Clinical factors associated with composition of lung microbiota and important taxa predicting clinical prognosis in patients with severe community-acquired pneumonia  

作　　者：Sisi Du Xiaojing Wu Binbin Li Yimin Wang Lianhan Shang Xu Huang Yudi Xia Donghao Yu Naicong Lu Zhibo Liu Chunlei Wang Xinmeng Liu Zhujia Xiong Xiaohui Zou Binghuai Lu Yingmei Liu Qingyuan Zhan Bin Cao 

机构地区：[1]China-Japan Friendship Hospital,National Clinical Research Center for Respiratory Diseases,National Center for Respiratory Medicine,Clinical Center for Pulmonary Infections,Capital Medical University,Beijing 100029,China [2]Institute of Respiratory Medicine,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100029,China [3]Department of Pulmonary and Critical Care Medicine,Center for Respiratory Diseases,China-Japan Friendship Hospital,Beijing 100029,China [4]Beijing University of Chinese Medicine,Beijing 100029,China [5]Beijing Luhe Hospital,Beijing 101100,China [6]Tsinghua University–Peking University Joint Center for Life Sciences,Beijing 100084,China

出　　处：《Frontiers of Medicine》2022年第3期389-402,共14页医学前沿（英文版）

基　　金：funded by the National Key Research and Devclopment Program of China(No,2017YFC1309301);the CAMS Innovation Fund for Medical Sciences(CIFMS:No.2018-12M-1-003);the National Science Grant for Distinguished Young Scholars(No.81425001/H0104);the Ministry of Science and Technology of China No.2017ZX10103004).

摘　　要：Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia(SCAP).We prospectively enrolled consecutive SCAP patients admitted to ICU.Bronchoscopy was performed at bedside within 48 h of ICU admission,and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid.The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy.Sixty-seven patients were included.Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota(R2=0.033;P=0.018),followed by acute kidney injury(AKI;R2=0.032;P=0.011)and plasma MIP-1βlevel(R2=0.027;P=0.044).Random forest identified that the families Prevotellaceae,Moraxellaceae,and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results.Multivariable Cox regression showed that the increase inα-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements.The positive bacteria lab test results,AKI,and plasma MIP-1βlevel were associated with patients’lung microbiota composition on ICU admission.The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.

关 键 词：severe community-acquired pneumonia lung microbiota clinical improvements 7-category ordinal scale Prevotellaceae 

分 类 号：R563.1[医药卫生—呼吸系统]