A persistent and diverse airway microbiota present during chronic obstructive pulmonary disease exacerbations.
Acute exacerbations of chronic obstructive pulmonary disease (COPD) are a major source of morbidity and contribute significantly to healthcare costs. Although bacterial infections are implicated in nearly 50% of exacerbations, only a handful of pathogens have been consistently identified in COPD airways, primarily by culture-based methods, and the bacterial microbiota in acute exacerbations remains largely uncharacterized. The aim of this study was to comprehensively profile airway bacterial communities using a culture-independent microarray, the 16S rRNA PhyloChip, of a cohort of COPD patients requiring ventilatory support and antibiotic therapy for exacerbation-related respiratory failure. PhyloChip analysis revealed the presence of over 1,200 bacterial taxa representing 140 distinct families, many previously undetected in airway diseases; bacterial community composition was strongly influenced by the duration of intubation. A core community of 75 taxa was detected in all patients, many of which are known pathogens. Bacterial community diversity in COPD airways is substantially greater than previously recognized and includes a number of potential pathogens detected in the setting of antibiotic exposure. Comprehensive assessment of the COPD airway microbiota using high-throughput, culture-independent methods may prove key to understanding the relationships between airway bacterial colonization, acute exacerbation, and clinical outcomes in this and other chronic inflammatory airway diseases.
Huang
Yvonne J
YJ
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco, California 94143-0538, USA.
Kim
Eugenia
E
Cox
Michael J
MJ
Brodie
Eoin L
EL
Brown
Ron
R
Wiener-Kronish
Jeanine P
JP
Lynch
Susan V
SV
D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000145:classification / Q000235:genetics; D001483:Base Sequence; D001980:Bronchi / Q000382:microbiology*; D001992:Bronchoalveolar Lavage Fluid; D015331:Cohort Studies; D017931:DNA Primers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000382:microbiology* / Q000503:physiopathology; D012336:RNA, Ribosomal, 16S / Q000235:genetics
D017931:DNA Primers; D012336:RNA, Ribosomal, 16S