Lower respiratory tract microbiota characteristics in patients with Pseudomonas aeruginosa pneumonia during antibiotic therapy
Abstract
INTRODUCTION: Pseudomonas aeruginosa (Pae) is a major cause of bacterial pneumonia in older adults, yet the composition of the lower respiratory tract (LRT) microbiota in patients with P. aeruginosa pneumonia (PAP), and its potential prognostic relevance, remain poorly defined.
METHODS: Here, we performed 16S rRNA gene sequencing of bronchoalveolar lavage fluid collected from older adults with PAP at hospital admission and discharge, yielding 42 paired samples. We characterized longitudinal microbiota dynamics, identified candidate microbial biomarkers using LEfSe and random forest analyses, inferred functional profiles with Tax4Fun2, and compared microbiota-associated changes following meropenem-based therapy (n = 12) or levofloxacin-based therapy (n = 9).
RESULTS: PAP was associated with marked shifts in LRT microbial community structure, with post-treatment samples showing reduced Pseudomonas abundance and increased relative abundances of Rothia, Streptococcus and Porphyromonas (p < 0.05). Random forest modeling identified P. aeruginosa, Streptococcus pneumoniae, and Prevotella melaninogenica as potential diagnostic biomarkers (AUC = 0.93). Functional prediction further suggested a reduction in biofilm-formation-related pathways after treatment (p < 0.01). Notably, Pseudomonas abundance correlated positively with white blood cell count and C-reactive protein, but inversely with lymphocyte and platelet counts, supporting the potential value of these clinical indices in…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 12 participants or records.
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