title: Detection of anaerobic bacteria in high numbers in sputum from patients with cystic fibrosis.
abstract: BACKGROUND
  Pulmonary infection in cystic fibrosis (CF) is polymicrobial and it is possible that anaerobic bacteria, not detected by routine aerobic culture methods, reside within infected anaerobic airway mucus.
  
  
  OBJECTIVE
  To determine whether anaerobic bacteria are present in the sputum of patients with CF.
  
  
  METHODS
  Sputum samples were collected from clinically stable adults with CF and bronchoalveolar lavage fluid (BALF) samples from children with CF. Induced sputum samples were collected from healthy volunteers who did not have CF. All samples were processed using anaerobic bacteriologic techniques and bacteria within the samples were quantified and identified.
  
  
  RESULTS
  Anaerobic species primarily within the genera Prevotella, Veillonella, Propionibacterium, and Actinomyces were isolated in high numbers from 42 of 66 (64%) sputum samples from adult patients with CF. Colonization with Pseudomonas aeruginosa significantly increased the likelihood that anaerobic bacteria would be present in the sputum. Similar anaerobic species were identified in BALF from pediatric patients with CF. Although anaerobes were detected in induced sputum samples from 16 of 20 volunteers, they were present in much lower numbers and were generally different species compared with those detected in CF sputum. Species-dependent differences in the susceptibility of the anaerobes to antibiotics with known activity against anaerobes were apparent with all isolates susceptible to meropenem.
  
  
  CONCLUSIONS
  A range of anaerobic species are present in large numbers in the lungs of patients with CF. If these anaerobic bacteria are contributing significantly to infection and inflammation in the CF lung, informed alterations to antibiotic treatment to target anaerobes, in addition to the primary infecting pathogens, may improve management.
authors.affiliation: School of Pharmacy, Medical Biology Centre, Queen's University Belfast, Belfast, United Kingdom. m.tunney@qub.ac.uk
authors.forename: Michael M
authors.initials: MM
authors.lastname: Tunney
authors.forename: Tyler R
authors.initials: TR
authors.lastname: Field
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Moriarty
authors.forename: Sheila
authors.initials: S
authors.lastname: Patrick
authors.forename: Gerd
authors.initials: G
authors.lastname: Doering
authors.forename: Marianne S
authors.initials: MS
authors.lastname: Muhlebach
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Wolfgang
authors.forename: Richard
authors.initials: R
authors.lastname: Boucher
authors.forename: Deirdre F
authors.initials: DF
authors.lastname: Gilpin
authors.forename: Andrew
authors.initials: A
authors.lastname: McDowell
authors.forename: J Stuart
authors.initials: JS
authors.lastname: Elborn
mesh_terms: D000293:Adolescent; D000328:Adult; D001421:Bacteria, Anaerobic / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D001431:Bacteriological Techniques; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications / Q000382:microbiology* / Q000503:physiopathology; D005541:Forced Expiratory Volume; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology*