Microbial Profiles in Feces and Sputum Linked to Treatment Outcomes in Mycobacterium abscessus PD
Overview
This study identified distinct microbial signatures in fecal and sputum microbiotas associated with treatment response in patients with Mycobacterium abscessus pulmonary disease (PD). Early treatment responders exhibited decreased fecal microbiota diversity and specific bacterial abundance changes, while sputum microbiota composition also correlated with outcomes.
Background
Mycobacterium abscessus is a rapidly growing nontuberculous mycobacterium causing challenging pulmonary disease due to antibiotic resistance. Treatment typically involves prolonged multidrug regimens, which may alter patients' microbiotas. The human microbiota plays a crucial role in health and disease, and prior studies have linked microbiota composition with outcomes in chronic respiratory diseases. However, longitudinal changes in gut and respiratory microbiotas during M abscessus PD treatment and their relationship with clinical response remain poorly understood.
Data Highlights
Parameter
Responders (n=15)
Nonresponders (n=12)
P value
Fecal microbiota diversity at 2 weeks
Significantly decreased
No significant change
0.029
Baseline fecal Eubacterium hallii abundance
Lower
Higher (indicative of unresponsiveness)
Not specified
Fecal Enterococcus abundance at 2 weeks
Increased (linked with favorable response)
Lower
Not specified
Baseline sputum Burkholderia-Caballeronia-Paraburkholderia and Porphyromonas
High levels (associated with good response)
Lower levels
Not specified
Sputum Rothia at 2 weeks
Decreased (associated with good response)
Not decreased
Not specified
Key Findings
Fifteen of 27 patients (55.6%) achieved sputum culture negative conversion at 2 weeks, sustained in 93.3% at 6 months.
Responders showed a significant decrease in fecal microbiota diversity at 2 weeks, unlike nonresponders (P = .029).
Higher baseline fecal abundance of Eubacterium hallii was indicative of treatment unresponsiveness.
Increased fecal Enterococcus at 2 weeks correlated with favorable treatment response.
High baseline sputum levels of Burkholderia-Caballeronia-Paraburkholderia and Porphyromonas were associated with good treatment outcomes.
Decreased sputum Rothia abundance at 2 weeks was linked to positive treatment response.
Clinical Implications
Monitoring changes in fecal and sputum microbiota diversity and specific bacterial abundances may serve as biomarkers to predict and assess treatment response in M abscessus pulmonary disease. These microbial signatures could potentially guide personalized therapeutic strategies and improve management of this difficult-to-treat infection.
Conclusion
Distinct alterations in gut and respiratory microbiota composition and diversity are associated with treatment outcomes in M abscessus PD. Microbial profiling holds promise as a tool for predicting and monitoring therapeutic response in this patient population.
References
Kwon et al. 2024 -- Microbial Profiles in Feces and Sputum Linked to Treatment Outcomes in Patients With Mycobacterium abscessus Pulmonary Disease
