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Changes in the airway microbiome in patients with bronchiectasis
Dongmei Lu1, Chenxi Li2, Zhiwei Zhong1,3
1Division of Respiratory and Critical Care Medicine, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, China.
Medicine
|December 20, 2023
Summary
Metagenomic next-generation sequencing (mNGS) identified more viruses, fungi, and bacteria in acute bronchiectasis exacerbations. This advanced technique improves pathogen detection compared to traditional methods, guiding better antibiotic therapy.
Area of Science:
- Microbiology
- Pulmonology
- Infectious Diseases
Background:
- Bronchiectasis exacerbations involve complex lower respiratory tract infections.
- Accurate pathogen identification is crucial for effective treatment and improved patient outcomes.
Purpose of the Study:
- To investigate microbial community changes in acute bronchiectasis exacerbations using metagenomic next-generation sequencing (mNGS).
- To compare mNGS findings with conventional microbiological tests.
- To guide clinical treatment strategies for better patient prognosis.
Main Methods:
- Prospective study of 54 acute exacerbation patients and 46 stable controls.
- Analysis of sputum and bronchoalveolar lavage fluid (BALF) using mNGS and routine cultures.
- Measurement of serum inflammatory markers.
Main Results:
- mNGS detected significantly more viruses, fungi (Candida albicans, Pneumocystis jirovecii, Aspergillus fumigatus), and bacteria (Acinetobacter baumannii, Mycobacterium tuberculosis, Haemophilus influenzae) in exacerbation patients.
- mNGS showed higher sensitivity than sputum culture, identifying pathogens in 66/77 cases with negative cultures.
- Acinetobacter baumannii was the most common bacterial species identified.
Conclusions:
- Acute bronchiectasis exacerbations are often associated with mixed lower respiratory tract infections.
- mNGS enhances the detection of diverse pathogens, including viruses, fungi, and bacteria.
- mNGS can improve the accuracy of diagnosis and the effectiveness of antibiotic therapy in bronchiectasis exacerbations.
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