Relationships of Variations in the Tongue Microbiota and Pneumonia Mortality in Nursing Home Residents
Relationships of Variations in the Tongue Microbiota and Pneumonia Mortality in Nursing Home Residents
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DOI：
10.1093/gerona/glx205
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发表时间：
2018-08-01
影响因子：
5.1
通讯作者：
Yamashita, Yoshihisa
中科院分区：
文献类型：
--
作者：
Kageyama, Shinya;Takeshita, Toru;Yamashita, Yoshihisa
背景：吸入含有致密口腔细菌的口腔碎屑是老年人肺炎的主要原因。这项研究调查了养老院居民的舌部微生物群组成与肺炎相关死亡发生率的关系。方法：在基线时评估受试者的健康状况，包括他们的舌部微生物区系。采用16S核糖体RNA基因测序和聚类法测定舌部微生物区系。对所有受试者(n=173)进行前瞻性追踪，中位数为19个月，以评估包括肺炎相关死亡在内的全因死亡的发生率。结果：将舌微生物区系分为两种群落类型：第一类以普氏杆菌和韦龙杆菌为主，第二类以奈瑟氏菌和梭杆菌为主。与II型患者相比，I型患者发生全因死亡(调整危险比=3.79，95%可信区间=1.38~10.39)和肺炎相关死亡(调整后危险比=13.88，95%CI=1.64~117.21)的风险显著增加。结论：在养老院居民中，舌部微生物区系类型与肺炎死亡风险显著相关。
Background: Aspiration of oral debris, containing dense oral bacteria, is a major cause of pneumonia in elderly adults. This study investigated the relationship between tongue microbiota composition and incidence of pneumonia-related deaths, in nursing home residents.Methods: The subjects were assessed for health conditions, including their tongue microbiota, at baseline. We determined tongue microbiota profiles by 16S ribosomal RNA gene sequencing and clustering approach. All subjects (n = 173) were followed prospectively for a median of 19 months to assess the incidence of all-cause death, including pneumonia-related death. We evaluated risk estimates of microbiota effects on death using multivariate Cox proportional hazards regression analysis.Results: Tongue microbiota were classified into two community types: type I was dominated by Prevotella and Veillonella species, while type II was dominated by Neisseria and Fusobacterium species. The subjects with type I microbiota exhibited a significantly greater risk of all-cause death (adjusted hazard ratio [aHR] = 3.79, 95% confidence interval [CI] = 1.38-10.39) and pneumonia-related death (aHR = 13.88, 95% CI = 1.64-117.21), than those with type II microbiota. There was no significant association between microbiota type and other-cause death.Conclusions: The tongue microbiota type was significantly associated with an increased mortality risk from pneumonia in nursing home residents.