Anaerobic Bacterial Infection in Patients with Cystic Fibrosis

Tai, Andrew; Ranganath, S.B.

doi:10.1164/ajrccm.178.9.994

Cited by 5 publications

(3 citation statements)

References 4 publications

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“…Anaerobic taxa have only recently been found in significant numbers in the CF lung, 39–47 and still play a largely undefined role in CF disease development. 45 In fact, different studies have ascribed diametrically opposed impacts for anaerobic taxa.…”

Section: Discussionmentioning

confidence: 99%

Microbiome networks and change-point analysis reveal key community changes associated with cystic fibrosis pulmonary exacerbations

Layeghifard

Wang

et al. 2019

npj Biofilms Microbiomes

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Over 90% of cystic fibrosis (CF) patients die due to chronic lung infections leading to respiratory failure. The decline in CF lung function is greatly accelerated by intermittent and progressively severe acute pulmonary exacerbations (PEs). Despite their clinical impact, surprisingly few microbiological signals associated with PEs have been identified. Here we introduce an unsupervised, systems-oriented approach to identify key members of the microbiota. We used two CF sputum microbiome data sets that were longitudinally collected through periods spanning baseline health and PEs. Key taxa were defined based on three strategies: overall relative abundance, prevalence, and co-occurrence network interconnectedness. We measured the association between changes in the abundance of the key taxa and changes in patient clinical status over time via change-point detection, and found that taxa with the highest level of network interconnectedness tracked changes in patient health significantly better than taxa with the highest abundance or prevalence. We also cross-sectionally stratified all samples into the clinical states and identified key taxa associated with each state. We found that network interconnectedness most strongly delineated the taxa among clinical states, and that anaerobic bacteria were over-represented during PEs. Many of these anaerobes are oropharyngeal bacteria that have been previously isolated from the respiratory tract, and/or have been studied for their role in CF. The observed shift in community structure, and the association of anaerobic taxa and PEs lends further support to the growing consensus that anoxic conditions and the subsequent growth of anaerobic microbes are important predictors of PEs.

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Section: Discussionmentioning

confidence: 99%

Microbiome networks and change-point analysis reveal key community changes associated with cystic fibrosis pulmonary exacerbations

Layeghifard

Wang

et al. 2019

npj Biofilms Microbiomes

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“…Although the inflammatory response to individual aerobic organisms identified in BAL fluid from infants and young children with CF has been described (46), no such data linking anaerobes to inflammation or clinical outcomes are available. Studies in younger subjects might help to elucidate the role of anaerobes in disease pathogenesis and whether or not their presence in the lower airways represents an epiphenomenon (47). Existing studies are in older subjects who have therefore experienced a more complex infection history.…”

Section: Seminars For Cliniciansmentioning

confidence: 99%

Antibiotic Management of Lung Infections in Cystic Fibrosis. II. Nontuberculous Mycobacteria, Anaerobic Bacteria, and Fungi

et al. 2014

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Airway infections are a key component of cystic fibrosis (CF) lung disease. Whereas the approach to common pathogens such as Pseudomonas aeruginosa is guided by a significant body of evidence, other infections often pose a considerable challenge to treating physicians. In Part I of this series on the antibiotic management of difficult lung infections, we discussed bacterial organisms including methicillin-resistant Staphylococcus aureus, gram-negative bacterial infections, and treatment of multiple bacterial pathogens. Here, we summarize the approach to infections with nontuberculous mycobacteria, anaerobic bacteria, and fungi. Nontuberculous mycobacteria can significantly impact the course of lung disease in patients with CF, but differentiation between colonization and infection is difficult clinically as coinfection with other micro-organisms is common. Treatment consists of different classes of antibiotics, varies in intensity, and is best guided by a team of specialized clinicians and microbiologists. The ability of anaerobic bacteria to contribute to CF lung disease is less clear, even though clinical relevance has been reported in individual patients. Anaerobes detected in CF sputum are often resistant to multiple drugs, and treatment has not yet been shown to positively affect patient outcome. Fungi have gained significant interest as potential CF pathogens. Although the role of Candida is largely unclear, there is mounting evidence that Scedosporium species and Aspergillus fumigatus, beyond the classical presentation of allergic bronchopulmonary aspergillosis, can be relevant in patients with CF and treatment should be considered. At present, however there remains limited information on how best to select patients who could benefit from antifungal therapy.

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“…Careful microbial culture of airway samples detects these pathogens and can guide antimicrobial therapy. In addition to routinely cultured bacteria, other potential pathogens include fungi, viruses, mixed anaerobic bacteria, and nontuberculous mycobacterium (136–138). The most common fungus detected in CF airway samples, Aspergillus fumigatus , causes allergic bronchopulmonary Aspergillosis (ABPA) in 1% to 15% of patients with CF (139).…”

Section: Cf Lung Infections: Research Opportunitiesmentioning

confidence: 99%

Measuring and improving respiratory outcomes in cystic fibrosis lung disease: Opportunities and challenges to therapy

Zemanick

Harris

Conway

et al. 2010

Journal of Cystic Fibrosis

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Cystic fibrosis (CF) is a life-shortening disease with significant morbidity. Despite overall improvements in survival, patients with CF experience frequent pulmonary exacerbations and declining lung function, which often accelerates during adolescence. New treatments target steps in the pathogenesis of lung disease, such as the basic defect in CF (CF Transmembrane Conductance Regulator [CFTR]), pulmonary infections, inflammation, and mucociliary clearance. These treatments offer hope but also present challenges to patients, clinicians, and researchers. Comprehensive assessment of efficacy is critical to identify potentially beneficial treatments. Lung function and pulmonary exacerbation are the most commonly used outcome measures in CF clinical research. Other outcome measures under investigation include measures of CFTR function; biomarkers of infection, inflammation, lung injury and repair; and patient-reported outcomes. Molecular diagnostics may help elucidate the complex CF airway microbiome. As new treatments are developed for patients with CF, efforts should be made to balance treatment burden with quality of life. This review highlights emerging treatments, obstacles to optimizing outcomes, and key future directions for research.

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Anaerobic Bacterial Infection in Patients with Cystic Fibrosis

Cited by 5 publications

References 4 publications

Microbiome networks and change-point analysis reveal key community changes associated with cystic fibrosis pulmonary exacerbations

Microbiome networks and change-point analysis reveal key community changes associated with cystic fibrosis pulmonary exacerbations

Antibiotic Management of Lung Infections in Cystic Fibrosis. II. Nontuberculous Mycobacteria, Anaerobic Bacteria, and Fungi

Measuring and improving respiratory outcomes in cystic fibrosis lung disease: Opportunities and challenges to therapy

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