연구성과 홍보

J Infect Dis. 2025 Jun 2;231(5):1117-1126.

Title : Fecal and Sputum Microbiota and Treatment Response in Patients With Mycobacterium abscessus Pulmonary Disease

Authors : Joong-Yub Kim1, Sujin An2,3, So Yeon Kim1, Eunhye Bae4, Yong-Joon Cho5,6, Nakwon Kwak1, Donghyun Kim2,3,7*, Jae-Joon Yim1*

Affiliations :

1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

2Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.

3Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea.

4Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Republic of Korea.

5Department of Molecular Bioscience, Kangwon National University, Chuncheon, Republic of Korea.

6Multidimensional Genomics Research Center, Kangwon National University, Chuncheon, Republic of Korea.

7Institute of Endemic Diseases, Seoul National University Medical Research Center, Seoul, Republic of Korea.

DOI: 10.1093/infdis/jiae542.

Abstract :

Background: The microbiota may provide biomarkers for clinical outcomes in chronic respiratory conditions, though its role in Mycobacterium abscessus pulmonary disease (PD) remains largely unknown. We aimed to identify microbial signatures in fecal and sputum microbiotas associated with treatment response in M abscessus PD.

Methods: We prospectively enrolled patients undergoing antibiotic therapy, collecting fecal and sputum samples at baseline, 2 weeks, and 6 months. Using 16S rRNA amplicon sequencing, we analyzed microbiota diversity and composition in early treatment responders and nonresponders, classified by sputum culture results at 2 weeks.

Results: Among 32 participants, 27 patients (median age, 66 years; 85.2% women; 48.1% with subspecies abscessus) were included for analysis. Fifteen patients (55.6%) achieved negative conversion at 2 weeks, sustained in 93.3% at 6 months. Responders showed signifcantly decreased fecal microbiota diversity at 2 weeks, unlike nonresponders (P = .029). Increased abundance of Eubacterium hallii in baseline fecal microbiota was indicative of unresponsiveness, whereas increased Enterococcus in feces at 2 weeks was linked with favorable response. In sputum, high baseline levels of Burkholderia-Caballeronia-Paraburkholderia and Porphyromonas, along with decreased Rothia at 2 weeks, were associated with good treatment response.

Conclusions: In M abscessus PD, changes in microbial diversity and compositional signatures reflect treatment response.