肺炎检查仪，一种新型的气溶胶收集装置，可捕获空气中的结核分枝杆菌，并对肺结核患者的咳嗽气微生物组进行特征分析。
PneumoniaCheck, a novel aerosol collection device, permits capture of airborne Mycobacterium tuberculosis and characterisation of the cough aeromicrobiome in people with tuberculosis.
机构信息
DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, SAMRC Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, 7505, South Africa.
African Microbiome Institute, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, 7505, South Africa.
出版信息
Ann Clin Microbiol Antimicrob. 2024 Aug 22;23(1):74. doi: 10.1186/s12941-024-00735-x.
BACKGROUND
Tuberculosis (TB), a major cause of disease and antimicrobial resistance, is spread via aerosols. Aerosols have diagnostic potential and airborne-microbes other than Mycobacterium tuberculosis complex (MTBC) may influence transmission. We evaluated whether PneumoniaCheck (PMC), a commercial aerosol collection device, captures MTBC and the aeromicrobiome of people with TB.
METHODS
PMC was done in sputum culture-positive people (≥ 30 forced coughs each, n = 16) pre-treatment and PMC air reservoir (bag, corresponding to upper airways) and filter (lower airways) washes underwent Xpert MTB/RIF Ultra (Ultra) and 16S rRNA gene sequencing (sequencing also done on sputum). In a subset (n = 6), PMC microbiota (bag, filter) was compared to oral washes and bronchoalveolar lavage fluid (BALF).
FINDINGS
54% (7/13) bags and 46% (6/14) filters were Ultra-positive. Sequencing read counts and microbial diversity did not differ across bags, filters, and sputum. However, microbial composition in bags (Sphingobium-, Corynebacterium-, Novosphingobium-enriched) and filters (Mycobacterium-, Sphingobium-, Corynebacterium-enriched) each differed vs. sputum. Furthermore, sequencing only detected Mycobacterium in bags and filters but not sputum. In the subset, bag and filter microbial diversity did not differ vs. oral washes or BALF but microbial composition differed. Bags vs. BALF were Sphingobium-enriched and Mycobacterium-, Streptococcus-, and Anaerosinus-depleted (Anaerosinus also depleted in filters vs. BALF). Compared to BALF, none of the aerosol-enriched taxa were enriched in oral washes or sputum.
INTERPRETATION
PMC captures aerosols with Ultra-detectable MTBC and MTBC is more detectable in aerosols than sputum by sequencing. The aeromicrobiome is distinct from sputum, oral washes and BALF and contains differentially-enriched lower respiratory tract microbes.
背景
结核病（TB）是一种主要的疾病和抗微生物药物耐药性的原因，通过气溶胶传播。气溶胶具有诊断潜力，除结核分枝杆菌复合体（MTBC）以外的空气中微生物可能会影响传播。我们评估了 PneumoniaCheck（PMC），一种商业性气溶胶收集装置，是否可以捕获 MTBC 和患有结核病的人的空气微生物组。
方法
在治疗前，对痰培养阳性的人（每次 30 次用力咳嗽，n=16）进行 PMC，然后对 PMC 空气储存器（袋，对应上呼吸道）和过滤器（下呼吸道）进行冲洗，进行 Xpert MTB/RIF Ultra（Ultra）和 16S rRNA 基因测序（也对痰液进行测序）。在一个亚组（n=6）中，PMC 微生物组（袋，过滤器）与口腔冲洗液和支气管肺泡灌洗液（BALF）进行比较。
结果
54%（7/13）的袋子和 46%（6/14）的过滤器 Ultra 阳性。袋子、过滤器和痰液的测序读长计数和微生物多样性没有差异。然而，袋子（富含鞘氨醇单胞菌、棒状杆菌、新鞘氨醇单胞菌）和过滤器（富含分枝杆菌、鞘氨醇单胞菌、棒状杆菌）中的微生物组成与痰液不同。此外，测序仅在袋子和过滤器中检测到分枝杆菌，而在痰液中未检测到。在亚组中，袋子和过滤器的微生物多样性与口腔冲洗液或 BALF 没有差异，但微生物组成不同。与 BALF 相比，袋子中富含鞘氨醇单胞菌，且分枝杆菌、链球菌和厌氧链球菌（厌氧链球菌在过滤器中也比 BALF 中耗竭）耗竭；而在过滤器中则耗竭厌氧链球菌。与 BALF 相比，气溶胶富集的分类群在口腔冲洗液或痰液中均未被富集。
解释
PMC 可捕获具有 Ultra 可检测性的 MTBC 的气溶胶，且通过测序，气溶胶中的 MTBC 比痰液中更易被检测到。空气微生物组与痰液、口腔冲洗液和 BALF 不同，且包含不同程度富集的下呼吸道微生物。
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