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Imbert S, Revers M, Enaud R, Orieux A, Camino A, Massri A, Villeneuve L, Carrié C, Petit L, Boyer A, Berger P, Gruson D, Delhaes L, Prével R. Lower airway microbiota compositions differ between influenza, COVID-19 and bacteria-related acute respiratory distress syndromes. Crit Care 2024; 28:133. [PMID: 38649970 PMCID: PMC11036773 DOI: 10.1186/s13054-024-04922-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Acute respiratory distress syndrome (ARDS) is responsible for 400,000 deaths annually worldwide. Few improvements have been made despite five decades of research, partially because ARDS is a highly heterogeneous syndrome including various types of aetiologies. Lower airway microbiota is involved in chronic inflammatory diseases and recent data suggest that it could also play a role in ARDS. Nevertheless, whether the lower airway microbiota composition varies between the aetiologies of ARDS remain unknown. The aim of this study is to compare lower airway microbiota composition between ARDS aetiologies, i.e. pulmonary ARDS due to influenza, SARS-CoV-2 or bacterial infection. METHODS Consecutive ARDS patients according to Berlin's classification requiring invasive ventilation with PCR-confirmed influenza or SARS-CoV-2 infections and bacterial infections (> 105 CFU/mL on endotracheal aspirate) were included. Endotracheal aspirate was collected at admission, V3-V4 and ITS2 regions amplified by PCR, deep-sequencing performed on MiSeq sequencer (Illumina®) and data analysed using DADA2 pipeline. RESULTS Fifty-three patients were included, 24 COVID-19, 18 influenza, and 11 bacterial CAP-related ARDS. The lower airway bacteriobiota and mycobiota compositions (β-diversity) were dissimilar between the three groups (p = 0.05 and p = 0.01, respectively). The bacterial α-diversity was significantly lower in the bacterial CAP-related ARDS group compared to the COVID-19 ARDS group (p = 0.04). In contrast, influenza-related ARDS patients had higher lung mycobiota α-diversity than the COVID-19-related ARDS (p = 0 < 01). CONCLUSION Composition of lower airway microbiota (both microbiota and mycobiota) differs between influenza, COVID-19 and bacterial CAP-related ARDS. Future studies investigating the role of lung microbiota in ARDS pathophysiology should take aetiology into account.
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Affiliation(s)
- Sébastien Imbert
- HU Bordeaux, Mycology-Parasitology Department, CIC 1401, 33000, Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, Inserm UMR 1045, Univ Bordeaux, 33000, Bordeaux, France
| | - Mathilde Revers
- HU Bordeaux, Mycology-Parasitology Department, CIC 1401, 33000, Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, Inserm UMR 1045, Univ Bordeaux, 33000, Bordeaux, France
| | - Raphaël Enaud
- Centre de Recherche Cardio-Thoracique de Bordeaux, Inserm UMR 1045, Univ Bordeaux, 33000, Bordeaux, France
- CHU Bordeaux, CRCM Pédiatrique, CIC 1401, 33000, Bordeaux, France
| | - Arthur Orieux
- CHU Bordeaux, Medical Intensive Care Unit, 33000, Bordeaux, France
| | - Adrian Camino
- Centre de Recherche Cardio-Thoracique de Bordeaux, Inserm UMR 1045, Univ Bordeaux, 33000, Bordeaux, France
| | | | | | - Cédric Carrié
- d CHU Bordeaux, Surgical Intensive Care Unit, 33000, Bordeaux, France
| | - Laurent Petit
- d CHU Bordeaux, Surgical Intensive Care Unit, 33000, Bordeaux, France
| | - Alexandre Boyer
- Centre de Recherche Cardio-Thoracique de Bordeaux, Inserm UMR 1045, Univ Bordeaux, 33000, Bordeaux, France
- CHU Bordeaux, Medical Intensive Care Unit, 33000, Bordeaux, France
| | - Patrick Berger
- Centre de Recherche Cardio-Thoracique de Bordeaux, Inserm UMR 1045, Univ Bordeaux, 33000, Bordeaux, France
| | - Didier Gruson
- Centre de Recherche Cardio-Thoracique de Bordeaux, Inserm UMR 1045, Univ Bordeaux, 33000, Bordeaux, France
- CHU Bordeaux, Medical Intensive Care Unit, 33000, Bordeaux, France
| | - Laurence Delhaes
- HU Bordeaux, Mycology-Parasitology Department, CIC 1401, 33000, Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, Inserm UMR 1045, Univ Bordeaux, 33000, Bordeaux, France
| | - Renaud Prével
- Centre de Recherche Cardio-Thoracique de Bordeaux, Inserm UMR 1045, Univ Bordeaux, 33000, Bordeaux, France.
- CHU Bordeaux, Medical Intensive Care Unit, 33000, Bordeaux, France.
- Medical Intensive Care Unit, Pellegrin Hospital, Place Amélie Raba-Léon, 33076, Bordeaux, France.
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