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The CF lung facilitates the cohabitation of diverse microbial organisms. These communities diversify as a result of interactions with both the environment and each other. Cystic fibrosis-related diabetes (CFRD) is an increasingly recognised and complex issue in the management of CF patients. There has been little research into the effect that this change in the host has on the associated microbiome.
Objectives
The main objective of this study was to determine the bacterial community structure in patients with CFRD.
Methods and Results
Clinically significant dysglycemia was confirmed using continuous glucose monitoring showing interstitial glucose readings of 7.8 mmol/L for more than 4.5% of the time. Amplicon-sequencing using Illumina Miseq of the 16S rRNA gene was performed on DNA extracted from sputum samples taken during outpatient visits. Analysis was performed using uSearch/Qiime pipeline and R package. Sequencing of 19 diabetic and 22 non-diabetic patients revealed a diverse microbial population. In CFRD patients, a significantly higher level of S. maltophilia was detected and confirmed using qPCR. In vitro studies were performed using physiologically relevant levels of glucose (0–10 µM). S. maltophilia displays a significant increase in growth in glucose rich environments suggesting that this bacterium is adept at exploiting this niche.
The importance of glucose control in CFRD cannot be underestimated as it has potential to predispose the growth of resistant organisms. Increased understanding of these complex interactions between the microbiome and host may ultimately lead to altered CF patient management.
We acknowledge the Leverhulme Trust for funding.
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© 2015 European Cystic Fibrosis Society. Published by Elsevier Inc.
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