Invasive Pulmonary Aspergillosis Patients: Lung Microbiome Diversity, Specific Taxa, and Prognostic Value

Objective To analyze the characteristics of lung microbiota in patients with invasive pulmonary aspergillosis (IPA) and see if the microbiome can predict how IPA will turn out. Methods A retrospective analysis was conducted on 189 hospitalized patients with invasive pulmonary aspergillosis (IPA) and patients with other lung infections hospitalized at Ningxia Medical University General Hospital, using propensity score matching. By analyzing the upper and lower respiratory tract microbial specimens from both groups, the composition and diversity differences of lung microbiota were evaluated, as well as their predictive ability for clinical outcomes in IPA patients. Results The airway microbiota of IPA patients showed a notable increase in bacterial diversity; the Firmicutes phylum and the Acinetobacter and Pseudomonas genera might raise the risk of developing IPA. The bacterial diversity in the lung microbiota failed to predict clinical outcomes. Conclusion Unlike previous studies that reported a significant loss of bacterial diversity in the respiratory tracts of IPA patients, this study found that IPA patients actually had more bacterial diversity in their airways. Specific phyla and genera may increase the risk of IPA, but bacterial diversity doesn't really help predict how patients will do. This shows that the changes in lung microbiota over time may promote the onset of IPA and further alter the lung microbiota.