Pharyngeal Microbial Signatures Are Predictive of the Risk of Fungal Pneumonia in Hematologic Patients

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Authors

COSTANTINI Claudio NUNZI Emilia SPOLZINO Angelica PALMIERI Melissa RENGA Giorgia ZELANTE Teresa ENGLMAIER Lukas COUFALÍKOVÁ Kateřina SPÁČIL Zdeněk BORGHI Monica BELLET Marina M. ACERBI Enzo PUCCETTI Matteo GIOVAGNOLI Stefano SPACCAPELO Roberta TALESA Vincenzo N. LOMURNO Giuseppe MERLI Francesco FACCHINI Luca SPADEA Antonio MELILLO Lorella CODELUPPI Katia MARCHESI Francesco MARCHESINI Gessica VALENTE Daniela DRAGONETTI Giulia NADALI Gianpaolo PAGANO Livio AVERSA Franco ROMANI Luigina

Year of publication 2021
Type Article in Periodical
Magazine / Source INFECTION AND IMMUNITY
MU Faculty or unit

Faculty of Science

Citation
Web https://journals.asm.org/doi/10.1128/IAI.00105-21
Doi http://dx.doi.org/10.1128/IAI.00105-21
Keywords hematological malignancies; airway microbiome; antibiotics; indole-3-aldehyde; invasive fungal infection; metabolomics; tryptophan
Description The ability to predict invasive fungal infections (IFI) in patients with hematological malignancies is fundamental for successful therapy. Although gut dysbiosis is known to occur in hematological patients, whether airway dysbiosis also contributes to the risk of IFI has not been investigated. Nasal and oropharyngeal swabs were collected for functional microbiota characterization in 173 patients with hematological malignancies recruited in a multicenter, prospective, observational study and stratified according to the risk of developing IFI. A lower microbial richness and evenness were found in the pharyngeal microbiota of high-risk patients that were associated with a distinct taxonomic and metabolic profile. A murine model of IFI provided biologic plausibility for the finding that loss of protective anaerobes, such as Clostridiales and Bacteroidetes, along with an apparent restricted availability of tryptophan, is causally linked to the risk of IFI in hematologic patients and indicates avenues for antimicrobial stewardship and metabolic reequilibrium in IFI.
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