[PDF][PDF] Direct lung sampling indicates that established pathogens dominate early infections in children with cystic fibrosis

P Jorth, Z Ehsan, A Rezayat, E Caldwell, C Pope… - Cell reports, 2019 - cell.com
P Jorth, Z Ehsan, A Rezayat, E Caldwell, C Pope, JJ Brewington, CH Goss, D Benscoter…
Cell reports, 2019cell.com
Culture and sequencing have produced divergent hypotheses about cystic fibrosis (CF) lung
infections. Culturing suggests that CF lungs are uninfected before colonization by a limited
group of CF pathogens. Sequencing suggests diverse communities of mostly oral bacteria
inhabit lungs early on and diversity decreases as disease progresses. We studied the lung
microbiota of CF children using bronchoscopy and sequencing, with measures to reduce
contamination. We found no evidence for oral bacterial communities in lung lavages that …
Summary
Culture and sequencing have produced divergent hypotheses about cystic fibrosis (CF) lung infections. Culturing suggests that CF lungs are uninfected before colonization by a limited group of CF pathogens. Sequencing suggests diverse communities of mostly oral bacteria inhabit lungs early on and diversity decreases as disease progresses. We studied the lung microbiota of CF children using bronchoscopy and sequencing, with measures to reduce contamination. We found no evidence for oral bacterial communities in lung lavages that lacked CF pathogens. Lavage microbial diversity varied widely, but decreases in diversity appeared to be driven by increased CF pathogen abundance, which reduced the signal from contaminants. Streptococcus, Prevotella, and Veillonella DNA was detected in some lavages containing CF pathogens, but DNA from these organisms was vastly exceeded by CF pathogen DNA and was not associated with inflammation. These findings support the hypothesis that established CF pathogens are primarily responsible for CF lung infections.
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