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. 2024 Sep 9;23(1):83.
doi: 10.1186/s12941-024-00742-y.

Dynamic changes of respiratory microbiota associated with treatment outcome in drug-sensitive and drug-resistant pulmonary tuberculosis

Yuan Lin #  1 , Zhuozhi Liang #  2 , Xingshan Cai  3 , Yang Luo  3 , Bitong Wu  1 , Yongzhong Feng  1 , Zhiqun Cai  1 , Xiaopeng Liang  1 , Shouyong Tan  4
Affiliations

Dynamic changes of respiratory microbiota associated with treatment outcome in drug-sensitive and drug-resistant pulmonary tuberculosis

Yuan Lin et al. Ann Clin Microbiol Antimicrob. .

Abstract

Background: Respiratory microbiota is closely related to tuberculosis (TB) initiation and progression. However, the dynamic changes of respiratory microbiota during treatment and its association with TB progression remains unclear.

Methods: A total of 16 healthy individuals and 16 TB patients (10 drug-sensitive TB (DS-TB) and 6 drug-resistant TB (DR-TB)) were recruited. Sputum samples were collected at baseline for all anticipants and after anti-TB treatment at Month-6 for TB patients. High throughput 16 S RNA sequencing was used to characterize the respiratory microbiota composition.

Results: Compared to the healthy individuals, TB patients exhibited lower respiratory microbiota diversity (p < 0.05). This disruption was alleviated after anti-TB treatment, especially for DS-TB patients. Parvimonas spp. numbers significantly increased after six months of anti-TB treatment in both DS-TB and DR-TB patients (p < 0.05). Rothia spp. increase during treatment was associated with longer sputum-culture conversion time and worse pulmonary lesion absorption (p < 0.05). Besides, Moraxella spp. prevalence was associated with longer sputum-culture conversion time, while Gemella spp. increase was associated with worsening resolving of pulmonary lesions (p < 0.05).

Conclusion: Dynamic changes of respiratory microbiota during anti-TB treatment is closely related to TB progression. The involvement of critical microorganisms, such as Parvimonas spp., Rothia spp., Moraxella, and Gemella spp., appears to be associated with pulmonary inflammatory conditions, particularly among DR-TB. These microorganisms could potentially serve as biomarkers or even as targets for therapeutic intervention to enhance the prognosis of tuberculosis patients.

Keywords: Respiratory microbiota; Treatment outcome; Tuberculosis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Association between respiratory microbiota diversity and anti-TB treatment outcome. (A) Boxplot showing difference in respiratory microbiota diversity between healthy individuals, DS-TB patients, and DR-TB patients. (B) Dynamic changes of microbiota diversity for TB patients, DS-TB patients, and DR-TB patients. (C) Heatmap visualization of bacterial generas abundance in TB patients before and after anti-TB treatments. (D) Venn diagram showing the number of microbiota generas that significantly changed after anti-TB treatment. (E) Dynamic changes of Parvimonas spp., Megasphaera spp., Streptococcus spp., and Prevotella spp. before and after anti-TB treatment
Fig. 2
Fig. 2
Association between dynamic changes of respiratory microbiota and sputum-culture conversion. (A) Heatmap visualization of foldchanges in bacterial generas abundance in TB patients with long and short sputum-culture conversion time. (B) Venn diagram showing the number of microbiota generas that were associated with sputum-culture conversion. (C) Boxplot showing the foldchanges in Moraxella spp., Rothia spp., Kingella spp., and Peptostreptococcus spp. among TB patients with long and short sputum-culture conversion time
Fig. 3
Fig. 3
Association between dynamic changes of respiratory microbiota and resolving of pulmonary lesions. (A) Heatmap visualization of foldchanges in bacterial generas abundance in TB patients with complete and incomplete resolving of pulmonary lesions. (B) Venn diagram showing the number of microbiota generas that were associated with resolving of pulmonary lesions. (C) Boxplot showing the foldchanges in Rothia spp., Gemella spp., Alloprevotella spp., Saccharibacteria spp., Corynebacterium spp., and Peptostreptococcaceae_incertae_sedis spp. among TB patients with complete and incomplete resolving of pulmonary lesions
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