Clinical and Lung Microbiome Impact of Chronic Versus Intermittent Pseudomonas aeruginosa Infection in Bronchiectasis

Fernández-Barat, Laia; López-Aladid, Ruben; Alcaraz-Serrano, Victoria; Vázquez, Nil; Bueno-Freire, Leticia; Pastor-Ibañez, Roque; Lingren, Lena; Sanz-Fraile, Héctor; Oscanoa, Patricia; Motos, Ana; Cabrera, Roberto; Vila, Jordi; Martínez, Daniel; Otero, Jordi; Farré, Ramon; Høiby, Niels; Torres, Antoni

doi:10.1016/j.arbres.2025.03.003

Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and translational research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

It is a monthly journal in which all manuscripts are sent to peer-review and handled by the editor or an associate editor from the team and the final decision is made on the basis of the comments from the expert reviewers and the editors. The journal is published solely in English. All the published data is composed of novel manuscripts not previously published in any other journal and not being in consideration for publication in any other journal..

The journal is indexed at Science Citation Index Expanded, Medline/Pubmed, Embase and SCOPUS. Access to any published article is possible through the journal's web page as well as from Pubmed, ScienceDirect, and other international databases. Furthermore, the journal is also present in X, Facebook and Linkedin. Manuscripts can be submitted electronically using the following web site: https://www.editorialmanager.com/ARBR/.

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, Ruben López-Aladida,b,c, Victoria Alcaraz-Serranoa,b,c, Nil Vázqueza,b,c, Leticia Bueno-Freirea,b,c, Roque Pastor-Ibañeza,b,c, Lena Lingrenf,g, Héctor Sanz-Fraileb, Patricia Oscanoaa,b,c, Ana Motosa,b,c, Roberto Cabreraa,b,c, Jordi Vilae, Daniel Martínezd, Jordi Oterob, Ramon Farréb, Niels Høibyf,g, Antoni Torresa,b,c

a CELLEX Research Laboratories, CibeRes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

b School of Medicine, Department of Medicine & Department of Biophysics and Bioengineering, University of Barcelona, Spain

c Pulmonology Department, Hospital Clínic, Barcelona, Spain

d Pathology Department, Hospital Clínic, Barcelona, Spain

e Microbiology Department, Hospital Clínic, CRESIB ISglobal, Barcelona, Spain

f Department of Clinical Microbiology of Rigshospitalet, Copenhagen, Denmark

g Institute of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark

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Figures (6)

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Tables (2)

Table 1. Characteristics of BE Patients With Intermittent vs. Chronic P. aeruginosa Infection.

Table 2. Univariate and Multivariable Logistic Regressison Analyses for Factors Independently Associated With Chronic Infection.

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Additional material (3)

Abstract

Background

In patients with non-cystic fibrosis bronchiectasis (BE) Pseudomonas aeruginosa (PA) has been recently associated with low rather than high number of exacerbations without distinguishing chronic versus intermittent infection. The aim of our study was to determine whether the intermittent or chronic stage of P. aeruginosa (PA) infection is associated with the rate of exacerbations, quality of life and respiratory microbiome biodiversity after a one-year follow-up.

Methods

We conducted a longitudinal study, with 1-year follow-up, in patients with BE intermittently or chronically infected by PA involving sequential (3-monthly) measurements of microbiological (cultures, PA load, phenotype and biofilms presence) immunological (Serum IgGs against P. aeruginosa were measured by ELISA immunoassay) and clinical variables (Quality-of-Life and the number exacerbations). Additionaly, 16S sequencing was performed on a MiSeq Platform and compared between chronically infected patients with the mucoid PA versus intermittently infected patients with the non-mucoid PA.

Results

We collected 235 sputa and 262 serum samples from 80 BE patients, 61 with chronic and 19 with intermittent PA infection. Chronically compared to intermittently.

Presented reduced quality of life but less hospitalized exacerbations after 1-year follow-up. Chronically infected patients presented reduced sputum biodiversity and higher systemic IgGs against P. aeruginosa levels that were associated to decreased number of hospitalized exacerbations.

Conclusions

The assessment of Chronic versus intermittent P. aeruginosa infection has clinical implications such as quality of life, rate of hospitalized exacerbations and lung microbiome biodiversity. The distinction of these two phenotypes is easy to perform in clinical practice.

Trial registration

NCT04803695.

Keywords:

Pseudomonas aeruginosa

Non-cystic fibrosis bronchiectasis

Exacerbations

Quality of life

Mucoid/non-mucoid phenotype

Microbiota

Microbiome

16S profiling

Biofilms