ANTIMICROBIAL resistance genes are more prevalent in the lower airways of patients with chronic lung diseases, raising concerns about the long-term impact of antibiotic use on respiratory health.
Antimicrobial resistance is a growing global threat, driven in part by the overuse of antibiotics. While resistance has been widely studied in the gut, less is known about how resistance genes develop and persist in the respiratory microbiome, particularly in patients with chronic lung conditions.
Antimicrobial Resistance Genes Higher in Lung Disease
In this cross-sectional study, researchers analysed bronchoalveolar samples from healthy individuals and patients with conditions including chronic obstructive pulmonary disease, asthma, sarcoidosis, and idiopathic pulmonary fibrosis. Using metagenomic sequencing, they identified the presence and abundance of antimicrobial resistance genes in the lower airways.
The results showed that resistance genes were more common in patients with chronic lung disease than in healthy controls. The highest prevalence was observed in idiopathic pulmonary fibrosis and sarcoidosis, where a significant proportion of patients carried at least one resistance gene.
Common Resistance Types Identified
The most frequently detected antimicrobial resistance genes were associated with resistance to tetracyclines, followed by beta-lactam and macrolide antibiotics. These findings reflect commonly used antibiotic classes in respiratory care, suggesting a link between treatment patterns and resistance development.
Recent Antibiotic Use Drives Resistance
The study found a strong association between recent antibiotic use and higher levels of resistance genes. Patients who had used antibiotics within the previous 3 months showed significantly greater resistance gene counts compared with those without recent exposure.
This suggests that antibiotic treatment may contribute to the accumulation of resistance genes in the lung microbiome, potentially affecting future treatment effectiveness.
Implications for Respiratory Care
The findings highlight the need for careful antibiotic stewardship in patients with chronic lung disease. Overuse of antibiotics may not only reduce treatment effectiveness over time but also contribute to the broader spread of resistance.
Understanding the role of antimicrobial resistance genes in the respiratory microbiome could help guide more targeted therapies and reduce unnecessary antibiotic exposure.
Further research is needed to determine how these resistance patterns influence clinical outcomes and whether they contribute to disease progression or transmission within populations.
Reference
Kringeland GD et al. Antimicrobial resistance genes and antibiotic use in chronic lung disease: a bronchoscopy study of the lower airways microbiome. BMJ Open Respir Res. 2026;13(1):e003864.
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