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Bacterial Landscape of Bloodstream Infections in Neutropenic Patients via High Throughput Sequencing

BACKGROUND: Bloodstream infection (BSI) is a common and potentially life-threatening complication in patients with hematological malignancies and therapy-induced neutropenia. Administration of broad spectrum antibiotics has substantially decreased the mortality rate in febrile neutropenia, but bacte...

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Autores principales: Gyarmati, Peter, Kjellander, Christian, Aust, Carl, Kalin, Mats, Öhrmalm, Lars, Giske, Christian G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536222/
https://www.ncbi.nlm.nih.gov/pubmed/26270467
http://dx.doi.org/10.1371/journal.pone.0135756
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author Gyarmati, Peter
Kjellander, Christian
Aust, Carl
Kalin, Mats
Öhrmalm, Lars
Giske, Christian G.
author_facet Gyarmati, Peter
Kjellander, Christian
Aust, Carl
Kalin, Mats
Öhrmalm, Lars
Giske, Christian G.
author_sort Gyarmati, Peter
collection PubMed
description BACKGROUND: Bloodstream infection (BSI) is a common and potentially life-threatening complication in patients with hematological malignancies and therapy-induced neutropenia. Administration of broad spectrum antibiotics has substantially decreased the mortality rate in febrile neutropenia, but bacterial infection is documented in only one-third or fewer of the cases. BSI is typically diagnosed by blood culture; however, this method can detect only culturable pathogens. METHODS: In the present study, a total of 130 blood samples from hematological patients receiving dose-intensive antitumoural treatment were subjected to 16S rRNA PCR and 62 of them were cultured. PCR positive samples were processed to high throughput sequencing by amplifying the V1-V3 regions of the 16S rRNA gene to obtain a full spectrum of bacteria present in BSI. RESULTS: Five phyla and 30 genera were identified with sequencing compared to 2 phyla and 4 genera with culture. The largest proportion of bacteria detected by sequencing belonged to Proteobacteria (55.2%), Firmicutes (33.4%) and Actinobacteria (8.6%), while Fusobacteria (0.4%) and Bacteroidetes (0.1%) were also detected. Ninety-eight percent of the bacteria identified by sequencing were opportunistic human pathogens and 65% belonged to the normal human microbiota. CONCLUSIONS: The present study indicates that BSIs in neutropenic hosts contain a much broader diversity of bacteria, likely with host origin, than previously realized. The elevated ratio of Proteobacteria in BSI corroborates the results found in other systemic inflammatory diseases, such as inflammatory bowel disease or mucosal infections. This knowledge may become of value for tailoring antimicrobial drug administration.
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spelling pubmed-45362222015-08-20 Bacterial Landscape of Bloodstream Infections in Neutropenic Patients via High Throughput Sequencing Gyarmati, Peter Kjellander, Christian Aust, Carl Kalin, Mats Öhrmalm, Lars Giske, Christian G. PLoS One Research Article BACKGROUND: Bloodstream infection (BSI) is a common and potentially life-threatening complication in patients with hematological malignancies and therapy-induced neutropenia. Administration of broad spectrum antibiotics has substantially decreased the mortality rate in febrile neutropenia, but bacterial infection is documented in only one-third or fewer of the cases. BSI is typically diagnosed by blood culture; however, this method can detect only culturable pathogens. METHODS: In the present study, a total of 130 blood samples from hematological patients receiving dose-intensive antitumoural treatment were subjected to 16S rRNA PCR and 62 of them were cultured. PCR positive samples were processed to high throughput sequencing by amplifying the V1-V3 regions of the 16S rRNA gene to obtain a full spectrum of bacteria present in BSI. RESULTS: Five phyla and 30 genera were identified with sequencing compared to 2 phyla and 4 genera with culture. The largest proportion of bacteria detected by sequencing belonged to Proteobacteria (55.2%), Firmicutes (33.4%) and Actinobacteria (8.6%), while Fusobacteria (0.4%) and Bacteroidetes (0.1%) were also detected. Ninety-eight percent of the bacteria identified by sequencing were opportunistic human pathogens and 65% belonged to the normal human microbiota. CONCLUSIONS: The present study indicates that BSIs in neutropenic hosts contain a much broader diversity of bacteria, likely with host origin, than previously realized. The elevated ratio of Proteobacteria in BSI corroborates the results found in other systemic inflammatory diseases, such as inflammatory bowel disease or mucosal infections. This knowledge may become of value for tailoring antimicrobial drug administration. Public Library of Science 2015-08-13 /pmc/articles/PMC4536222/ /pubmed/26270467 http://dx.doi.org/10.1371/journal.pone.0135756 Text en © 2015 Gyarmati et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Gyarmati, Peter
Kjellander, Christian
Aust, Carl
Kalin, Mats
Öhrmalm, Lars
Giske, Christian G.
Bacterial Landscape of Bloodstream Infections in Neutropenic Patients via High Throughput Sequencing
title Bacterial Landscape of Bloodstream Infections in Neutropenic Patients via High Throughput Sequencing
title_full Bacterial Landscape of Bloodstream Infections in Neutropenic Patients via High Throughput Sequencing
title_fullStr Bacterial Landscape of Bloodstream Infections in Neutropenic Patients via High Throughput Sequencing
title_full_unstemmed Bacterial Landscape of Bloodstream Infections in Neutropenic Patients via High Throughput Sequencing
title_short Bacterial Landscape of Bloodstream Infections in Neutropenic Patients via High Throughput Sequencing
title_sort bacterial landscape of bloodstream infections in neutropenic patients via high throughput sequencing
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536222/
https://www.ncbi.nlm.nih.gov/pubmed/26270467
http://dx.doi.org/10.1371/journal.pone.0135756
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