Bacterial Signatures of Cerebral Thrombi in Large Vessel Occlusion Stroke.
Bacterial Signatures of Cerebral Thrombi in Large Vessel Occlusion Stroke.
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作者：
了解脑卒中患者脑血栓的微生物特征及其临床相关性具有重要意义，但相关资料较少。我们的目的是研究脑卒中大血管闭塞（LVO）患者取栓后获得的脑血栓的微生物特征及其与3个月死亡率的相关性。在一项前瞻性队列研究中，在三级医院成功血运重建的LVO脑卒中患者机械取栓期间收集血栓样本。入院后12小时内采集口腔、粪便和分离血浆样本。采用16S rRNA基因扩增子新一代测序法比较所有样品的微生物组成。采用荧光原位杂交法(FISH)检测血栓样品中的细菌。主要终点为3个月死亡率。同时记录48 h内围手术期不良事件（ae）。在104例患者的血栓样本中，96.2%检测到细菌DNA，并且在血栓中观察到细菌信号簇。与粪便和口腔样品相比，血栓菌群的主要特征是变形菌群过度富集，主要来源于血浆。在心脏栓塞性和大动脉粥样硬化性中风的血栓中，细菌浓度、优势细菌和分布模式不同。不动杆菌和肠杆菌科的高丰度与围手术期不良反应的高风险相关，而不动杆菌的高丰度与90天死亡率的高风险独立相关。本研究表明，在左心室卒中患者取栓后的脑血栓中存在细菌，其中一些细菌与患者预后相关。
It is important to understand the microbial features of the cerebral thrombus and its clinical relevance in stroke patients, of which data were scarce. We aimed to investigate the microbial features of cerebral thrombi retrieved via thrombectomy in stroke patients with large vessel occlusion (LVO) and their correlations with 3-month mortality. In a prospective cohort study, thrombus samples were collected during mechanical thrombectomy in LVO stroke patients with successful revascularization at a tertiary hospital. Oral, fecal, and isolated plasma samples were collected within 12 h of admission. The microbial compositions of all samples were compared using 16S rRNA gene amplicon next-generation sequencing. Fluorescent in situ hybridization (FISH) was used to detect bacteria in thrombus samples. The primary outcome was 3-month mortality. Perioperative adverse events (AEs) within 48 h were also recorded. Bacterial DNA was detected in 96.2% of thrombus samples from 104 patients, and clusters of bacterial signals were seen in the thrombi with FISH. Compared with fecal and oral samples, the thrombus microbiota was mainly characterized by excessive enrichment of Proteobacteria, mainly originating from plasma. The bacterial concentrations, dominant bacteria, and distribution patterns differed in thrombi obtained from cardioembolic and large-artery atherosclerotic strokes. Higher abundances of Acinetobacter and Enterobacteriaceae were associated with a higher risk of perioperative AEs, and a higher abundance of Acinetobacter was independently associated with a higher risk of 90-day mortality. This study demonstrated the presence of bacteria in cerebral thrombi retrieved with thrombectomy in LVO strokes, with some bacteria associated with patients’ prognoses.
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影响因子：
158.5
作者：
Berkhemer, O. A.;Fransen, P. S. S.;Dippel, D. W. J.
通讯作者：
Dippel, D. W. J.
影响因子：
1.7
作者：
Khashim, Zenith;Fitzgerald, Sean;Kallmes, David F.
通讯作者：
Kallmes, David F.
DOI：
10.1084/jem.20211520
发表时间：
2022-03-07
期刊：
The Journal of experimental medicine
影响因子：
--
作者：
Di Marco Barros R;Fitzpatrick Z;Clatworthy MR
通讯作者：
Clatworthy MR
影响因子：
11.8
作者：
Gales, AC;Jones, RN;Verhoef, J
通讯作者：
Verhoef, J
影响因子：
8.3
作者：
Fiorelli, M;Bastianello, S;Bozzao, L
通讯作者：
Bozzao, L