Does bacterial density in cystic fibrosis sputum increase prior to pulmonary exacerbation?
Open accessAbstract
Background Cystic Fibrosis (CF) lung disease is characterised by an inexorable decline in lung function, punctuated by periods of symptomatic worsening known as pulmonary exacerbations (referred to here as CFPE). Despite their clinical significance, the cause of CFPE remains undetermined. It has been suggested that an increase in bacterial density may be a trigger, although this has not been shown empirically.Methods Here, a previously validated quantitative PCR-based approach was used to assess numbers of Pseudomonas aeruginosa and of total bacteria in respiratory secretions from patients during the period leading up to CFPE. Sputum samples collected from 12 adult CF patients were selected retrospectively to fall approximately 21, 14, 7 and 0 days prior to CFPE diagnosis. In addition, the relationships between clinical parameters (FEV(1), temperature and patient reported outcome measures) and microbiological data were investigated.Results No significant changes either in total bacterial or P. aeruginosa numbers were identified prior to CFPE. Of all the correlations tested, only temperature showed a significant correlation with total bacterial numbers in the period leading to CFPE.Conclusions These findings strongly suggest that CFPE do not generally result from increased bacterial density within the airways. Instead, data presented here are consistent with alternative models of pulmonary exacerbation.
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Culture-independent studies comparing bacterial communities at baseline and during exacerbations in the airways of patients with COPD, cystic fibrosis, or bronchiectasis consistently report no increase in bacterial burden and no decrease in community diversity during exacerbations.
“With remarkable consistency, all studies report no increase in bacterial burden and no decrease in community diversity during exacerbations.”
From The microbiome and critical illness (2016) · cites this paper as [134]
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- Authors
- Stressmann, F. A., Rogers, G. B., Marsh, P., Lilley, A. K., Daniels, T. W. V., Carroll, M. P., Hoffman, L. R., Jones, G., Allen, C. E., Patel, N., Forbes, B., Tuck, A., & Bruce, K. D.
- Affiliations
- King's College London (GB)
- Southampton General Hospital (GB)
- University Hospital Southampton NHS Foundation Trust (GB)
- University of Washington (US)
- Corresponding author
- Rogers, Geraint B.
- ORCID
- Venue
- Journal of Cystic Fibrosis
- Publisher
- Elsevier BV
- Published
- 2011-09
- Volume
- 10
- Issue
- 5
- Pages
- 357-365
- ISSN
- 1569-1993 (ISSN-L)
- OpenAlex
- W2009245754
- Cited by
- 130
- References
- 47
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 7 · 2022: 7 · 2021: 7 · 2020: 17 · 2019: 9 · 2018: 10 · 2017: 9 · 2016: 7 · 2015: 16 · 2014: 10 · 2013: 15 · 2012: 7
- FWCI
- 9.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Cystic Fibrosis (publishedVersion)
- PubMed (publishedVersion)
- Research Repository (Kingston University London) (submittedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Anna Trust
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- pulmonary exacerbations, sputum bacterial density, Pseudomonas aeruginosa, real-time PCR, respiratory secretions, airway microbiology, fever, disease triggers, lung function decline
- MeSH terms
- Adolescent, Adult, Anti-Bacterial Agents, Cystic Fibrosis, Female, Humans, Male, Middle Aged, Pseudomonas aeruginosa, Pseudomonas Infections, Respiratory Function Tests, Severity of Illness Index, Sputum, Pneumonia, Bacterial, Young Adult, Bacterial Load, Real-Time Polymerase Chain Reaction
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