
11
2018
revised:
26
02
2019
accepted:
26
02
2019
pubmed:
25
3
2019
medline:
11
11
2020
entrez:
26
3
2019
Statut:
ppublish
Résumé
Routine clinical culture detects a subset of the cystic fibrosis (CF) airways microbiota based on culture-independent (molecular) methods. This study aimed to determine how extended sputum culture of viable bacteria changes over time in relation to clinical status and predicts exacerbations. Sputa from patients at a baseline stable and up to three subsequent time-points were analysed by extended-quantitative culture; aerobe/anaerobe densities, ecological indexes and community structure were assessed together with clinical outcomes. Eighty patients were prospectively recruited. Sputa were successfully collected and cultured at 199/267 (74.5%) study visits. Eighty-two sputa from 25 patients comprised a complete sample-set for longitudinal analyses. Bacterial density, ecological indexes and clinical outcomes were unchanged in 18 patients with three sequential stable visits. Conversely, in 7 patients who had an exacerbation, total bacterial and aerobe densities differed over four study visits (P < .001) with this difference particularly apparent between the baseline visit and completion of acute antibiotic treatment where a decrease in density was observed. Bacterial communities were more similar within than between patients but stable patients had the least variation in community structure over time. Using logistic regression in a further analysis, baseline features in 37 patients without compared to 15 patients with a subsequent exacerbation showed that clinical measures rather than bacterial density or ecological indexes were independent predictors of an exacerbation. Greater fluctuation in the viable bacterial community during treatment of an exacerbation than between stable visits was observed. Extended-quantitative culture did not provide prognostic information of a future exacerbation.
Sections du résumé
BACKGROUND
Routine clinical culture detects a subset of the cystic fibrosis (CF) airways microbiota based on culture-independent (molecular) methods. This study aimed to determine how extended sputum culture of viable bacteria changes over time in relation to clinical status and predicts exacerbations.
METHODS
Sputa from patients at a baseline stable and up to three subsequent time-points were analysed by extended-quantitative culture; aerobe/anaerobe densities, ecological indexes and community structure were assessed together with clinical outcomes.
RESULTS
Eighty patients were prospectively recruited. Sputa were successfully collected and cultured at 199/267 (74.5%) study visits. Eighty-two sputa from 25 patients comprised a complete sample-set for longitudinal analyses. Bacterial density, ecological indexes and clinical outcomes were unchanged in 18 patients with three sequential stable visits. Conversely, in 7 patients who had an exacerbation, total bacterial and aerobe densities differed over four study visits (P < .001) with this difference particularly apparent between the baseline visit and completion of acute antibiotic treatment where a decrease in density was observed. Bacterial communities were more similar within than between patients but stable patients had the least variation in community structure over time. Using logistic regression in a further analysis, baseline features in 37 patients without compared to 15 patients with a subsequent exacerbation showed that clinical measures rather than bacterial density or ecological indexes were independent predictors of an exacerbation.
CONCLUSIONS
Greater fluctuation in the viable bacterial community during treatment of an exacerbation than between stable visits was observed. Extended-quantitative culture did not provide prognostic information of a future exacerbation.
Identifiants
pubmed: 30905581
pii: S1569-1993(19)30052-9
doi: 10.1016/j.jcf.2019.02.012
pmc: PMC6754815
mid: NIHMS1525162
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
808-816Subventions
Organisme : NHLBI NIH HHS
ID : P50 HL084934
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL092964
Pays : United States
Informations de copyright
Copyright © 2019 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
Références
Sci Rep. 2017 Sep 27;7(1):12350
pubmed: 28955051
Lancet. 2016 Nov 19;388(10059):2519-2531
pubmed: 27140670
Proc Natl Acad Sci U S A. 2012 Apr 10;109(15):5809-14
pubmed: 22451929
J Cyst Fibros. 2003 Mar;2(1):29-34
pubmed: 15463843
Eur Respir J. 2005 Aug;26(2):319-38
pubmed: 16055882
Environ Microbiol. 2010 May;12(5):1293-303
pubmed: 20192960
Am J Respir Crit Care Med. 2015 Dec 1;192(11):1314-24
pubmed: 26266556
J Pediatr. 2008 Aug;153(2):S4-S14
pubmed: 18639722
PLoS One. 2015 May 20;10(5):e0126980
pubmed: 25992575
Chest. 2005 Oct;128(4):2347-54
pubmed: 16236893
Eur Respir J. 2018 Jul 11;52(1):
pubmed: 29946004
Am J Respir Crit Care Med. 2008 Feb 1;177(3):253-60
pubmed: 18006882
Thorax. 2011 Jul;66(7):579-84
pubmed: 21270069
PLoS One. 2012;7(9):e45001
pubmed: 23049765
PLoS One. 2011;6(7):e22702
pubmed: 21829484
Thorax. 2016 Mar;71(3):216-22
pubmed: 25777587
Int J Antimicrob Agents. 2016 Feb;47(2):140-5
pubmed: 26774156
N Engl J Med. 1994 Sep 8;331(10):637-42
pubmed: 7503821
ISME J. 2016 May;10(5):1081-91
pubmed: 26555248
Chest. 2016 Dec;150(6):1323-1332
pubmed: 27395423
Eur Respir J. 2018 Jan 31;51(2):
pubmed: 29386349
PLoS Pathog. 2018 Jan 18;14(1):e1006798
pubmed: 29346420
PLoS One. 2010 Jun 23;5(6):e11044
pubmed: 20585638
Ann Am Thorac Soc. 2014 Sep;11(7):1049-55
pubmed: 25072206
Microbiome. 2015 Apr 01;3:12
pubmed: 25834733
Thorax. 2006 Nov;61(11):969-74
pubmed: 16844728
Am J Respir Crit Care Med. 2008 May 1;177(9):995-1001
pubmed: 18263800
Respir Res. 2010 Oct 08;11:140
pubmed: 20932301