Oropharyngeal detection of specific gut-derived Enterobacterales is associated with increased respiratory infection risk in older adults

Respiratory tract infections (RTI) are a major contributor to morbidity and mortality in later life. RTI risk factors in older populations, including declining general health, altered airway physiology, and increased pharmaceutical exposures, also contribute to changes in the oropharyngeal (OP) micr...

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Main Authors: Sophie J. Miller, Frank Zhang, Steven L. Taylor, Andrew P. Shoubridge, Erin Flynn, Egi Vasil, Richard J. Woodman, Lito E. Papanicolas, Geraint B. Rogers
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Aging
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Online Access:https://www.frontiersin.org/articles/10.3389/fragi.2025.1566034/full
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author Sophie J. Miller
Sophie J. Miller
Frank Zhang
Steven L. Taylor
Steven L. Taylor
Andrew P. Shoubridge
Andrew P. Shoubridge
Erin Flynn
Egi Vasil
Egi Vasil
Richard J. Woodman
Lito E. Papanicolas
Lito E. Papanicolas
Lito E. Papanicolas
Geraint B. Rogers
Geraint B. Rogers
author_facet Sophie J. Miller
Sophie J. Miller
Frank Zhang
Steven L. Taylor
Steven L. Taylor
Andrew P. Shoubridge
Andrew P. Shoubridge
Erin Flynn
Egi Vasil
Egi Vasil
Richard J. Woodman
Lito E. Papanicolas
Lito E. Papanicolas
Lito E. Papanicolas
Geraint B. Rogers
Geraint B. Rogers
author_sort Sophie J. Miller
collection DOAJ
description Respiratory tract infections (RTI) are a major contributor to morbidity and mortality in later life. RTI risk factors in older populations, including declining general health, altered airway physiology, and increased pharmaceutical exposures, also contribute to changes in the oropharyngeal (OP) microbiota. We sought to investigate whether such changes predict future incidence of RTI. OP microbiota characteristics were measured in 190 residents of long-term aged care. Fifty-four participants (28.4%) experienced one or more study-defined RTIs during the 12-month follow-up period, of which 28 (14.7%) occurred within 90 days of sample collection. OP microbiota composition was significantly associated with days to RTI event (F = 1.74, R2 = 1.02%, p = 0.04). Detection of Enterobacterales species (Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Klebsiella variicola, and Proteus mirabilis) were independently associated with RTI risk after covariate adjustment (subdistribution HR: 4.84; 95% CI: 1.65–14.19; p = 0.002). Strain-level analysis performed on metagenomes from contemporaneous OP and stool samples identified co-carriage of indistinguishable Enterobacterales strains in those with Enterobacterales-positive OP samples, suggesting intra-participant strain acquisition. We report OP carriage of Enterobacterales species to be a marker of future RTI risk in long-term aged care residents, reflecting the independent influence of common ageing-associated risk exposures.
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spelling doaj-art-1c67a8fb0ca6443c9ed9eb1b96c9e5f72025-08-20T02:34:50ZengFrontiers Media S.A.Frontiers in Aging2673-62172025-05-01610.3389/fragi.2025.15660341566034Oropharyngeal detection of specific gut-derived Enterobacterales is associated with increased respiratory infection risk in older adultsSophie J. Miller0Sophie J. Miller1Frank Zhang2Steven L. Taylor3Steven L. Taylor4Andrew P. Shoubridge5Andrew P. Shoubridge6Erin Flynn7Egi Vasil8Egi Vasil9Richard J. Woodman10Lito E. Papanicolas11Lito E. Papanicolas12Lito E. Papanicolas13Geraint B. Rogers14Geraint B. Rogers15Microbiome and Host Health Program, South Australian Health and Medical Research Institute, Adelaide, SA, AustraliaCollege of Medicine and Public Health, Flinders University, Bedford Park, SA, AustraliaMicrobiology and Infectious Diseases, SA Pathology, Adelaide, SA, AustraliaMicrobiome and Host Health Program, South Australian Health and Medical Research Institute, Adelaide, SA, AustraliaCollege of Medicine and Public Health, Flinders University, Bedford Park, SA, AustraliaMicrobiome and Host Health Program, South Australian Health and Medical Research Institute, Adelaide, SA, AustraliaCollege of Medicine and Public Health, Flinders University, Bedford Park, SA, AustraliaMicrobiology and Infectious Diseases, SA Pathology, Adelaide, SA, AustraliaMicrobiome and Host Health Program, South Australian Health and Medical Research Institute, Adelaide, SA, AustraliaCollege of Medicine and Public Health, Flinders University, Bedford Park, SA, AustraliaFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, AustraliaMicrobiome and Host Health Program, South Australian Health and Medical Research Institute, Adelaide, SA, AustraliaCollege of Medicine and Public Health, Flinders University, Bedford Park, SA, AustraliaMicrobiology and Infectious Diseases, SA Pathology, Adelaide, SA, AustraliaMicrobiome and Host Health Program, South Australian Health and Medical Research Institute, Adelaide, SA, AustraliaCollege of Medicine and Public Health, Flinders University, Bedford Park, SA, AustraliaRespiratory tract infections (RTI) are a major contributor to morbidity and mortality in later life. RTI risk factors in older populations, including declining general health, altered airway physiology, and increased pharmaceutical exposures, also contribute to changes in the oropharyngeal (OP) microbiota. We sought to investigate whether such changes predict future incidence of RTI. OP microbiota characteristics were measured in 190 residents of long-term aged care. Fifty-four participants (28.4%) experienced one or more study-defined RTIs during the 12-month follow-up period, of which 28 (14.7%) occurred within 90 days of sample collection. OP microbiota composition was significantly associated with days to RTI event (F = 1.74, R2 = 1.02%, p = 0.04). Detection of Enterobacterales species (Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Klebsiella variicola, and Proteus mirabilis) were independently associated with RTI risk after covariate adjustment (subdistribution HR: 4.84; 95% CI: 1.65–14.19; p = 0.002). Strain-level analysis performed on metagenomes from contemporaneous OP and stool samples identified co-carriage of indistinguishable Enterobacterales strains in those with Enterobacterales-positive OP samples, suggesting intra-participant strain acquisition. We report OP carriage of Enterobacterales species to be a marker of future RTI risk in long-term aged care residents, reflecting the independent influence of common ageing-associated risk exposures.https://www.frontiersin.org/articles/10.3389/fragi.2025.1566034/fullolder peoplenursing homespneumoniamicrobiomeEnterobacterales
spellingShingle Sophie J. Miller
Sophie J. Miller
Frank Zhang
Steven L. Taylor
Steven L. Taylor
Andrew P. Shoubridge
Andrew P. Shoubridge
Erin Flynn
Egi Vasil
Egi Vasil
Richard J. Woodman
Lito E. Papanicolas
Lito E. Papanicolas
Lito E. Papanicolas
Geraint B. Rogers
Geraint B. Rogers
Oropharyngeal detection of specific gut-derived Enterobacterales is associated with increased respiratory infection risk in older adults
Frontiers in Aging
older people
nursing homes
pneumonia
microbiome
Enterobacterales
title Oropharyngeal detection of specific gut-derived Enterobacterales is associated with increased respiratory infection risk in older adults
title_full Oropharyngeal detection of specific gut-derived Enterobacterales is associated with increased respiratory infection risk in older adults
title_fullStr Oropharyngeal detection of specific gut-derived Enterobacterales is associated with increased respiratory infection risk in older adults
title_full_unstemmed Oropharyngeal detection of specific gut-derived Enterobacterales is associated with increased respiratory infection risk in older adults
title_short Oropharyngeal detection of specific gut-derived Enterobacterales is associated with increased respiratory infection risk in older adults
title_sort oropharyngeal detection of specific gut derived enterobacterales is associated with increased respiratory infection risk in older adults
topic older people
nursing homes
pneumonia
microbiome
Enterobacterales
url https://www.frontiersin.org/articles/10.3389/fragi.2025.1566034/full
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