Cystic Fibrosis and Airways Microbiology Research Group, School of Medicine, Dentistry, and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.
Am J Respir Crit Care Med. 2013 May 15;187(10):1118-26. doi: 10.1164/rccm.201210-1937OC.
Characterization of bacterial populations in infectious respiratory diseases will provide improved understanding of the relationship between the lung microbiota, disease pathogenesis, and treatment outcomes.
To comprehensively define lung microbiota composition during stable disease and exacerbation in patients with bronchiectasis.
Sputum was collected from patients when clinically stable and before and after completion of antibiotic treatment of exacerbations. Bacterial abundance and community composition were analyzed using anaerobic culture and 16S rDNA pyrosequencing.
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 (κ = 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.
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.
对感染性呼吸道疾病中细菌种群的特征进行描述，将有助于我们更好地理解肺部微生物群、疾病发病机制和治疗结果之间的关系。
全面描述支气管扩张症患者在疾病稳定期和加重期时肺部微生物群的组成。
当患者临床状况稳定时、以及在加重期抗生素治疗前后采集其痰液样本。使用厌氧培养和 16S rDNA 焦磷酸测序分析细菌丰度和群落组成。
在临床稳定的患者中，40 份痰液样本（100%）中分别检测到需氧菌和厌氧菌，33 份（83%）样本中可培养出细菌。培养出的主要病原体包括铜绿假单胞菌（10 例患者）、流感嗜血杆菌（12 例）、普雷沃氏菌属（18 例）和韦荣球菌属（13 例）。焦磷酸测序产生了 150000 多个序列，代表了 113 个不同的微生物类群；观察到的群落丰富度主要来自低丰度的分类群，且在临床稳定患者和加重期患者中具有相似的菌群分布模式。加重期治疗后，总负荷（P = 0.925）、需氧菌（P = 0.917）或厌氧菌（P = 0.683）均无变化，群落组成也仅有有限的变化。培养和焦磷酸测序检测细菌的一致性很好，如铜绿假单胞菌（κ = 0.84），但对于其他属（包括厌氧菌）的一致性较差。一致性差主要是由于某些细菌可通过焦磷酸测序检测到，但不能通过培养检测到。
支气管扩张症患者肺部存在复杂的微生物群，且在加重期治疗过程中保持稳定，这表明微生物群组成的变化不是加重的原因。
