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Published on: November 7, 2020
Complexity, temporal stability, and clinical correlates of airway bacterial community composition in primary ciliary
Geraint B Rogers1, Mary P Carroll, Nur Masirah M Zain
1Immunity, Infection, and Inflammation Program, Mater Medical Research Institute, South Brisbane, Australia.
Abstract:
Primary ciliary dyskinesia (PCD) is a genetic disease characterized by abnormalities in ciliary function, leading to compromised airway clearance and chronic bacterial infection of the upper and lower airways. The compositions of these infections and the relationships between their characteristics and disease presentation are poorly defined. We describe here the first systematic culture-independent evaluation of lower airway bacteriology in PCD. Thirty-three airway samples (26 from sputum, 7 from bronchoalveolar lavage [BAL] fluid) were collected from 24 PCD patients aged 4 to 73 years. 16S rRNA quantitative PCR and pyrosequencing were used to determine the bacterial loads and community compositions of the samples. Bacterial loads, which ranged from 1.3 × 10(4) to 5.2 × 10(9) CFU/ml, were positively correlated with age (P = 0.002) but not lung function. An analysis of ∼7,000 16S rRNA sequences per sample identified bacterial species belonging to 128 genera. The concurrently collected paired samples showed high bacterial community similarity. The mean relative abundance of the dominant genera was 64.5% (standard deviation [SD], 24.5), including taxa reported through standard diagnostic microbiology (members of the genera Pseudomonas, Haemophilus, and Streptococcus) and those requiring specific ex vivo growth conditions (members of the genera Prevotella and Porphyromonas). The significant correlations observed included a positive relationship between Pseudomonas aeruginosa relative abundance and age and a negative relationship between P. aeruginosa relative abundance and lung function. Members of the genus Ralstonia were also found to contribute substantially to the bacterial communities in a number of patients. Follow-up samples from a subset of patients revealed high levels of bacterial community temporal stability. The detailed microbiological characterization presented here provides a basis for the reassessment of the clinical management of PCD airway infections.
Insights
This study reveals the bacterial communities in primary ciliary dyskinesia (PCD) airways, finding bacterial load increases with age. Pseudomonas aeruginosa abundance also correlates with age and poorer lung function in PCD patients.
Area of Science:
- Genetics and Microbiology
- Pulmonology
Background:
- Primary ciliary dyskinesia (PCD) causes impaired airway clearance and chronic infections.
- The specific bacteria and their impact on PCD presentation are not well understood.
Purpose of the Study:
- To conduct the first culture-independent analysis of lower airway bacteria in PCD patients.
- To characterize bacterial loads and community composition in relation to disease factors.
Main Methods:
- Collected 33 airway samples (sputum, bronchoalveolar lavage) from 24 PCD patients (ages 4-73).
- Utilized 16S rRNA quantitative PCR and pyrosequencing for bacterial analysis.
- Analyzed approximately 7,000 16S rRNA sequences per sample.
Main Results:
- Bacterial loads ranged from 1.3 × 10(4) to 5.2 × 10(9) CFU/ml, positively correlating with age.
- Identified 128 bacterial genera, with Pseudomonas, Haemophilus, and Streptococcus being dominant.
- Found positive correlation between Pseudomonas aeruginosa and age, and negative correlation with lung function.
Conclusions:
- This detailed microbiological profile offers insights into PCD airway infections.
- Findings suggest a basis for re-evaluating the clinical management of PCD.
- Bacterial communities in PCD airways show temporal stability.
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