Analysis of the microbiota of sputum samples from patients with lower respiratory tract infections.

Sputum is the most common sample collected from patients suffering from lower respiratory tract infections and it is crucial for the bacterial identification of these infections. In this study, we enrolled 101 sputum samples from 101 patients with lower respiratory tract infections. Initially, pyrosequencing of the 16S rDNA V3 hypervariable regions of the bacteria contained in the sputum was utilized as a culture-independent approach for microbiota analysis. For comparison, clinical laboratory tests using a culture-dependent automated bacterial identification system for the same cohort of sputum samples were also done. By pyrosequencing, >70,000 DNA fragments were found and classified into 129 bacterial genera after being analyzed by the Ribosomal Database Project (RDP) process. Most sequences belonged to several predominant genera, such as Streptococcus and Staphylococcus, indicating that these genera play an important role in lower respiratory tract infections. In addition, some sequences belonging to potential causative agents, such as Mycoplasma, Haemophilus, and Moraxella, were also found, but these sequences were not found by clinical laboratory tests. For the nine genera detected by both methods, the methods' sensitivities were compared and the results showed that pyrosequencing was more sensitive, except for Klebsiella and Mycobacterium. Significantly, this method revealed much more complicated bacterial communities and it showed a promising ability for the detection of bacteria.

[1]  James R. Cole,et al.  The Ribosomal Database Project: improved alignments and new tools for rRNA analysis , 2008, Nucleic Acids Res..

[2]  T. File Community-acquired pneumonia , 2003, The Lancet.

[3]  R. Brown,et al.  Community-acquired pneumonia caused by mixed aerobic bacteria. , 1986, Chest.

[4]  A. Ahuja,et al.  Role of ‘atypical pathogens’ among adult hospitalized patients with community‐acquired pneumonia , 2009, Respirology.

[5]  J. Ravel,et al.  Community Analysis of Chronic Wound Bacteria Using 16S rRNA Gene-Based Pyrosequencing: Impact of Diabetes and Antibiotics on Chronic Wound Microbiota , 2009, PloS one.

[6]  U. Stenzel,et al.  Parallel tagged sequencing on the 454 platform , 2008, Nature Protocols.

[7]  D. Alland,et al.  A detailed analysis of 16S ribosomal RNA gene segments for the diagnosis of pathogenic bacteria. , 2007, Journal of microbiological methods.

[8]  R. Holman,et al.  Risk Factors for Lower Respiratory Tract Infection Death Among Infants in the United States, 1999–2004 , 2009, Pediatrics.

[9]  J. Sarles,et al.  Microbial diversity in the sputum of a cystic fibrosis patient studied with 16S rDNA pyrosequencing , 2009, European Journal of Clinical Microbiology & Infectious Diseases.

[10]  J. Tiedje,et al.  Naïve Bayesian Classifier for Rapid Assignment of rRNA Sequences into the New Bacterial Taxonomy , 2007, Applied and Environmental Microbiology.

[11]  I. Harman-boehm,et al.  Clinical and epidemiologic investigation of two Legionella-Rickettsia co-infections. , 2003, The Israel Medical Association journal : IMAJ.

[12]  Christina C. Chang,et al.  Lower respiratory tract infections. , 2009, Pediatric clinics of North America.

[13]  Susan M. Huse,et al.  Metagenomic study of the oral microbiota by Illumina high-throughput sequencing. , 2009, Journal of microbiological methods.

[14]  S. Dowell,et al.  Epidemiology of severe pneumonia caused by Legionella longbeachae, Mycoplasma pneumoniae, and Chlamydia pneumoniae: 1-year, population-based surveillance for severe pneumonia in Thailand. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[15]  S. Awasthi,et al.  Atypical bacterial pathogens in community-acquired pneumonia in children: a hospital-based study , 2009, Tropical doctor.

[16]  Les Dethlefsen,et al.  The Pervasive Effects of an Antibiotic on the Human Gut Microbiota, as Revealed by Deep 16S rRNA Sequencing , 2008, PLoS biology.

[17]  M. Blaser,et al.  What are the consequences of the disappearing human microbiota? , 2009, Nature Reviews Microbiology.

[18]  Naoko Chiba,et al.  Co‐Infection with Respiratory Syncytial Virus Subgroup A and Streptococcus Pneumoniae Detected by a Comprehensive Real‐Time Polymerase Chain Reaction Assay in an Elderly Patient with Community‐Acquired Pneumonia , 2009, Journal of the American Geriatrics Society.

[19]  J. Nikkilä,et al.  Diarrhoea-predominant irritable bowel syndrome distinguishable by 16S rRNA gene phylotype quantification. , 2009, World journal of gastroenterology.

[20]  M. de Vincentiis,et al.  [Paucisymptomatic pneumonia due to Rothia mucilaginosa: case report and literature review]. , 2009, Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive.

[21]  Isao Ishikawa,et al.  Comparison of the Oral Bacterial Flora in Saliva from a Healthy Subject and Two Periodontitis Patients by Sequence Analysis of 16S rDNA Libraries , 2000, Microbiology and immunology.

[22]  G. Toews,et al.  Rapid diagnosis of community-acquired bacterial pneumonia. , 1983, The American review of respiratory disease.

[23]  U. Stenzel,et al.  Targeted high-throughput sequencing of tagged nucleic acid samples , 2007, Nucleic acids research.

[24]  K. Strålin Usefulness of aetiological tests for guiding antibiotic therapy in community-acquired pneumonia. , 2008, International journal of antimicrobial agents.

[25]  Susan M. Huse,et al.  Pyrosequencing analysis of the Oral Microflora of healthy adults , 2008, Journal of dental research.