Detection of Anaerobic Bacteria in High Numbers in Sputum from Patients with Cystic Fibrosis

Michael M. Tunney, Tyler R. Field, Thomas F. Moriarty, Sheila Patrick, Gerd Doering, Marianne S. Muhlebach, Matthew C. Wolfgang, Richard Boucher, Deirdre F. Gilpin, Andrew McDowell, J. Stuart Elborn

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    Abstract

    RATIONALE: Pulmonary infection in cystic fibrosis (CF) is polymicrobial and it is possible that anaerobic bacteria, not detected by routine aerobic culture methods, reside within infected anaerobic airway mucus.OBJECTIVES: To determine whether anaerobic bacteria are present in the sputum of patients with CF.METHODS: Sputum samples were collected from clinically stable adults with CF and bronchoalveolar lavage fluid (BALF) samples from children with CF. Induced sputum samples were collected from healthy volunteers who did not have CF. All samples were processed using anaerobic bacteriologic techniques and bacteria within the samples were quantified and identified.MEASUREMENTS AND MAIN RESULTS: Anaerobic species primarily within the genera Prevotella, Veillonella, Propionibacterium, and Actinomyces were isolated in high numbers from 42 of 66 (64%) sputum samples from adult patients with CF. Colonization with Pseudomonas aeruginosa significantly increased the likelihood that anaerobic bacteria would be present in the sputum. Similar anaerobic species were identified in BALF from pediatric patients with CF. Although anaerobes were detected in induced sputum samples from 16 of 20 volunteers, they were present in much lower numbers and were generally different species compared with those detected in CF sputum. Species-dependent differences in the susceptibility of the anaerobes to antibiotics with known activity against anaerobes were apparent with all isolates susceptible to meropenem.CONCLUSIONS: A range of anaerobic species are present in large numbers in the lungs of patients with CF. If these anaerobic bacteria are contributing significantly to infection and inflammation in the CF lung, informed alterations to antibiotic treatment to target anaerobes, in addition to the primary infecting pathogens, may improve management.
    LanguageEnglish
    Pages995-1001
    JournalAmerican Journal of Respiratory and Critical Care Medicine
    Volume177
    Issue number9
    DOIs
    Publication statusPublished - 2008

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    Anaerobic Bacteria
    Sputum
    Cystic Fibrosis
    meropenem
    Bronchoalveolar Lavage Fluid
    Lung
    Bacteriological Techniques
    Veillonella
    Prevotella
    Propionibacterium
    Anti-Bacterial Agents
    Actinomyces
    Mucus
    Infection
    Pseudomonas aeruginosa
    Volunteers
    Healthy Volunteers
    Pediatrics
    Inflammation
    Bacteria

    Cite this

    Tunney, M. M., Field, T. R., Moriarty, T. F., Patrick, S., Doering, G., Muhlebach, M. S., ... Elborn, J. S. (2008). Detection of Anaerobic Bacteria in High Numbers in Sputum from Patients with Cystic Fibrosis. American Journal of Respiratory and Critical Care Medicine, 177(9), 995-1001. https://doi.org/10.1164/rccm.200708-1151OC
    Tunney, Michael M. ; Field, Tyler R. ; Moriarty, Thomas F. ; Patrick, Sheila ; Doering, Gerd ; Muhlebach, Marianne S. ; Wolfgang, Matthew C. ; Boucher, Richard ; Gilpin, Deirdre F. ; McDowell, Andrew ; Elborn, J. Stuart. / Detection of Anaerobic Bacteria in High Numbers in Sputum from Patients with Cystic Fibrosis. In: American Journal of Respiratory and Critical Care Medicine. 2008 ; Vol. 177, No. 9. pp. 995-1001.
    @article{7bf0a2d2526740e6b5ce09eec90278b8,
    title = "Detection of Anaerobic Bacteria in High Numbers in Sputum from Patients with Cystic Fibrosis",
    abstract = "RATIONALE: Pulmonary infection in cystic fibrosis (CF) is polymicrobial and it is possible that anaerobic bacteria, not detected by routine aerobic culture methods, reside within infected anaerobic airway mucus.OBJECTIVES: To determine whether anaerobic bacteria are present in the sputum of patients with CF.METHODS: Sputum samples were collected from clinically stable adults with CF and bronchoalveolar lavage fluid (BALF) samples from children with CF. Induced sputum samples were collected from healthy volunteers who did not have CF. All samples were processed using anaerobic bacteriologic techniques and bacteria within the samples were quantified and identified.MEASUREMENTS AND MAIN RESULTS: Anaerobic species primarily within the genera Prevotella, Veillonella, Propionibacterium, and Actinomyces were isolated in high numbers from 42 of 66 (64{\%}) sputum samples from adult patients with CF. Colonization with Pseudomonas aeruginosa significantly increased the likelihood that anaerobic bacteria would be present in the sputum. Similar anaerobic species were identified in BALF from pediatric patients with CF. Although anaerobes were detected in induced sputum samples from 16 of 20 volunteers, they were present in much lower numbers and were generally different species compared with those detected in CF sputum. Species-dependent differences in the susceptibility of the anaerobes to antibiotics with known activity against anaerobes were apparent with all isolates susceptible to meropenem.CONCLUSIONS: A range of anaerobic species are present in large numbers in the lungs of patients with CF. If these anaerobic bacteria are contributing significantly to infection and inflammation in the CF lung, informed alterations to antibiotic treatment to target anaerobes, in addition to the primary infecting pathogens, may improve management.",
    author = "Tunney, {Michael M.} and Field, {Tyler R.} and Moriarty, {Thomas F.} and Sheila Patrick and Gerd Doering and Muhlebach, {Marianne S.} and Wolfgang, {Matthew C.} and Richard Boucher and Gilpin, {Deirdre F.} and Andrew McDowell and Elborn, {J. Stuart}",
    year = "2008",
    doi = "10.1164/rccm.200708-1151OC",
    language = "English",
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    Tunney, MM, Field, TR, Moriarty, TF, Patrick, S, Doering, G, Muhlebach, MS, Wolfgang, MC, Boucher, R, Gilpin, DF, McDowell, A & Elborn, JS 2008, 'Detection of Anaerobic Bacteria in High Numbers in Sputum from Patients with Cystic Fibrosis', American Journal of Respiratory and Critical Care Medicine, vol. 177, no. 9, pp. 995-1001. https://doi.org/10.1164/rccm.200708-1151OC

    Detection of Anaerobic Bacteria in High Numbers in Sputum from Patients with Cystic Fibrosis. / Tunney, Michael M.; Field, Tyler R.; Moriarty, Thomas F.; Patrick, Sheila; Doering, Gerd; Muhlebach, Marianne S.; Wolfgang, Matthew C.; Boucher, Richard; Gilpin, Deirdre F.; McDowell, Andrew; Elborn, J. Stuart.

    In: American Journal of Respiratory and Critical Care Medicine, Vol. 177, No. 9, 2008, p. 995-1001.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Detection of Anaerobic Bacteria in High Numbers in Sputum from Patients with Cystic Fibrosis

    AU - Tunney, Michael M.

    AU - Field, Tyler R.

    AU - Moriarty, Thomas F.

    AU - Patrick, Sheila

    AU - Doering, Gerd

    AU - Muhlebach, Marianne S.

    AU - Wolfgang, Matthew C.

    AU - Boucher, Richard

    AU - Gilpin, Deirdre F.

    AU - McDowell, Andrew

    AU - Elborn, J. Stuart

    PY - 2008

    Y1 - 2008

    N2 - RATIONALE: Pulmonary infection in cystic fibrosis (CF) is polymicrobial and it is possible that anaerobic bacteria, not detected by routine aerobic culture methods, reside within infected anaerobic airway mucus.OBJECTIVES: To determine whether anaerobic bacteria are present in the sputum of patients with CF.METHODS: Sputum samples were collected from clinically stable adults with CF and bronchoalveolar lavage fluid (BALF) samples from children with CF. Induced sputum samples were collected from healthy volunteers who did not have CF. All samples were processed using anaerobic bacteriologic techniques and bacteria within the samples were quantified and identified.MEASUREMENTS AND MAIN RESULTS: Anaerobic species primarily within the genera Prevotella, Veillonella, Propionibacterium, and Actinomyces were isolated in high numbers from 42 of 66 (64%) sputum samples from adult patients with CF. Colonization with Pseudomonas aeruginosa significantly increased the likelihood that anaerobic bacteria would be present in the sputum. Similar anaerobic species were identified in BALF from pediatric patients with CF. Although anaerobes were detected in induced sputum samples from 16 of 20 volunteers, they were present in much lower numbers and were generally different species compared with those detected in CF sputum. Species-dependent differences in the susceptibility of the anaerobes to antibiotics with known activity against anaerobes were apparent with all isolates susceptible to meropenem.CONCLUSIONS: A range of anaerobic species are present in large numbers in the lungs of patients with CF. If these anaerobic bacteria are contributing significantly to infection and inflammation in the CF lung, informed alterations to antibiotic treatment to target anaerobes, in addition to the primary infecting pathogens, may improve management.

    AB - RATIONALE: Pulmonary infection in cystic fibrosis (CF) is polymicrobial and it is possible that anaerobic bacteria, not detected by routine aerobic culture methods, reside within infected anaerobic airway mucus.OBJECTIVES: To determine whether anaerobic bacteria are present in the sputum of patients with CF.METHODS: Sputum samples were collected from clinically stable adults with CF and bronchoalveolar lavage fluid (BALF) samples from children with CF. Induced sputum samples were collected from healthy volunteers who did not have CF. All samples were processed using anaerobic bacteriologic techniques and bacteria within the samples were quantified and identified.MEASUREMENTS AND MAIN RESULTS: Anaerobic species primarily within the genera Prevotella, Veillonella, Propionibacterium, and Actinomyces were isolated in high numbers from 42 of 66 (64%) sputum samples from adult patients with CF. Colonization with Pseudomonas aeruginosa significantly increased the likelihood that anaerobic bacteria would be present in the sputum. Similar anaerobic species were identified in BALF from pediatric patients with CF. Although anaerobes were detected in induced sputum samples from 16 of 20 volunteers, they were present in much lower numbers and were generally different species compared with those detected in CF sputum. Species-dependent differences in the susceptibility of the anaerobes to antibiotics with known activity against anaerobes were apparent with all isolates susceptible to meropenem.CONCLUSIONS: A range of anaerobic species are present in large numbers in the lungs of patients with CF. If these anaerobic bacteria are contributing significantly to infection and inflammation in the CF lung, informed alterations to antibiotic treatment to target anaerobes, in addition to the primary infecting pathogens, may improve management.

    U2 - 10.1164/rccm.200708-1151OC

    DO - 10.1164/rccm.200708-1151OC

    M3 - Article

    VL - 177

    SP - 995

    EP - 1001

    JO - American Journal of Respiratory and Critical Care Medicine

    T2 - American Journal of Respiratory and Critical Care Medicine

    JF - American Journal of Respiratory and Critical Care Medicine

    SN - 1073-449X

    IS - 9

    ER -