Association of Increased Circulating Acetic Acid With Poor Survival in Pseudomonas aeruginosa Ventilator-Associated Pneumonia Patients.
Association of Increased Circulating Acetic Acid With Poor Survival in Pseudomonas aeruginosa Ventilator-Associated Pneumonia Patients.
复制标题
循环乙酸增加与铜绿假单胞菌呼吸机相关肺炎患者生存率低之间的关系
DOI：
10.3389/fcimb.2021.669409
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发表时间：
2021
影响因子：
5.7
通讯作者：
Liu J
中科院分区：
文献类型：
--
作者：
Qi X;Zhang L;Xu J;Tao Z;Wang X;Qiu Y;Pan T;Liu Z;Qu H;Tan R;Liu J
背景我们之前发现，铜绿假单胞菌呼吸机相关性肺炎（PA-VAP）患者的微生物破坏是持久的。长期的微生物失调可能会导致代谢物的变化。短链脂肪酸（SCFA）是微生物发酵产物，对肺炎患者具有有益作用。在本研究中，我们旨在探讨 PA-VAP 患者循环 SCFA 水平与临床结果之间的关联。方法在本研究中，我们通过气相色谱-质谱分析法分析了 49 例 PA-VAP 患者血清中的 SCFA。其中 20 名患者死亡，29 人幸存。分析血清 SCFA 与患者生存率和免疫参数之间的相关性。结果 我们开发了偏最小二乘判别分析 (PLS-DA) 模型来检查 49 名 PA-VAP 患者的差异 SCFA。在七种 SCFA 中，只有乙酸在非幸存者中增加（P = 0.031，VIP > 1）。此外，在 Kaplan-Meier 生存分析中，与低水平乙酸（<1.96ug/ml）相比，高水平乙酸（>1.96ug/ml）显示 90 天死亡率增加（P = 0.027）。乙酸增加还与循环淋巴细胞和单核细胞计数减少相关。结论 我们的研究表明，循环乙酸增加与 PA-VAP 患者的 90 天死亡率相关。淋巴细胞和单核细胞减少可能是受醋酸影响而导致预后不良。
Background We previously found that microbial disruption in Pseudomonas aeruginosa ventilator-associated pneumonia (PA-VAP) patients are long-lasting. Long-term microbial dysbiosis may lead to changes in metabolites. Short-chain fatty acids (SCFAs) are microbial fermentation products and show beneficial effects in patients with pneumonia. In this study, we aimed to explore the association between circulating SCFA levels and clinical outcomes in patients with PA-VAP. Methods In this study, we analyzed SCFAs in the serum of 49 patients with PA-VAP by gas chromatography-mass spectrometry analysis. Twenty of these patients died, and 29 survived. The correlation between serum SCFAs and patient survival and immune parameters was analyzed. Results We developed a partial least squares discriminant analysis (PLS-DA) model to examine differential SCFAs in 49 patients with PA-VAP. Among the seven SCFAs, only acetic acid was increased in non-survivors (P = 0.031, VIP > 1). Furthermore, high levels of acetic acid (>1.96ug/ml) showed increased 90-day mortality compared to low levels of acetic acid (<1.96ug/ml) in Kaplan-Meier survival analyses (P = 0.027). Increased acetic acid also correlated with reduced circulating lymphocyte and monocyte counts. Conclusion Our study showed that increased circulating acetic acid is associated with 90-day mortality in PA-VAP patients. The decrease in lymphocytes and monocytes might be affected by acetic acid and involved in the poor prognosis.