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PLoS One. 2016 May 20;11(5):e0155033. doi: 10.1371/journal.pone.0155033. eCollection 2016.

Characterisation of Candida within the Mycobiome/Microbiome of the Lower Respiratory Tract of ICU Patients.

Author information

1
Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
2
Bioinformatics, Institute for Knowledge Discovery, University of Technology, Graz, Austria and OMICS Center Graz, Graz, Austria.
3
BioTechMed-Graz, Graz, Austria.
4
Institute of Pathology, Medical University of Graz, Graz, Austria.
5
Institute of Molecular Biotechnology, University of Technology, Graz, Austria.
6
Center for Medical Research, Medical University of Graz, Graz, Austria.
7
Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.
8
Department of Medicine I, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
9
Division of Clinical Infectious Diseases, Research Center Borstel, Leibnitz Center for Medicine and Biosciences, Borstel, Germany.
10
Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
11
Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
12
Theodor Escherich Laboratory for Microbiome Research, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
13
Institute for Medical Informatics, Statistics, and Documentation, Medical University of Graz, Graz, Austria.

Abstract

Whether the presence of Candida spp. in lower respiratory tract (LRT) secretions is a marker of underlying disease, intensive care unit (ICU) treatment and antibiotic therapy or contributes to poor clinical outcome is unclear. We investigated healthy controls, patients with proposed risk factors for Candida growth in LRT (antibiotic therapy, ICU treatment with and without antibiotic therapy), ICU patients with pneumonia and antibiotic therapy and candidemic patients (for comparison of truly invasive and colonizing Candida spp.). Fungal patterns were determined by conventional culture based microbiology combined with molecular approaches (next generation sequencing, multilocus sequence typing) for description of fungal and concommitant bacterial microbiota in LRT, and host and fungal biomarkes were investigated. Admission to and treatment on ICUs shifted LRT fungal microbiota to Candida spp. dominated fungal profiles but antibiotic therapy did not. Compared to controls, Candida was part of fungal microbiota in LRT of ICU patients without pneumonia with and without antibiotic therapy (63% and 50% of total fungal genera) and of ICU patients with pneumonia with antibiotic therapy (73%) (p<0.05). No case of invasive candidiasis originating from Candida in the LRT was detected. There was no common bacterial microbiota profile associated or dissociated with Candida spp. in LRT. Colonizing and invasive Candida strains (from candidemic patients) did not match to certain clades withdrawing the presence of a particular pathogenic and invasive clade. The presence of Candida spp. in the LRT rather reflected rapidly occurring LRT dysbiosis driven by ICU related factors than was associated with invasive candidiasis.

PMID:
27206014
PMCID:
PMC4874575
DOI:
10.1371/journal.pone.0155033
[Indexed for MEDLINE]
Free PMC Article
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