Microbial dynamics and pulmonary immune responses in COVID-19 secondary bacterial pneumonia

Bibliographic Details
Title: Microbial dynamics and pulmonary immune responses in COVID-19 secondary bacterial pneumonia
Authors: Natasha Spottiswoode, Alexandra Tsitsiklis, Victoria T. Chu, Hoang Van Phan, Catherine DeVoe, Christina Love, Rajani Ghale, Joshua Bloomstein, Beth Shoshana Zha, Cole P. Maguire, Abigail Glascock, Aartik Sarma, Peter M. Mourani, Katrina L. Kalantar, Angela Detweiler, Norma Neff, Sidney C. Haller, COMET Consortium, Joseph L. DeRisi, David J. Erle, Carolyn M. Hendrickson, Kirsten N. Kangelaris, Matthew F. Krummel, Michael A. Matthay, Prescott G. Woodruff, Carolyn S. Calfee, Charles R. Langelier
Source: Nature Communications, Vol 15, Iss 1, Pp 1-16 (2024)
Publisher Information: Nature Portfolio, 2024.
Publication Year: 2024
Collection: LCC:Science
Subject Terms: Science
More Details: Abstract Secondary bacterial pneumonia (2°BP) is associated with significant morbidity following respiratory viral infection, yet remains incompletely understood. In a prospective cohort of 112 critically ill adults intubated for COVID-19, we comparatively assess longitudinal airway microbiome dynamics and the pulmonary transcriptome of patients who developed 2°BP versus controls who did not. We find that 2°BP is significantly associated with both mortality and corticosteroid treatment. The pulmonary microbiome in 2°BP is characterized by increased bacterial RNA mass and dominance of culture-confirmed pathogens, detectable days prior to 2°BP clinical diagnosis, and frequently also present in nasal swabs. Assessment of the pulmonary transcriptome reveals suppressed TNFα signaling in patients with 2°BP, and sensitivity analyses suggest this finding is mediated by corticosteroid treatment. Further, we find that increased bacterial RNA mass correlates with reduced expression of innate and adaptive immunity genes in both 2°BP patients and controls. Taken together, our findings provide fresh insights into the microbial dynamics and host immune features of COVID-19-associated 2°BP, and suggest that suppressed immune signaling, potentially mediated by corticosteroid treatment, permits expansion of opportunistic bacterial pathogens.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2041-1723
Relation: https://doaj.org/toc/2041-1723
DOI: 10.1038/s41467-024-53566-x
Access URL: https://doaj.org/article/c54e44e92cce4848a4f22b7f58a64b95
Accession Number: edsdoj.54e44e92cce4848a4f22b7f58a64b95
Database: Directory of Open Access Journals
More Details
ISSN:20411723
DOI:10.1038/s41467-024-53566-x
Published in:Nature Communications
Language:English