학술논문
Profiling Bacteria in the Lungs of Patients with Severe Influenza Versus COVID-19 with or without Aspergillosis.
Document Type
Academic Journal
Author
Feys S; KU Leuven University Hospitals Leuven, Leuven, Belgium.; Cardinali-Benigni M; Barcelona Supercomputing Centre (BSC-CNS), Barcelona, Spain.; Lauwers HM; KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Flanders, Belgium.; Jacobs C; KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Flanders, Belgium.; Stevaert A; KU Leuven, Leuven, Flanders, Belgium.; Gonçalves SM; UMinho, Braga, Portugal.; ICVS 3B's Associate Laboratory, Guimaraes, Braga, Portugal.; Cunha C; University of Minho, Life and Health Sciences Research Institute (ICVS), Braga, Portugal.; Debaveye Y; KU Leuven, Belgium, Laboratory of Intensive Care Medicine, Division of Cellular and Molecular Medicine, Leuven, Belgium.; Hermans G; KU Leuven University Hospitals Leuven, Department of Cellular and Molecular Medicine, Leuven, Flanders, Belgium.; KU Leuven University Hospitals Leuven, Department of Critical Care , Leuven, Flanders, Belgium.; Heylen J; KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Flanders, Belgium.; KU Leuven, Leuven, Flanders, Belgium.; Humblet-Baron S; KU Leuven, Laboratory of Adaptive Immunity, Department of Microbiology, Immunology and Transplantation, Leuven, Flanders, Belgium.; Lagrou K; KU Leuven - University of Leuven, Leuven, Belgium, Department of Microbiology and Immunology, Leuven, Belgium.; Maessen L; University Hospitals Leuven, Leuven, Vlaams-Brabant, Belgium.; Meersseman P; University Hospitals Leuven, Medical Intensive Care Unit, Leuven, Belgium.; Peetermans M; KU Leuven, Department of Microbiology, Immunology and Transplantation, Leuven, Flanders, Belgium.; Katholieke Universiteit Leuven UZ Leuven, Medical Intensive Care Unit, Leuven, Flanders, Belgium.; Redondo-Rios A; IRB Barcelona, Barcelona, Spain.; Seldeslachts L; KU Leuven, Biomedical MRI, Department of Imaging and Pathology, Leuven, Flanders, Belgium.; Starick MR; KU Leuven Department of Microbiology Immunology and Transplantation, Leuven, Flanders, Belgium.; Thevissen K; KU Leuven, Department of Microbial and Molecular Systems, Leuven, Flanders, Belgium.; Vande Velde G; KU Leuven, Biomedical MRI, Department of Imaging and Pathology, Leuven, Flanders, Belgium.; Vandenbriele C; KU Leuven Biomedical Sciences Group, Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Leuven, Belgium.; KU Leuven University Hospitals Leuven, Department of Cardiovascular Diseases, Leuven, Belgium.; Vanderbeke L; University Hospitals Leuven, Leuven, Vlaams-Brabant, Belgium.; Wilmer A; University Hospitals Leuven, Medical Intensive Care Unit, Leuven, Belgium.; Naesens L; KU Leuven, Laboratory of Virology and Chemotherapy (Rega Institute), Department of Microbiology, Immunology and Transplantation, Leuven, Flanders, Belgium.; van de Veerdonk FL; Radboudumc, Nijmegen, Gelderland, Netherlands.; Van Weyenbergh J; KU Leuven, Laboratory for Clinical and Epidemiological Virology - Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Flanders, Belgium.; Gabaldón T; Barcelona Supercomputing Centre (BSC-CNS), Barcelona, Spain.; Wauters J; KU Leuven, Leuven, Flanders, Belgium.; Carvalho A; University of Minho, Braga, Portugal; agostinhocarvalho@med.uminho.pt.
Source
Publisher: American Thoracic Society Country of Publication: United States NLM ID: 9421642 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1535-4970 (Electronic) Linking ISSN: 1073449X NLM ISO Abbreviation: Am J Respir Crit Care Med Subsets: MEDLINE
Subject
Language
English
Abstract
Rationale: The influence of the lung bacterial microbiome, including potential pathogens, in patients with influenza- or COVID-19-associated pulmonary aspergillosis (IAPA or CAPA) is yet to be explored.
Objectives: To explore the composition of the lung bacterial microbiome and its association with viral and fungal infection, immunity and outcome in severe influenza versus COVID-19 with or without aspergillosis.
Methods: We performed a retrospective study in mechanically ventilated influenza and COVID-19 patients with or without invasive aspergillosis in whom bronchoalveolar lavage (BAL) for bacterial culture (with or without PCR) was obtained within two weeks after ICU admission. Additionally, 16S rRNA gene sequencing data and viral and bacterial load of BAL samples from a subset of these patients, and of patients requiring non-invasive ventilation, were analyzed. We integrated 16S rRNA gene sequencing data with existing immune parameter datasets.
Measurements and Main Results: Potential bacterial pathogens were detected in 20% (28/142) of influenza and 37% (104/281) of COVID-19 patients, while aspergillosis was detected in 38% (54/142) of influenza and 31% (86/281) of COVID-19 patients. A significant association between bacterial pathogens in BAL and 90-day mortality was found only in influenza patients, particularly IAPA patients. COVID-19 but not influenza patients showed increased pro-inflammatory pulmonary cytokine responses to bacterial pathogens.
Conclusions: Aspergillosis is more frequently detected in lungs of severe influenza patients than bacterial pathogens. Detection of bacterial pathogens associates with worse outcome in influenza patients, particularly in those with IAPA, but not in COVID-19 patients. The immunological dynamics of tripartite viral-fungal-bacterial interactions deserve further investigation. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Objectives: To explore the composition of the lung bacterial microbiome and its association with viral and fungal infection, immunity and outcome in severe influenza versus COVID-19 with or without aspergillosis.
Methods: We performed a retrospective study in mechanically ventilated influenza and COVID-19 patients with or without invasive aspergillosis in whom bronchoalveolar lavage (BAL) for bacterial culture (with or without PCR) was obtained within two weeks after ICU admission. Additionally, 16S rRNA gene sequencing data and viral and bacterial load of BAL samples from a subset of these patients, and of patients requiring non-invasive ventilation, were analyzed. We integrated 16S rRNA gene sequencing data with existing immune parameter datasets.
Measurements and Main Results: Potential bacterial pathogens were detected in 20% (28/142) of influenza and 37% (104/281) of COVID-19 patients, while aspergillosis was detected in 38% (54/142) of influenza and 31% (86/281) of COVID-19 patients. A significant association between bacterial pathogens in BAL and 90-day mortality was found only in influenza patients, particularly IAPA patients. COVID-19 but not influenza patients showed increased pro-inflammatory pulmonary cytokine responses to bacterial pathogens.
Conclusions: Aspergillosis is more frequently detected in lungs of severe influenza patients than bacterial pathogens. Detection of bacterial pathogens associates with worse outcome in influenza patients, particularly in those with IAPA, but not in COVID-19 patients. The immunological dynamics of tripartite viral-fungal-bacterial interactions deserve further investigation. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).