Lower respiratory tract microbial composition was diversified in Pseudomonas aeruginosa ventilator-associated pneumonia patients.
Lower respiratory tract microbial composition was diversified in Pseudomonas aeruginosa ventilator-associated pneumonia patients.
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铜绿假单胞菌呼吸机相关性肺炎患者下呼吸道微生物组成多样化
DOI：
10.1186/s12931-018-0847-3
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发表时间：
2018-07-27
影响因子：
5.8
通讯作者：
Liu J
中科院分区：
文献类型：
--
作者：
Qi X;Qu H;Yang D;Zhou L;He YW;Yu Y;Qu J;Liu J
益生菌可预防铜绿假单胞菌在下呼吸道（LRT）定植，降低铜绿假单胞菌呼吸机相关性肺炎（VAP）的发生率。最近的研究还表明，益生菌可以改善感染铜绿假单胞菌的小鼠的肺部炎症。因此，微生物群调节可能是铜绿假单胞菌VAP患者的潜在治疗方法。然而，我们对铜绿假单胞菌VAP患者的LRT微生物组成及其与预后的相关性知之甚少。本研究旨在描述铜绿假单胞菌VAP患者的LRT微生物群特征，并探讨微生物群与患者预后的关系。通过插管对受试者的深部气管内分泌物进行采样。通过16 S核糖体RNA基因测序鉴定群落。评价铜绿假单胞菌VAP患者的微生物群与预后的关系。临床肺部感染评分和重症监护室生存率均为患者预后的指标。在本研究中，铜绿假单胞菌VAP患者的LRT微生物组成与未感染插管患者存在显著差异，并表现出显著的个体差异，形成两个聚类。根据各类群的优势类群，将这两个类群分别命名为Pro类群和Fir-Bac类群。Pro菌群以变形菌门为主（adj.P < 0.001），Fir-Bac菌群以厚壁菌门和拟杆菌门为主（均为adj.P < 0.001）。这两个不同的聚类（Pro和Fir-Bac聚类）与患者的原发病有关（χ2检验，P < 0.0001）。Pro簇的原发疾病主要为胃肠道疾病（63%），Fir-Bac簇主要为呼吸系统疾病（89%）。在为期两周的动态观察期间，尽管使用了抗生素，但铜绿假单胞菌VAP患者的LRT微生物群的优势属和Shannon多样性并未发生显著变化。在预后分析中，我们发现乳酸菌与诊断当天的临床肺部感染评分呈显著负相关（P = 0.014）;但我们发现幸存者和非幸存者之间的微生物组成无显著差异。铜绿假单胞菌VAP患者LRT菌群组成多样，形成两个与患者原发病相关的菌群。本文的在线版本（10.1186/s12931-018-0847-3）包含补充材料，可供授权用户使用。
Probiotics could prevent Pseudomonas aeruginosa colonization in lower respiratory tract (LRT) and reduced P. aeruginosa ventilator-associated pneumonia (VAP) rate. Recent studies also suggested that probiotics could improve lung inflammation in mice infected with P. aeruginosa. It seems that microbiota regulation may be a potential therapy for P. aeruginosa VAP patients. However, we know less about the LRT microbial composition and its correlation with prognosis in P. aeruginosa VAP patients. This study aimed to characterize LRT microbiota in P. aeruginosa VAP patients and explore the relationship between microbiota and patient prognosis. Deep endotracheal secretions were sampled from subjects via intubation. Communities were identified by 16S ribosomal RNA gene sequencing. The relationship between microbiota and the prognosis of P. aeruginosa VAP patients were evaluated. Clinical pulmonary infection score and the survival of intensive care unit were both the indicators of patient prognosis. In this study, the LRT microbial composition of P. aeruginosa VAP patients was significantly different from non-infected intubation patients, and showed significant individual differences, forming two clusters. According to the predominant phylum of each cluster, these two clusters were named Pro cluster and Fir-Bac cluster respectively. Patients from Pro cluster were dominated by Proteobacteria (adj.P < 0.001), while those from Fir-Bac cluster were dominated by Firmicutes, and Bacteroidetes (both adj.P < 0.001). These two varied clusters (Pro and Fir-Bac cluster) were associated with the patients’ primary disease (χ2-test, P < 0.0001). The primary disease of the Pro cluster mainly included gastrointestinal disease (63%), and the Fir-Bac cluster was predominantly respiratory disease (89%). During the two-week dynamic observation period, despite the use of antibiotics, the dominant genera and Shannon diversity of the LRT microbiota did not change significantly in patients with P. aeruginosa VAP. In prognostic analysis, we found a significant negative correlation between Lactobacillus and clinical pulmonary infection score on the day of diagnosis (P = 0.014); but we found no significant difference of microbial composition between survivors and non-survivors. LRT microbial composition was diversified among P. aeruginosa VAP patients, forming two clusters which were associated with the primary diseases of the patients. The online version of this article (10.1186/s12931-018-0847-3) contains supplementary material, which is available to authorized users.
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DOI：
10.1097/shk.0000000000000066
发表时间：
2013-12
期刊：
Shock (Augusta, Ga.)
影响因子：
--
作者：
Khailova L;Baird CH;Rush AA;McNamee EN;Wischmeyer PE
通讯作者：
Wischmeyer PE
影响因子：
4.9
作者：
Rosenthal, Victor D.;Hu Bijie;Jayatilleke, Kushlani
通讯作者：
Jayatilleke, Kushlani
影响因子：
4
作者：
Matsumoto, T.;Ishikawa, H.;Yamaguchi, K.
通讯作者：
Yamaguchi, K.
DOI：
10.1164/rccm.200912-1853oc
发表时间：
2010-10-15
影响因子：
24.7
作者：
Morrow, Lee E.;Kollef, Marin H.;Casale, Thomas B.
通讯作者：
Casale, Thomas B.
影响因子：
15.5
作者：
Kelly BJ;Imai I;Bittinger K;Laughlin A;Fuchs BD;Bushman FD;Collman RG
通讯作者：
Collman RG