The researchers examined patients with COPD, asthma, pulmonary fibrosis (IPF), and sarcoidosis, and compared them with healthy individuals. The results, now published in BMJ Open Respiratory Research, show that antibiotic resistance genes were present in all groups.

Very few studies have previously examined the presence of resistance genes in the lower airways. In the present work, bronchoscopy samples were analyzed using gene sequencing (shotgun metagenomics). This method enables the mapping of microbes while also providing insight into the microbes’ genetic properties, including antibiotic resistance.

Surprising findings

It was surprising to find resistance genes in as many as 35 percent of healthy participants, says the study’s first author, Guri Kringeland. Patients with pulmonary fibrosis and sarcoidosis showed a clearly higher prevalence. We also observed that individuals who had recently used antibiotics carried more resistance genes.

This is consistent with what we already know, that antibiotic use is a key driver of resistance, Kringeland adds.

The most unexpected finding was the high prevalence of resistance genes in patients with sarcoidosis, she says. This group stood out as younger, generally healthier, and with limited antibiotic use compared to the other groups. This suggests that additional mechanisms may contribute to the development of resistance in these patients.

Antibiotic resistance is rapidly becoming one of the greatest global health challenges of our time. The development of new antibiotics alone is unlikely to solve the problem. Understanding the dynamics of resistance is essential to improve the use of existing antibiotics and may represent a step toward the development of new classes of therapeutics.

The researchers examined patients with COPD, asthma, pulmonary fibrosis (IPF), and sarcoidosis, and compared them with healthy individuals. The results, now published in BMJ Open Respiratory Research, show that antibiotic resistance genes were present in all groups.

Very few studies have previously examined the presence of resistance genes in the lower airways. In the present work, bronchoscopy samples were analyzed using gene sequencing (shotgun metagenomics). This method enables the mapping of microbes while also providing insight into the microbes’ genetic properties, including antibiotic resistance.

Surprising findings

It was surprising to find resistance genes in as many as 35 percent of healthy participants, says the study’s first author, Guri Kringeland. Patients with pulmonary fibrosis and sarcoidosis showed a clearly higher prevalence. We also observed that individuals who had recently used antibiotics carried more resistance genes.

This is consistent with what we already know, that antibiotic use is a key driver of resistance, Kringeland adds.

The most unexpected finding was the high prevalence of resistance genes in patients with sarcoidosis, she says. This group stood out as younger, generally healthier, and with limited antibiotic use compared to the other groups. This suggests that additional mechanisms may contribute to the development of resistance in these patients.

Antibiotic resistance is rapidly becoming one of the greatest global health challenges of our time. The development of new antibiotics alone is unlikely to solve the problem. Understanding the dynamics of resistance is essential to improve the use of existing antibiotics and may represent a step toward the development of new classes of therapeutics.

Click the link below to read the full article in BMJ Open Respiratory Research: Antimicrobial resistance genes and antibiotic use in chronic lung disease: a bronchoscopy study of the lower airways microbiom