A persistent and diverse airway microbiota present during chronic obstructive pulmonary disease exacerbations

OMICS. 2010 Feb;14(1):9-59. doi: 10.1089/omi.2009.0100.

Abstract

Acute exacerbations of chronic obstructive pulmonary disease (COPD) are a major source of morbidity and contribute significantly to healthcare costs. Although bacterial infections are implicated in nearly 50% of exacerbations, only a handful of pathogens have been consistently identified in COPD airways, primarily by culture-based methods, and the bacterial microbiota in acute exacerbations remains largely uncharacterized. The aim of this study was to comprehensively profile airway bacterial communities using a culture-independent microarray, the 16S rRNA PhyloChip, of a cohort of COPD patients requiring ventilatory support and antibiotic therapy for exacerbation-related respiratory failure. PhyloChip analysis revealed the presence of over 1,200 bacterial taxa representing 140 distinct families, many previously undetected in airway diseases; bacterial community composition was strongly influenced by the duration of intubation. A core community of 75 taxa was detected in all patients, many of which are known pathogens. Bacterial community diversity in COPD airways is substantially greater than previously recognized and includes a number of potential pathogens detected in the setting of antibiotic exposure. Comprehensive assessment of the COPD airway microbiota using high-throughput, culture-independent methods may prove key to understanding the relationships between airway bacterial colonization, acute exacerbation, and clinical outcomes in this and other chronic inflammatory airway diseases.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bacteria / classification
  • Bacteria / genetics
  • Base Sequence
  • Bronchi / microbiology*
  • Bronchoalveolar Lavage Fluid
  • Cohort Studies
  • DNA Primers
  • Female
  • Humans
  • Male
  • Middle Aged
  • Phylogeny
  • Polymerase Chain Reaction
  • Pulmonary Disease, Chronic Obstructive / microbiology*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • RNA, Ribosomal, 16S / genetics

Substances

  • DNA Primers
  • RNA, Ribosomal, 16S