Repertoire of Intensive Care Unit Pneumonia Microbiota
Repertoire of Intensive Care Unit Pneumonia Microbiota
复制标题
重症监护病房肺炎微生物群库
作者：
S. Bousbia;L. Papazian;P. Saux;J. Forel;J. Auffray;Claude D Martin;D. Raoult;B. La Scola
尽管迄今为止报道了大量研究，但肺炎的病原体尚未完全确定。我们综合应用现代和传统的实验室诊断技术来识别重症监护病房（ICU）入院或出现肺炎的患者的微生物群。在三年的时间里，我们测试了呼吸机相关性肺炎、社区获得性肺炎、非呼吸机 ICU 肺炎和吸入性肺炎患者的支气管肺泡灌洗 (BAL)，并将结果与非肺炎患者（对照）的结果进行了比较。通过扩增 16S rDNA、18S rDNA 基因，然后进行克隆和测序以及针对特定病原体的 PCR 来测试样本。我们还包括培养、阿米巴共培养、针对选定药物的抗体检测和尿抗原测试。基于分子检测，我们鉴定出了 160 种细菌，其中 73 种细菌以前从未在肺炎中报道过。此外，我们发现了 37 种假定的新细菌系统型，其 16S rDNA 基因与已知系统型的差异≥98%。我们还鉴定了 24 种真菌，其中 6 种以前未在肺炎中报道过，还有 7 种病毒。患者在一份 BAL 中可呈现多达 16 种不同的微生物（平均值±标准差；3.77±2.93）。一些被认为是 ICU 肺炎典型的病原体，如铜绿假单胞菌和链球菌，在对照组和肺炎患者中都可以检测到，这引人注目地凸显了核心肺部微生物群的存在。记录了不同形式肺炎的微生物群差异。
Despite the considerable number of studies reported to date, the causative agents of pneumonia are not completely identified. We comprehensively applied modern and traditional laboratory diagnostic techniques to identify microbiota in patients who were admitted to or developed pneumonia in intensive care units (ICUs). During a three-year period, we tested the bronchoalveolar lavage (BAL) of patients with ventilator-associated pneumonia, community-acquired pneumonia, non-ventilator ICU pneumonia and aspiration pneumonia, and compared the results with those from patients without pneumonia (controls). Samples were tested by amplification of 16S rDNA, 18S rDNA genes followed by cloning and sequencing and by PCR to target specific pathogens. We also included culture, amoeba co-culture, detection of antibodies to selected agents and urinary antigen tests. Based on molecular testing, we identified a wide repertoire of 160 bacterial species of which 73 have not been previously reported in pneumonia. Moreover, we found 37 putative new bacterial phylotypes with a 16S rDNA gene divergence ≥98% from known phylotypes. We also identified 24 fungal species of which 6 have not been previously reported in pneumonia and 7 viruses. Patients can present up to 16 different microorganisms in a single BAL (mean ± SD; 3.77±2.93). Some pathogens considered to be typical for ICU pneumonia such as Pseudomonas aeruginosa and Streptococcus species can be detected as commonly in controls as in pneumonia patients which strikingly highlights the existence of a core pulmonary microbiota. Differences in the microbiota of different forms of pneumonia were documented.
DOI：
10.1086/593193
发表时间：
2008-12-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
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作者：
Heo SM;Haase EM;Lesse AJ;Gill SR;Scannapieco FA
通讯作者：
Scannapieco FA