Analysis of the Dynamics of the Lung Microbiota During Acute Exacerbation of COPD Requiring Admission to Intensive Care Unit

Study Overview
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Brief Summary
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This study aims to investigate the correlation between pulmonary microbiota dynamics (including bacteria, fungi and viruses) and COPD exacerbation for COPD patients admitted to ICU

Detailed Description
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Chronic obstructive pulmonary disease (COPD) is a frequent cause of ICU admission. COPD exacerbations are a leading cause of lung function worsening and of morbimortality. Hospitalizations due to COPD exacerbations are highly expensive for health insurance system. Bacterial pulmonary microbiota has been shown to be correlated to the severity of COPD and to exacerbations. Nevertheless fungi and viruses which are full actors of pulmonary microbiota have not yet been investigated. Our primary outcome will be the assessment of alpha and beta diversity dynamics of the whole pulmonary microbiota (bacteria, fungi and viruses) between COPD exacerbation and steady state. This study will prospectively include 24 patients at ICU admission for COPD exacerbation with sputum sampling. Steady-state as defined during a 2 months-later visit will be studied with another sputum collection.

Official Title
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Analysis of the Dynamics of the Lung Microbiota During Acute Exacerbation of COPD Requiring Admission to Intensive Care

Conditions
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Chronic Obstructive Pulmonary Disease

Intervention / Treatment
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* Biological: Sputum collection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient above 18 admitted in ICU Admitted for COPD exacerbation defined by sustained (> 2 days) worsening of respiratory symptoms considering Anthonisen's criteria with life-threatening condition. Needing mechanical ventilation (noninvasive ventilation or oro-tracheal intubation) COPD condition will be presumed according to patient's respiratory history or previous lung function testing Able to consent or with the patient's family consent Affiliated to a social insurance scheme No inclusion Criteria: COPD patient admitted for another cause than respiratory failure person under tutorship or curatorship living further than 100 kilometers away from the ICU expected survival inferior to 1 week Exclusion Criteria - Lung function testing not consistent with COPD at steady-state visit

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| exacerbating COPD patients needing ICU admission<br>sputum collection | Biological: Sputum collection<br>* Analysis of Sputum collection<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of differents types of cyto-bacteriological of sputum in Bacteriology | After extraction of the DNA and sequencing, the obtained sequences allow a taxonomic assignment of the microorganisms. The number of different taxonomic groups and the number of sequences within each taxonomic group to evaluate the α diversity through the coefficient developed by Shannon and the β diversity | Day 0 | 
| Number of differents types of Cyto-bacteriological of sputum in Mycology | After extraction of the DNA and sequencing, the obtained sequences allow a taxonomic assignment of the microorganisms. The number of different taxonomic groups and the number of sequences within each taxonomic group to evaluate the α diversity through the coefficient developed by Shannon and the β diversity. | Day 0 | 
| Number of differents types of Cyto-bacteriological of sputum in Virology | After extraction of the RNA and sequencing, the obtained sequences allow a taxonomic assignment of the microorganisms. The number of different taxonomic groups and the number of sequences within each taxonomic group to evaluate the α diversity and the β diversity. | Day 0 | 
| Number of differents types of Cyto-bacteriological of sputum in Bacteriology | After extraction of the DNA and sequencing, the obtained sequences allow a taxonomic assignment of the microorganisms. The number of different taxonomic groups and the number of sequences within each taxonomic group to evaluate the α diversity through the coefficient developed by Shannon and the β diversity | Day 60 | 
| Number of differents types of Cyto-bacteriological of sputum in Mycology | After extraction of the DNA and sequencing, the obtained sequences allow a taxonomic assignment of the microorganisms. The number of different taxonomic groups and the number of sequences within each taxonomic group to evaluate the α diversity through the coefficient developed by Shannon. | Day 60 | 
| Number of differents types of Cyto-bacteriological of sputum in Virology | After extraction of the RNA and sequencing, the obtained sequences allow a taxonomic assignment of the microorganisms. The number of different taxonomic groups and the number of sequences within each taxonomic group to evaluate the α diversity and the β diversity. | Day 60 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pulmonary microbiota, Chronic obstructive pulmonary disease