HeiraliAcostaStoreyEtAl2019
Référence
Heirali, A.A., Acosta, N., Storey, D.G., Workentine, M.L., Somayaji, R., Laforest-Lapointe, I., Leung, W., Quon, B.S., Berthiaume, Y., Rabin, H.R., Waddell, B.J., Rossi, L., Surette, M.G., Parkins, M.D. (2019) The effects of cycled inhaled aztreonam on the cystic fibrosis (CF) lung microbiome. Journal of Cystic Fibrosis, 18(6):829-837. (Scopus 
)
Résumé
Background: To improve clinical outcomes, cystic fibrosis (CF) patients with chronic Pseudomonas aeruginosa infections are prescribed inhaled anti-pseudomonal antibiotics. Although, a diverse microbial community exists within CF airways, little is known about how the CF microbiota influences patient outcomes. We hypothesized that organisms within the CF microbiota are affected by inhaled-antibiotics and baseline microbiome may be used to predict therapeutic response. Methods: Adults with chronic P. aeruginosa infection from four clinics were observed during a single 28-day on/off inhaled-aztreonam cycle. Patients performed serial sputum collection, CF-respiratory infection symptom scores (CRISS), and spirometry. Patients achieving a decrease of ≥2 CRISS by day 28 were categorized as subjective responders (SR). The airway microbiome was defined by Illumina MiSeq analysis of the 16S rRNA gene. Results: Thirty-seven patients (median 37.4 years and FEV1 44% predicted) were enrolled. No significant cohort-wide changes in the microbiome were observed between on/off AZLI cycles in either alpha- or beta-diversity metrics. However, at an individual level shifts were apparent. Twenty-one patients (57%) were SR and fourteen patients did not subjectively respond. While alpha-diversity metrics did not associate with response, patients who did not subjectively respond had a higher abundance of Staphylococcus and Streptococcus, and lower abundance of Haemophilus. Conclusions: The CF microbiome is relatively resilient to AZLI perturbations. However, associated changes were observed at the individual patient level. The relative abundance of key “off-target” organisms associated with subjective improvements suggesting that the microbiome may be used as a tool to predict patient response - potentially improving outcomes. © 2019
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@ARTICLE { HeiraliAcostaStoreyEtAl2019,
AUTHOR = { Heirali, A.A. and Acosta, N. and Storey, D.G. and Workentine, M.L. and Somayaji, R. and Laforest-Lapointe, I. and Leung, W. and Quon, B.S. and Berthiaume, Y. and Rabin, H.R. and Waddell, B.J. and Rossi, L. and Surette, M.G. and Parkins, M.D. },
JOURNAL = { Journal of Cystic Fibrosis },
TITLE = { The effects of cycled inhaled aztreonam on the cystic fibrosis (CF) lung microbiome },
YEAR = { 2019 },
NOTE = { cited By 10 },
NUMBER = { 6 },
PAGES = { 829-837 },
VOLUME = { 18 },
ABSTRACT = { Background: To improve clinical outcomes, cystic fibrosis (CF) patients with chronic Pseudomonas aeruginosa infections are prescribed inhaled anti-pseudomonal antibiotics. Although, a diverse microbial community exists within CF airways, little is known about how the CF microbiota influences patient outcomes. We hypothesized that organisms within the CF microbiota are affected by inhaled-antibiotics and baseline microbiome may be used to predict therapeutic response. Methods: Adults with chronic P. aeruginosa infection from four clinics were observed during a single 28-day on/off inhaled-aztreonam cycle. Patients performed serial sputum collection, CF-respiratory infection symptom scores (CRISS), and spirometry. Patients achieving a decrease of ≥2 CRISS by day 28 were categorized as subjective responders (SR). The airway microbiome was defined by Illumina MiSeq analysis of the 16S rRNA gene. Results: Thirty-seven patients (median 37.4 years and FEV1 44% predicted) were enrolled. No significant cohort-wide changes in the microbiome were observed between on/off AZLI cycles in either alpha- or beta-diversity metrics. However, at an individual level shifts were apparent. Twenty-one patients (57%) were SR and fourteen patients did not subjectively respond. While alpha-diversity metrics did not associate with response, patients who did not subjectively respond had a higher abundance of Staphylococcus and Streptococcus, and lower abundance of Haemophilus. Conclusions: The CF microbiome is relatively resilient to AZLI perturbations. However, associated changes were observed at the individual patient level. The relative abundance of key “off-target” organisms associated with subjective improvements suggesting that the microbiome may be used as a tool to predict patient response - potentially improving outcomes. © 2019 },
AFFILIATION = { Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada; Department of Biological Sciences, University of Calgary, Calgary, AB, Canada; Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada; Department of Medicine, University of Calgary, Calgary, AB, Canada; Departments of Physiology & Pharmacology, University of Calgary, Calgary, AB, Canada; Department of Pediatrics, University of CalgaryAlberta, Canada; Department of Medicine, University of Alberta, Edmonton, AB, Canada; Department of Medicine and Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada; Institut de recherches cliniques de Montreal and Department of Medicine, Universite de MontrealQB, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada },
AUTHOR_KEYWORDS = { AZLI; Cycled therapy; Inhaled antibiotics; Nebulized; Pseudomonas aeruginosa; Staphylococcus aureus; Streptococcus },
DOCUMENT_TYPE = { Article },
DOI = { 10.1016/j.jcf.2019.02.010 },
SOURCE = { Scopus },
URL = { https://www.scopus.com/inward/record.uri?eid=2-s2.0-85062439113&doi=10.1016%2fj.jcf.2019.02.010&partnerID=40&md5=eba21a94f19983557c022cab1c22ea98 },
}
