𝐂𝐡𝐚𝐧𝐠𝐞𝐬 𝐢𝐧 𝐬𝐩𝐮𝐭𝐮𝐦 𝐦𝐢𝐜𝐫𝐨𝐛𝐢𝐨𝐭𝐚 𝐝𝐮𝐫𝐢𝐧𝐠 𝐭𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 𝐟𝐨𝐫 𝐧𝐨𝐧𝐭𝐮𝐛𝐞𝐫𝐜𝐮𝐥𝐨𝐮𝐬 𝐦𝐲𝐜𝐨𝐛𝐚𝐜𝐭𝐞𝐫𝐢𝐚𝐥 𝐩𝐮𝐥𝐦𝐨𝐧𝐚𝐫𝐲 𝐝𝐢𝐬𝐞𝐚𝐬𝐞

💡 This study investigates the dynamic alterations in sputum bacterial microbiota diversity in patients with non-tuberculous mycobacterial pulmonary disease (NTM-PD) undergoing antibiotic treatment.

📍 Methods:

Serial sputum samples were collected, and 16S rRNA sequencing was employed for microbiota analysis. Alpha-diversity (ACE, Chao1, Jackknife) and beta-diversity at genus/species levels were assessed. Linear discriminant analysis (LEfSe) identified taxonomic shifts. Subgroup analyses focused on culture conversion and treatment refractory patients.

📍 Key Findings:

📌 Alpha-Diversity Reduction: Overall, alpha-diversity significantly decreased during antibiotic treatment at 1, 3, 6, and 12 months in all NTM-PD patients. This reduction was observed in both culture conversion and refractory groups, indicating antibiotic-induced diversity decline.

📌 Beta-Diversity Dynamics:

Culture Conversion Group: Significant beta-diversity differences at 1, 3, 6, and 12 months compared to treatment initiation, suggesting evolving microbial composition during successful treatment.

📌 Refractory Group: No significant beta-diversity changes observed, potentially indicating persistence of NTMs despite treatment.

LEfSe Analysis:

📌 Culture Conversion Group: Decreasing taxa at various levels (phylum/genus/species) without significant increases, suggesting a trend towards a stable microbial environment.

📌 Refractory Group: Multiple taxa decreased, but 𝘝𝘦𝘪𝘭𝘭𝘰𝘯𝘦𝘭𝘭𝘢 𝘥𝘪𝘴𝘱𝘢𝘳, 𝘍𝘶𝘴𝘰𝘣𝘢𝘤𝘵𝘦𝘳𝘪𝘶𝘮 𝘱𝘦𝘳𝘪𝘰𝘥𝘰𝘯𝘵𝘪𝘤𝘶𝘮, 𝘢𝘯𝘥 𝘗𝘴𝘦𝘶𝘥𝘰𝘮𝘰𝘯𝘢𝘴 𝘢𝘦𝘳𝘶𝘨𝘪𝘯𝘰𝘴𝘢 increased during treatment, indicating a distinct microbial shift in refractory cases.

Taxonomic Trends:

📌 Species like 𝘝𝘦𝘪𝘭𝘭𝘰𝘯𝘦𝘭𝘭𝘢 𝘥𝘪𝘴𝘱𝘢𝘳, 𝘍𝘶𝘴𝘰𝘣𝘢𝘤𝘵𝘦𝘳𝘪𝘶𝘮 𝘱𝘦𝘳𝘪𝘰𝘥𝘰𝘯𝘵𝘪𝘤𝘶𝘮, 𝘢𝘯𝘥 𝘗𝘴𝘦𝘶𝘥𝘰𝘮𝘰𝘯𝘢𝘴 𝘢𝘦𝘳𝘶𝘨𝘪𝘯𝘰𝘴𝘢  increased in refractory patients, potentially associated with dysbiosis or providing a favorable environment for NTM survival.

📌 𝘓𝘢𝘤𝘩𝘯𝘰𝘴𝘱𝘪𝘳𝘢𝘤𝘦𝘢𝘦 family decreased during antibiotic treatment, reflecting potential dysbiosis with clinical implications.

Discussion:

📌 The observed decrease in alpha-diversity during antibiotic treatment aligns with expectations for macrolide-based multidrug therapy in NTM-PD. However, relying solely on alpha-diversity may have limitations in predicting treatment response. In the refractory group, taxa increases and lack of beta-diversity changes suggest a distinctive microbial environment, potentially contributing to treatment resistance.

📍 This study provides valuable insights into the longitudinal dynamics of sputum microbiota in NTM-PD patients undergoing antibiotic treatment. The gut-lung axis effects, as indicated by 𝘓𝘢𝘤𝘩𝘯𝘰𝘴𝘱𝘪𝘳𝘢𝘤𝘦𝘢𝘦 reduction, warrant further investigation for potential therapeutic interventions that minimize dysbiosis during NTM-PD antibiotic treatment.

Link to the article : https://tinyurl.com/bdt56byz