Relationship between antibiotic therapy and development of antimicrobial resistance in patients with bronchiectasis

To decrease the risk of acute infective exacerbations or flare-ups of their condition, individuals with bronchiectasis are frequently prescribed long-term oral and inhaled antibiotics. However, it is not clear what effect such antibiotic treatment has on microbial community composition and the development of antibiotic resistance and how this relates to patient outcomes.

As part of an ongoing collaboration between Queens University Belfast and the University of Dundee, we have access to a large number of clinical samples and extensive clinical and biomarker data from patients enrolled in the European Bronchiectasis Registry (EMBARC). In this project, we will determine whether microbiota composition and presence of resistance genes in these samples correlates with antibiotic treatment. Metagenomic analysis will be performed to determine the abundance of genes encoding antimicrobial resistance, the ’resistome’, within the community of bacteria as a whole, and how it changes in response to treatment. The relationship between development of resistance and an extensive range of clinical outcomes (lung function, quality of life, time to next exacerbation) and measures of inflammation will also be determined.