Detection of Anaerobic Bacteria in High Numbers in Sputum from Patients with Cystic Fibrosis

• DOI: 10.1164/rccm.200708-1151oc
• Publication Date: 2008-02-09T02:49:52Z
• Authors: Michael M. Tunney; Tyler R. Field; Thomas F. Moriarty; Sheila Patrick; Gerd Doering; Marianne S. Muhle...; Matthew C. Wolfgang; Richard Boucher; Deirdre F. Gilpin; Andrew McDowell; J. Stuart Elborn
• Keywords: Adult; 570; Bacteriological Techniques; Adolescent; Cystic Fibrosis; Sputum; 610; Bacterial Infections; Middle Aged; 3. Good health; /dk/atira/pure/subjectarea/asjc/2700/2740; Bacteria, Anaerobic; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; Child, Preschool; Forced Expiratory Volume; Humans; Child; name=Pulmonary and Respiratory Medicine; Bronchoalveolar Lavage Fluid

Rationale: Pulmonary infection in cystic fibrosis (CF) is polymicrobial and it is possible that anaerobic bacteria, not detected by routine aerobic culture methods, reside within infected anaerobic airway mucus. Objectives: To determine whether anaerobic bacteria are present in the sputum of patients with CF. Methods: Sputumsamples were collected from clinically stable adults with CF and bronchoalveolar lavage fluid (BALF) samples from children with CF. Induced sputum samples were collected from healthy volunteers who did not have CF. All samples were processed using anaerobic bacteriologic techniques and bacteria within the samples were quantified and identified. Measurements and Main Results: Anaerobic species primarily within the genera Prevotella, Veillonella, Propionibacterium, and Actinomyces were isolated in high numbers from 42 of 66 (64%) sputum samples from adult patients with CF. Colonization with Pseudomonas aeruginosa significantly increased the likelihood that anaerobic bacteria would be present in the sputum. Similar anaerobic species were identified in BALF from pediatric patients with CF. Although anaerobes were detected in induced sputum samples from 16 of 20 volunteers, they were present in much lower numbers and were generally different species compared with those detected in CF sputum. Species-dependent differences in the susceptibility of the anaerobes to antibiotics with knownactivity against anaerobes were apparent with all isolates susceptible to meropenem. Conclusions: A range of anaerobic species are present in large numbers in the lungs of patients with CF. If these anaerobic bacteria are contributing significantly to infectionandinflammationin the CF lung, informed alterations to antibiotic treatment to target anaerobes, in addition to the primary infecting pathogens, may improve management.