Pulmonary Microbial Composition in Sepsis-Induced Acute Respiratory Distress Syndrome

Peng Zhang; Baoyi Liu; Weihao Zheng; Yantang Chen; Zhentao Wu; Yuting Lu; Jie Ma; Wenjie Lu; Mingzhu Zheng; Wanting Wu; Zijie Meng; Jinhua Wu; Yan Zheng; Xin Zhang; Shuang Zhang; Yanming Huang

doi:10.3389/fmolb.2022.862570

Pulmonary Microbial Composition in Sepsis-Induced Acute Respiratory Distress Syndrome

Front Mol Biosci. 2022 Jun 23:9:862570. doi: 10.3389/fmolb.2022.862570. eCollection 2022.

Authors

Peng Zhang¹, Baoyi Liu², Weihao Zheng¹, Yantang Chen¹, Zhentao Wu¹, Yuting Lu¹, Jie Ma¹, Wenjie Lu², Mingzhu Zheng², Wanting Wu², Zijie Meng², Jinhua Wu³, Yan Zheng⁴, Xin Zhang^{2

5

6}, Shuang Zhang¹, Yanming Huang^{2

7}

Affiliations

¹ Department of Critical Care Medicine, Jiangmen Central Hospital, Jiangmen, China.
² Clinical Experimental Center, Jiangmen Key Laboratory of Clinical Biobanks and Translational Research, Jiangmen Central Hospital, Jiangmen, China.
³ Department of Clinical Laboratory, Jiangmen Central Hospital, Jiangmen, China.
⁴ Department of Research and Development, Guangdong Research Institute of Genetic Diagnostic and Engineering Technologies for Thalassemia, Hybribio Limited, Guangzhou, China.
⁵ Dongguan Key Laboratory of Medical Bioactive Molecular Developmental and Translational Research, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, China.
⁶ Collaborative Innovation Center for Antitumor Active Substance Research and Development, Guangdong Medical University, Zhanjiang, China.
⁷ Department of Respiratory and Critical Care Medicine, Jiangmen Central Hospital, Jiangmen, China.

Abstract

Background: Acute respiratory distress syndrome (ARDS) is an unresolved challenge in the field of respiratory and critical care, and the changes in the lung microbiome during the development of ARDS and their clinical diagnostic value remain unclear. This study aimed to explore the role of the lung microbiome in disease progression in patients with sepsis-induced ARDS and potential therapeutic targets. Methods: Patients with ARDS were divided into two groups according to the initial site of infection, intrapulmonary infection (ARDSp, 111 cases) and extrapulmonary infection (ARDSexp, 45 cases), and a total of 28 patients with mild pulmonary infections were enrolled as the control group. In this study, we sequenced the DNA in the bronchoalveolar lavage fluid collected from patients using metagenomic next-generation sequencing (mNGS) to analyze the changes in the lung microbiome in patients with different infectious site and prognosis and before and after antibiotic treatment. Results: The Shannon-Wiener index indicated a statistically significant reduction in microbial diversity in the ARDSp group compared with the ARDSexp and control groups. The ARDSp group was characterized by a reduction in microbiome diversity, mainly in the normal microbes of the lung, whereas the ARDSexp group was characterized by an increase in microbiome diversity, mainly in conditionally pathogenic bacteria and intestinal microbes. Further analysis showed that an increase in Bilophila is a potential risk factor for death in ARDSexp. An increase in Escherichia coli, Staphylococcus aureus, Candida albicans, enteric microbes, or conditional pathogens may be risk factors for death in ARDSp. In contrast, Hydrobacter may be a protective factor in ARDSp. Conclusion: Different initial sites of infection and prognoses are likely to affect the composition and diversity of the pulmonary microbiome in patients with septic ARDS. This study provides insights into disease development and exploration of potential therapeutic targets.

Keywords: acute respiratory distress syndrome of extrapulmonary; acute respiratory distress syndrome of pulmonary; acute respiratory distress syndrome(ARDS); metagenomic next-generation sequencing(mNGS); pulmonary microbiome; sepsis.