Internal transcribed spacer (ITS) sequencing for Acute Lung Injury Registry

In critically ill patients, variation in the host inflammatory responses have been associated with poor outcomes. However, the biological mechanisms underlying this heterogeneity have not yet been defined. We investigated whether variation fungal communities (mycobiome) in the respiratory tract are associated with host inflammation and innate immune system activation and clinical and patient centered outcomes.We collected endotracheal aspirates (ETA), oral wash and plasma samples from critically ill patients. We used extracted DNA from ETAs and performed fungal rRNA gene sequencing (internal transcribed spacer [ITS]) on the Illumina MiSeq platform to characterize the lower respiratory tract mycobiome. We derived diversity metrics to classify patients into strata based on the alpha diversity of the mycobiome and examined for associations with diversity strata and clinical and patient centered outcomes.