High Individuality of Respiratory Bacterial Communities in a Large Cohort of Adult Cystic Fibrosis Patients under Continuous Antibiotic Treatment. human lung metagenome

Cystic fibrosis is the most prevalent inherited disease among the Caucasian population. Many of these patients suffer from irreversible lung damages due to bacterial infections which are in about 80% of the cases the final cause of death. Therefore, monitoring the lung microbiota is of high relevance for the health care of the CF patient. In this study we provide insight in the prevalence and community composition of the microbiota using advanced molecular diagnostics on a large set of sputum samples from a cohort of 56 adult CF patients. This set allowed us to study bacterial community composition across all members of the cohort and its dynamics during 2 years. Results of these molecular analyses demonstrated high individuality of bacterial communities together with long-term persistence of anaerobic bacteria in some of these communities not detected by cultivation-base clinical diagnostics. Comparison with the detailed genetic make-up of the CF patients revealed the non-canonical mutants of the CFTR gene could be less detrimental, as seen in the lower incidence of Pseudomonas aeruginosa, the most lethal bacterium in CF lungs, in these patients. Advanced molecular diagnostics for CF patients could improve health care by providing early information on pathogenic polymicrobial assemblages.