Microbiological characteristics of airway bacteria in adult patients with bronchiectasis and their correlation with the clinical features_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 LIU Bicui ^1,2 ^L , LI Kui ² ^L , DING Fei ² , HU Lili ² ,  LUO Yongxiao ¹ ,  LIU Chuntao ¹

1. Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Respiratory and Critical Care Medicine, Bishan Hospital of Chongqing Medical University, Bishan, Chongqing 420706, P. R. China;

Corresponding author：

LUO Yongxiao, Email: 249614740@qq.com

Keywords：

Bronchiectasis; bronchoalveolar lavage fluid; 16S rRNA gene sequencing; clinical characteristics; microbiology

DOI：

10.7507/1671-6205.202209060

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Objective To analyze the microbiological characteristics of airway bacteria in adult patients with bronchiectasis and to analyze their correlation with the clinical features. Methods Patients diagnosed with bronchiectasis in the Department of Respiratory and Critical Care Medicine of West China Hospital of Sichuan University from October 2017 to April 2018 were classified into the bronchiectasis group, while the control group was those who were found to have pulmonary nodules (diameter less than 10 mm) requiring bronchoscopy by physical examination. All subjects in both groups had not used antibiotics or hormones within 4 weeks and had no other respiratory diseases. Bronchoalveolar lavage fluid (BALF) from the lesion site of the branchial expansion group was collected, and BALF from the basal segment of the contralateral inferior bronchial lobe of the pulmonary nodule was collected in the control group. Bacterial culture and 16S rRNA gene sequencing were performed in both groups. Results Seventeen cases and six controls were enrolled in this study and the BALF specimens were collected. Eight cases were in stable period and nine cases were in acute period. The case group was divided into the bacteria-positive group and negative group based on bacterial culture of BALF. Shannon index in the bacteria-positive group was significantly lower than the bacteria-negative group and the control group. And Shannon index showed a negative correlation with positive bacterial culture in BALF. When Shannon index ≤4.5 was used to predict positive bacterial culture, the sensitivity and specificity were 83.3% and 90.9% respectively. The average relative abundance of bacteria was higher and the average sample distribution uniformity was lower in patients with acute period, compared with those in patients with stable period. Shannon index was negatively correlated with the acute exacerbation in patients. When Shannon index <5.0 was used to predict acute exacerbation, the sensitivity and specificity were 77.8% and 100.0%, respectively. Conclusions Shannon index in 16S rRNA gene sequencing results has certain predictive value for acute exacerbation stage. 16S rRNA gene sequencing combined with bacterial culture results can help guide clinicians to provide more precise treatment plans.

Citation： LIU Bicui, LI Kui, DING Fei, HU Lili, LUO Yongxiao, LIU Chuntao. Microbiological characteristics of airway bacteria in adult patients with bronchiectasis and their correlation with the clinical features. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(5): 311-318. doi: 10.7507/1671-6205.202209060 Copy

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4.	Pasteur MC, Helliwell SM, Houghton SJ, et al. An investigation into causative factors in patients with bronchiectasis. Am J Respir Crit Care Med, 2000, 162(4 Pt 1): 1277-1284.
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7.	Rogers GB, van der Gast CJ, Cuthbertson L, et al. Clinical measures of disease in adult non-CF bronchiectasis correlate with airway microbiota composition. Thorax, 2013, 68(8): 731-737.
8.	McShane PJ, Naureckas ET, Tino G, et al. Non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med, 2013, 188(6): 647-656.
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15.	Polverino E, Goeminne PC, McDonnell MJ, et al. European Respiratory Society Guidelines for the management of adult bronchiectasis. Eur Respir J, 2017, 50(3): 1700629.
16.	Tunney MM, Klem ER, Fodor AA, et al. Use of culture and molecular analysis to determine the effect of antibiotic treatment on microbial community diversity and abundance during exacerbation in patients with cystic fibrosis. Thorax, 2011, 66(7): 579-584.
17.	Whelan FJ, Heirali AA, Rossi L, et al. Longitudinal sampling of the lung microbiota in individuals with cystic fibrosis. PLoS One, 2017, 12(3): e0172811.
18.	Cox MJ, Turek EM, Hennessy C, et al. Longitudinal assessment of sputum microbiome by sequencing of the 16S rRNA gene in non-cystic fibrosis bronchiectasis patients. PLoS One, 2017, 12(2): e0170622.

1. Barker AF. Bronchiectasis. N Engl J Med, 2002, 346(18): 1383-1393.
2. Evans DJ, Greenstone M. Long-term antibiotics in the management of non-CF bronchiectasis--do they improve outcome?. Respir Med, 2003, 97(7): 851-858.
3. Martínez-García MA, Perpiñá-Tordera M, Román-Sánchez P, et al. Quality-of-life determinants in patients with clinically stable bronchiectasis. Chest, 2005, 128(2): 739-745.
4. Pasteur MC, Helliwell SM, Houghton SJ, et al. An investigation into causative factors in patients with bronchiectasis. Am J Respir Crit Care Med, 2000, 162(4 Pt 1): 1277-1284.
5. Tunney MM, Einarsson GG, Wei L, et al. Lung microbiota and bacterial abundance in patients with bronchiectasis when clinically stable and during exacerbation. Am J Respir Crit Care Med, 2013, 187(10): 1118-1126.
6. Byun MK, Chang J, Kim HJ, et al. Differences of lung microbiome in patients with clinically stable and exacerbated bronchiectasis. PLoS One, 2017, 12(8): e0183553.
7. Rogers GB, van der Gast CJ, Cuthbertson L, et al. Clinical measures of disease in adult non-CF bronchiectasis correlate with airway microbiota composition. Thorax, 2013, 68(8): 731-737.
8. McShane PJ, Naureckas ET, Tino G, et al. Non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med, 2013, 188(6): 647-656.
9. Fuchs HJ, Borowitz DS, Christiansen DH, et al. Effect of aerosolized recombinant human DNase on exacerbations of respiratory symptoms and on pulmonary function in patients with cystic fibrosis. The Pulmozyme Study Group. N Engl J Med, 1994, 331(10): 637-642.
10. Esty WW. The efficiency of Good's nonparametric coverage estimator. Ann Statist, 1986, 14(3): 1257-1260.
11. Rognes T, Flouri T, Nichols B, et al. VSEARCH: a versatile open source tool for metagenomics. PeerJ, 2016, 4: e2584.
12. Charlson ES, Bittinger K, Haas AR, et al. Topographical continuity of bacterial populations in the healthy human respiratory tract. Am J Respir Crit Care Med, 2011, 184(8): 957-963.
13. Dickson RP, Erb-Downward JR, Freeman CM, et al. Bacterial topography of the healthy human lower respiratory tract. mBio, 2017, 8(1): e02287-16.
14. Wang Z, Bafadhel M, Haldar K, et al. Lung microbiome dynamics in COPD exacerbations. Eur Respir J, 2016, 47(4): 1082-1092.
15. Polverino E, Goeminne PC, McDonnell MJ, et al. European Respiratory Society Guidelines for the management of adult bronchiectasis. Eur Respir J, 2017, 50(3): 1700629.
16. Tunney MM, Klem ER, Fodor AA, et al. Use of culture and molecular analysis to determine the effect of antibiotic treatment on microbial community diversity and abundance during exacerbation in patients with cystic fibrosis. Thorax, 2011, 66(7): 579-584.
17. Whelan FJ, Heirali AA, Rossi L, et al. Longitudinal sampling of the lung microbiota in individuals with cystic fibrosis. PLoS One, 2017, 12(3): e0172811.
18. Cox MJ, Turek EM, Hennessy C, et al. Longitudinal assessment of sputum microbiome by sequencing of the 16S rRNA gene in non-cystic fibrosis bronchiectasis patients. PLoS One, 2017, 12(2): e0170622.

Chinese Journal of Respiratory and Critical Care Medicine

Microbiological characteristics of airway bacteria in adult patients with bronchiectasis and their correlation with the clinical features

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