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Concordance between upper and lower airway microbiota in infants with cystic fibrosis

Sabine M P J Prevaes1, Wouter A A de Steenhuijsen Piters1,2, Karin M de Winter-de Groot1,2

  • 1Dept of Paediatrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands.

The European Respiratory Journal
|March 31, 2017
PubMed

Insights

The lungs of infants with cystic fibrosis (CF) may have a unique microbiome, distinct from the upper respiratory tract. This finding impacts how we understand and treat lower respiratory tract infections in infants with CF.

Area of Science:

  • Microbiology
  • Pediatric Pulmonology
  • Genomics

Background:

  • Nasopharyngeal and oropharyngeal samples are standard for guiding lower respiratory tract infection therapy in non-expectorating infants with cystic fibrosis (CF).
  • Understanding the lower airway microbiome is crucial for effective CF management.

Purpose of the Study:

  • To investigate the concordance between bacterial communities in nasopharyngeal, oropharyngeal, and bronchoalveolar lavage (BAL) samples from infants with CF.
  • To determine if upper airway microbiota accurately reflect the lower airway microbiome in infants with CF.

Main Methods:

  • Analysis of 25 sample sets (nasopharyngeal, oropharyngeal, BAL) from 17 infants with CF (aged ~5 and ~12 months).
  • Utilized conventional culturing and 16S-rRNA sequencing for bacterial community profiling.
  • Employed clustering analyses to compare microbial profiles across different sample types.

Main Results:

  • Bronchoalveolar lavage (BAL) microbiota generally comprised a mix of oral and nasopharyngeal bacteria, including commensals (e.g., Streptococcus, Neisseria) and potential pathogens (e.g., Staphylococcus aureus, Haemophilus influenzae).
  • Significant variation in concordance was observed between upper respiratory tract niches and corresponding BAL microbiota within individuals.
  • The degree of concordance between upper and lower respiratory tract microbiomes differed significantly among infants.

Conclusions:

  • The lower respiratory tract microbiome in infants with CF appears distinct from, though seeded by, the upper respiratory tract microbiome.
  • Inconsistent concordance suggests that upper airway sampling may not fully represent the lung's microbial environment in infants with CF.
  • This highlights the potential for a unique lung microbiome in CF infants, influencing therapeutic strategies.

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