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. 2021 Nov 1;40(11):962-968.
doi: 10.1097/INF.0000000000003211.

Impact of Anaerobic Antibacterial Spectrum on Cystic Fibrosis Airway Microbiome Diversity and Pulmonary Function

Michael J Bozzella  1 , Hollis Chaney  2   3 , Iman Sami  2   3 , Anastassios Koumbourlis  2   3 , James E Bost  3   4 , Edith T Zemanick  5 , Robert J Freishtat  3   6 , Keith A Crandall  7 , Andrea Hahn  1   3
Affiliations

Impact of Anaerobic Antibacterial Spectrum on Cystic Fibrosis Airway Microbiome Diversity and Pulmonary Function

Michael J Bozzella et al. Pediatr Infect Dis J. .

Abstract

Background: The role of anaerobic organisms in the cystic fibrosis (CF) lung microbiome is unclear. Our objectives were to investigate the effect of broad (BS) versus narrow (NS) spectrum antianaerobic antibiotic activity on lung microbiome diversity and pulmonary function, hypothesizing that BS antibiotics would cause greater change in microbiome diversity without a significant improvement in lung function.

Methods: Pulmonary function tests and respiratory samples were collected prospectively in persons with CF before and after treatment for pulmonary exacerbations. Treatment antibiotics were classified as BS or NS. Gene sequencing data from 16S rRNA were used for diversity analysis and bacterial genera classification. We compared the effects of BS versus NS on diversity indices, lung function and anaerobic/aerobic ratios. Statistical significance was determined by multilevel mixed-effects generalized linear models and mixed-effects regression models.

Results: Twenty patients, 6-20 years of age, experienced 30 exacerbations. BS therapy had a greater effect on beta diversity than NS therapy when comparing time points before antibiotics to after and at recovery. After antibiotics, the NS therapy group had a greater return toward baseline forced expiratory volume at 1 second and forced expiratory flow 25%-75% values than the BS group. The ratio of anaerobic/aerobic organisms showed a predominance of anaerobes in the NS group with aerobes dominating in the BS group.

Conclusions: BS antianaerobic therapy had a greater and possibly longer lasting effect on the lung microbiome of persons with CF, without achieving the recovery of pulmonary function seen with the NS therapy. Specific antibiotic therapies may affect disease progression by changing the airway microbiome.

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Conflict of interest statement

A.H. and the data in this study were funded by the National Heart, Lung and Blood Institute award number K12HL119994; partially supported by the National Center for Advancing Translational Sciences, award number UL1TR000075. A.H. is also supported by a Harry Shwachman Award through the Cystic Fibrosis Foundation. The other authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.. Box and whisker plots of alpha diversity measures calculated from baseline (B) points and hospitalization for exacerbation (H) points to treatment (T) and follow-up (FU) points.
“x” corresponds to mean values. Center horizontal line corresponds to median. Colored boxes represent the interquartile ranges. Small circles represent individual values.
Figure 2:
Figure 2:. Box and whisker plots of Morisita-Horn Values calculated from baseline (B) points and hospitalization for exacerbation (H) points to treatment (T) and follow-up (FU) points.
“x” corresponds to mean values. Center horizontal line corresponds to median. Colored boxes represent the interquartile ranges. Small circles represent individual values. *** = significant when controlled for individual patient and baseline disease stage
Figure 3:
Figure 3:. Box and whisker plot of the ratios of Anaerobic to Aerobic organisms at time points.
“x” corresponds to mean values. Center horizontal line corresponds to median. Colored boxes represent the interquartile ranges. Small circles represent individual values. The differences between treatments were not significant at each time point. However the differences in ratios from baseline (B) to treatment (T) and follow-up (FU) were significant.
Figure 4:
Figure 4:. Box and whisker plots of the relative changes in percent predicted values for Pulmonary Function Testing.
Relative changes were normalized to individual baseline values. “x” corresponds to mean values. Center horizontal line corresponds to median. Colored boxes represent the interquartile ranges. Small circles represent individual values. * = p < 0.05 when controlling for baseline disease stage. ** = p < 0.05 when controlling for individual patient.
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References

    1. O’Sullivan BP, Freedman SD. Cystic fibrosis. The Lancet. 2009;373(9678):1891–1904. - PubMed
    1. Surette MG. The Cystic Fibrosis Lung Microbiome. Ann Am Thorac Soc. 2014;11(Supplement 1):S61–S65. - PubMed
    1. 2017 Cystic Fibrosis Patient Registry Annual Data Report. 2017:96.
    1. Gibson RL, Burns JL, Ramsey BW. Pathophysiology and Management of Pulmonary Infections in Cystic Fibrosis. Am J Respir Crit Care Med. 2003;168(8):918–951. - PubMed
    1. Zemanick ET, Harris JK, Wagner BD, et al. Inflammation and Airway Microbiota during Cystic Fibrosis Pulmonary Exacerbations. PLOS ONE. 2013;8(4):e62917. - PMC - PubMed

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