Complexity, temporal stability, and clinical correlates of airway bacterial community composition in primary ciliary dyskinesia

Rogers, Geraint B., Carroll, Mary P., Zain, Nur Masirah M., Bruce, Kenneth D., Lock, Karen, Walker, Woolf, Jones, Graeme, Daniels, Thomas W.V. and Lucas, Jane S. (2013) Complexity, temporal stability, and clinical correlates of airway bacterial community composition in primary ciliary dyskinesia. Journal of Clinical Microbiology, 51 (12), 4029-4035. (doi:10.1128/JCM.02164-13). (PMID:24068019)

Abstract

Primary ciliary dyskinesia (PCD) is a genetic disease characterised by abnormalities in ciliary function, leading to compromised airway clearance and chronic bacterial infection of the upper and lower airways. The composition of these infections, and the relationships between their characteristics and disease, are ill-defined. We describe the first systematic, culture-independent evaluation of lower airway bacteriology in PCD. Thirty-three airway samples (26 sputa, 7 BAL) were collected from 24 PCD patients aged 4 to 73 years. 16S rRNA quantitative PCR and pyrosequencing were used to determine load and community composition. Bacterial load, which ranged from 1.3x10(4) to 5.2x10(9) cfu/ml, was positively correlated with age (p=0.002) but not lung function. Analysis of ?7000 16S rRNA sequences per sample identified bacterial species belonging to 128 genera. Concurrently collected paired samples showed high bacterial community similarity. Mean relative abundance of dominant genera was 64.5% (SD ± 24.5), with these taxa including those reported through standard diagnostic microbiology (members of the genera Pseudomonas, Haemophilus, and Streptococcus) and those requiring specific ex vivo growth conditions (members of the genera Prevotella and Porphyromonas). Significant correlations observed included a positive relationship between P. aeruginosa relative abundance and age, and a negative relationship between P. aeruginosa relative abundance and lung function. The genus Ralstonia was also found to contribute substantially to the bacterial communities of a number of patients. Follow-up samples from a subset of patients revealed high levels of community temporal stability. The detailed microbiological characterisation presented here provides a basis for a reassessment of the clinical management of PCD airway infections.

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Contributors

Author: Jane S. Lucas

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