Institut Pasteur, Université Paris Cité, Biologie des Bactéries Intracellulaires, Paris, France; CNRS UMR 6047, 75724 Paris, France.
Hospices Civils de Lyon, Centre National de Référence des Légionelles, Bron, France; Centre International de Recherche en Infectiologie, Université Lyon 1, UMR CNRS 5308, U1111 Inserm, École Normale Supérieure de Lyon, Lyon, France.
Cell Rep Med. 2023 Sep 19;4(9):101167. doi: 10.1016/j.xcrm.2023.101167. Epub 2023 Aug 25.
Bacterial pneumonia is a considerable problem worldwide. Here, we follow the inter-kingdom respiratory tract microbiome (RTM) of a unique cohort of 38 hospitalized patients (n = 97 samples) with pneumonia caused by Legionella pneumophila. The RTM composition is characterized by diversity drops early in hospitalization and ecological species replacement. RTMs with the highest bacterial and fungal loads show low diversity and pathogen enrichment, suggesting high biomass as a biomarker for secondary and/or co-infections. The RTM structure is defined by a "commensal" cluster associated with a healthy RTM and a "pathogen" enriched one, suggesting that the cluster equilibrium drives the microbiome to recovery or dysbiosis. Legionella biomass correlates with disease severity and co-morbidities, while clinical interventions influence the RTM dynamics. Fungi, archaea, and protozoa seem to contribute to progress of pneumonia. Thus, the interplay of the RTM equilibrium, the pathogen load dynamics, and clinical interventions play a critical role in patient recovery.
细菌性肺炎是一个全球性的重大问题。在这里，我们对由嗜肺军团菌引起肺炎的 38 名住院患者（n=97 个样本）这一独特队列的种间呼吸道微生物组（RTM）进行了研究。RTM 的组成特点是住院早期多样性下降，以及生态物种替代。具有最高细菌和真菌负荷的 RTM 表现出低多样性和病原体富集，表明高生物量是继发和/或合并感染的生物标志物。RTM 的结构由与健康 RTM 相关的“共生”簇和富含病原体的簇定义，这表明簇平衡促使微生物组恢复或出现微生态失调。军团菌生物量与疾病严重程度和合并症相关，而临床干预会影响 RTM 动态。真菌、古菌和原生动物似乎有助于肺炎的进展。因此，RTM 平衡、病原体负荷动态和临床干预的相互作用在患者康复中起着关键作用。
