Clinical factors associated with composition of lung microbiota and important taxa predicting clinical prognosis in patients with severe community-acquired pneumonia.
10.1007/s11684-021-0856-3
- Author:
Sisi DU
1
;
Xiaojing WU
1
;
Binbin LI
1
;
Yimin WANG
1
;
Lianhan SHANG
1
;
Xu HUANG
1
;
Yudi XIA
1
;
Donghao YU
1
;
Naicong LU
1
;
Zhibo LIU
1
;
Chunlei WANG
1
;
Xinmeng LIU
1
;
Zhujia XIONG
1
;
Xiaohui ZOU
1
;
Binghuai LU
1
;
Yingmei LIU
1
;
Qingyuan ZHAN
2
;
Bin CAO
3
Author Information
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. 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. drzhanqy@163.com.
3. 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. caobin_ben@163.com.
- Publication Type:Journal Article
- Keywords:
7-category ordinal scale;
Prevotellaceae;
clinical improvements;
lung microbiota;
severe community-acquired pneumonia
- MeSH:
Acute Kidney Injury/complications*;
Bacteria/classification*;
Chemokine CCL4/blood*;
Community-Acquired Infections/microbiology*;
Humans;
Lung;
Microbiota/genetics*;
Pneumonia, Bacterial/diagnosis*;
Prognosis;
RNA, Ribosomal, 16S/genetics*
- From:
Frontiers of Medicine
2022;16(3):389-402
- CountryChina
- Language:English
-
Abstract:
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-1β level (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 in α-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-1β level were associated with patients' lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.
