Differences in sputum microbiota based on cure status of patients with nontuberculous mycobacterial pulmonary disease

Kang, Noeul; Kim, Su-Young; Kim, Dae Hun; Jhun, Byung Woo

doi:.0..

Korean J Intern Med > Epub ahead of print

ORIGINAL ARTICLE

Differences in sputum microbiota based on cure status of patients with nontuberculous mycobacterial pulmonary disease

Noeul Kang¹, Su-Young Kim², Dae Hun Kim², and Byung Woo Jhun²

¹Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
²Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Corresponding Author: Byung Woo Jhun , Tel: +82-2-3410-0839, Fax: +82-2-3412-3996, Email: byungwoo.jhun@gmail.com

Received: June 9, 2024; Revised: September 2, 2024; Accepted: September 23, 2024.

Abstract

Background/Aims: To analyze the characteristics of the sputum microbiota of patients with nontuberculous mycobacteria pulmonary disease (NTM-PD) based on treatment status.
Methods: Twenty-eight sputum samples from 14 patients with NTM-PD, including 14 samples from the microbiologically cured group (7 at baseline and 7 during follow-up) and 14 from the treatment-refractory group (7 at baseline and 7 during follow-up) were included in this study. Bacterial microbiota was analyzed by sequencing the V3–V4 region of the 16S rRNA gene.
Results: Among the 14 patients, most had infections with Mycobacterium avium complex (n = 6), followed by Mycobacterium abscessus (n = 5); three patients exhibited mixed infection with both organisms. Alpha-diversity was higher in the cured group than in the treatment refractory group in both the baseline sputum (ACE, p = 0.005; Chao1, p = 0.010; Jackknife, p = 0.022, 0.043; Shannon, p = 0.048) and follow-up sputum (ACE, p = 0.018). Linear discriminant analysis effect size revealed that several taxa showed differential distributions based on treatment status. At the species level, Streptococcus pneumoniae, Prevotella melaninogenica, Haemophilus parahaemolyticus, Haemophilus haemolyticus, Fusobacterium nucleatum, Neisseria elongata, and Prevotella denticola were more abundant in sputum from the microbiologically cured group than in that from the refractory group (all p < 0.05).
Conclusions: In contrast to patients with treatment-refractory NTM-PD, those with stable disease without recurrence had higher microbial diversity in their sputum, including several predominant taxa.

Keywords: Lung ; Microbiota ; Mycobacterium avium complex ; Mycobacterium abscessus