Highlights
- •Although the progression of lung disease in CF has been associated with airway microbial communities with decreased bacterial diversity, a significant minority of individuals with advanced lung disease maintain relatively diverse communities, and these individuals experience greater lung transplant-free survival.
- •Elucidation of the relationship between lung disease and airway bacterial community structure has potential to advance novel strategies to improve clinical outcomes.
Abstract
Background
The progression of lung disease in people with cystic fibrosis (pwCF) has been associated
with a decrease in the diversity of airway bacterial communities. How often low diversity
communities occur in advanced CF lung disease and how they may be associated with
clinical outcomes is not clear, however.
Methods
We sequenced a region of the bacterial 16S ribosomal RNA gene to characterize bacterial
communities in sputum from 190 pwCF with advanced lung disease (FEV1≤40% predicted), with particular attention to the prevalence and relative abundance
of dominant genera. We evaluated relationships between community diversity and clinical
outcomes.
Results
Although most of the 190 pwCF with advanced lung disease had airway bacterial communities
characterized by low diversity with a dominant genus, a considerable minority (40%)
did not. The absence of a dominant genus, presence of methicillin-susceptible Staphylococcus aureus, and greater bacterial richness positively correlated with lung function. Higher
relative abundance of the dominant genus and greater antimicrobial use negatively
correlated with lung function. PwCF with a low diversity community and dominant genus
had reduced lung transplant-free survival compared to those without (median survival
of 1.6 vs 2.9 years).
Conclusions
A considerable proportion of pwCF with advanced lung disease do not have airway bacterial
communities characterized by low diversity and a dominant genus and these individuals
had better survival. An understanding of the antecedents of low diversity airway communities–
and the impact these may have on lung disease trajectory - may provide avenues for
improved management strategies.
Keywords
Abbreviations:
16S rRNA (16S ribosomal ribonucleic acid), ASV (amplicon sequence variant), BMI (body mass index), CF (cystic fibrosis), CFTR (cystic fibrosis transmembrane conductance regulator), MRSA (methicillin-resistant Staphylococcus aureus), MSSA (methicillin-sensitive Staphylococcus aureus), pwCF (people with cystic fibrosis), ppFEV1 (percent predicted forced expiratory volume in 1 s)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 09, 2023
Accepted:
January 4,
2023
Received in revised form:
December 22,
2022
Received:
October 21,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
