Relationship between preoperative gut microbiota and postoperative ventilator-associated pneumonia in patients undergoing coronary artery bypass grafting
10.3760/cma.j.cn131073-20250123-01107
- VernacularTitle:冠状动脉搭桥术患者术前肠道菌群与术后呼吸机相关性肺炎的关系
- Author:
Peiying HUANG
1
;
Lichao DI
;
Sichen CUI
;
Tianyu CAO
;
Shizhao WANG
;
Huan CHEN
;
Sha LI
;
Lining HUANG
Author Information
1. 河北医科大学第二医院麻醉科，石家庄 050000
- Publication Type:Journal Article
- Keywords:
Pneumonia, ventilator-associated;
Gastrointestinal microbiome;
Coronary artery bypass, off-pump;
Postoperative complications
- From:
Chinese Journal of Anesthesiology
2025;45(11):1422-1426
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the relationship between preoperative gut microbiota and post-operative ventilator-associated pneumonia (VAP) in patients undergoing coronary artery bypass grafting.Methods:This was a secondary analysis of a previous research project study. Patients who received invasive mechanical ventilation treatment after elective off-pump coronary artery bypass grafting at the Second Hospital of Hebei Medical University from April to September 2023 were selected and divided into VAP group and non-VAP group based on whether VAP occurred after surgery. Fecal samples were collected from patients before surgery, and 16S rRNA gene sequencing was used to analyze the characteristics of preoperative gut microbiota in the two groups. The differences in the diversity of gut microbiota between the two groups were compared. The linear discriminant analysis was used to identify the gut microbiota with significant differences between groups (differential bacteria), and logistic regression analysis was conducted to assess the association between differential bacteria and VAP. Receiver operating characteristic curves were drawn to analyze the predictive value of the differential bacteria for VAP.Results:A total of 79 patients were finally included, with 25 in VAP group and 54 in non-VAP group. The Beta diversity analysis showed statistically significant differences between VAP group and non-VAP group (pseudo- F=2.00, P=0.002). The linear discriminant analysis indicated that Bifidobacterium, Blautia and Megamonas were enriched in non-VAP group, while Klebsiella was enriched in VAP group. Multivariate logistic regression analysis showed that the relative abundance of Bifidobacterium was a protective factor for postoperative VAP ( OR=0.32, 95% confidence interval [ CI] 0.15-0.71, P=0.005), and the relative abundance of Klebsiella was a risk factor for postoperative VAP ( OR=2.49, 95% CI 1.143-5.43, P=0.022). The area under the receiver operating characteristic curve of the relative abundance of Bifidobacterium for predicting VAP was 0.80 (95% CI 0.69-0.90, P<0.001) and of the relative abundance of Klebsiella was 0.70 (95% CI 0.57-0.83, P=0.005). Conclusions:Bifidobacterium is a protective factor, while Klebsiella is a risk factor for postoperative VAP in patients undergoing coronary artery bypass grafting, and the relative abundance of both bacteria has a certain predictive value for VAP.
