Association of antibiotics, airway microbiome, and inflammation in infants with cystic fibrosis

Australian Respiratory Early Surveillance Team for Cystic Fibrosis

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Rationale: The underlying defect in the cystic fibrosis (CF) airway leads to defective mucociliary clearance and impaired bacterial killing, resulting in endobronchial infection and inflammation that contributes to progressive lung disease. Little is known about the respiratory microbiota in the early CF airway and its relationship to inflammation. Objectives: To examine the bacterial microbiota and inflammatory profiles in bronchoalveolar lavage fluid and oropharyngeal secretions in infants with CF. Methods: Infants with CF from U.S. and Australian centers were enrolled in a prospective, observational study examining the bacterial microbiota and inflammatory profiles of the respiratory tract. Bacterial diversity and density (load) were measured. Lavage samples were analyzed for inflammatory markers (interleukin 8, unbound neutrophil elastase, and absolute neutrophil count) in the epithelial lining fluid. Results: Thirty-two infants (mean age, 4.7 months) underwent bronchoalveolar lavage and oropharyngeal sampling. Shannon diversity strongly correlated between upper and lower airway samples from a given subject, although community compositions differed. Microbial diversity was lower in younger subjects and in those receiving daily antistaphylococcal antibiotic prophylaxis. In lavage samples, reduced diversity correlated with lower interleukin 8 concentration and absolute neutrophil count. Conclusions: In infants with CF, reduced bacterial diversity in the upper and lower airways was strongly associated with the use of prophylactic antibiotics and younger age at the time of sampling; less diversity in the lower airway correlated with lower inflammation on bronchoalveolar lavage. Our findings suggest modification of the respiratory microbiome in infants with CF may influence airway inflammation.

Original languageEnglish (US)
Pages (from-to)1548-1555
Number of pages8
JournalAnnals of the American Thoracic Society
Volume14
Issue number10
DOIs
StatePublished - Oct 1 2017

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Microbiota
Cystic Fibrosis
Anti-Bacterial Agents
Inflammation
Therapeutic Irrigation
Bronchoalveolar Lavage
Interleukin-8
Neutrophils
Mucociliary Clearance
Fluids and Secretions
Leukocyte Elastase
Antibiotic Prophylaxis
Bronchoalveolar Lavage Fluid
Respiratory System
Lung Diseases
Observational Studies
Prospective Studies
Infection

Keywords

  • Bacterial infection
  • Cystic fibrosis
  • Microbiota
  • Pediatric lung disease inflammation
  • Respiratory infection

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Association of antibiotics, airway microbiome, and inflammation in infants with cystic fibrosis. / Australian Respiratory Early Surveillance Team for Cystic Fibrosis.

In: Annals of the American Thoracic Society, Vol. 14, No. 10, 01.10.2017, p. 1548-1555.

Research output: Contribution to journalArticle

Australian Respiratory Early Surveillance Team for Cystic Fibrosis. / Association of antibiotics, airway microbiome, and inflammation in infants with cystic fibrosis. In: Annals of the American Thoracic Society. 2017 ; Vol. 14, No. 10. pp. 1548-1555.
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abstract = "Rationale: The underlying defect in the cystic fibrosis (CF) airway leads to defective mucociliary clearance and impaired bacterial killing, resulting in endobronchial infection and inflammation that contributes to progressive lung disease. Little is known about the respiratory microbiota in the early CF airway and its relationship to inflammation. Objectives: To examine the bacterial microbiota and inflammatory profiles in bronchoalveolar lavage fluid and oropharyngeal secretions in infants with CF. Methods: Infants with CF from U.S. and Australian centers were enrolled in a prospective, observational study examining the bacterial microbiota and inflammatory profiles of the respiratory tract. Bacterial diversity and density (load) were measured. Lavage samples were analyzed for inflammatory markers (interleukin 8, unbound neutrophil elastase, and absolute neutrophil count) in the epithelial lining fluid. Results: Thirty-two infants (mean age, 4.7 months) underwent bronchoalveolar lavage and oropharyngeal sampling. Shannon diversity strongly correlated between upper and lower airway samples from a given subject, although community compositions differed. Microbial diversity was lower in younger subjects and in those receiving daily antistaphylococcal antibiotic prophylaxis. In lavage samples, reduced diversity correlated with lower interleukin 8 concentration and absolute neutrophil count. Conclusions: In infants with CF, reduced bacterial diversity in the upper and lower airways was strongly associated with the use of prophylactic antibiotics and younger age at the time of sampling; less diversity in the lower airway correlated with lower inflammation on bronchoalveolar lavage. Our findings suggest modification of the respiratory microbiome in infants with CF may influence airway inflammation.",
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AU - Akers, Kathryn

AU - Storch, Gregory A.

AU - Hatch, Joseph

AU - Quante, Jane

AU - Frayman, Katherine B.

AU - Clarke, Nadeene

AU - Davis, Miriam

AU - Stick, Stephen M.

AU - Hall, Graham L.

AU - Montgomery, Gregory

AU - Ranganathan, Sarath

AU - Davis, Stephanie

AU - Ferkol, Thomas W.

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KW - Cystic fibrosis

KW - Microbiota

KW - Pediatric lung disease inflammation

KW - Respiratory infection

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