Objective To explore the correlation between changes in gut microbiota and the occurrence of chronic renal failure(CRF)in elderly patients,providing theoretical evidence for the prevention and treatment of CRF in the elderly.Methods A total of 57 elderly patients with CRF admitted to Department of Nephrology,Jilin People's Hospital from June 2021 to June 2023 were selected as observation group,while 65 healthy individuals who underwent physical examinations at the same hospital during the same period were chosen as control group.Baseline data,gut microbiota composition,and biochemical indicators were compared between two groups.Results The levels of γ-glutamyl transferase,creatinine,urea,uric acid,N-terminal pro-brain natriuretic peptide,parathyroid hormone,hypersensitive C-reactive protein,and serum phosphorus were higher in observation group than those in control group,whereas serum calcium was lower;all differences were statistically significant(P＜0.05).Firmicutes and Bacteroidetes were dominant in two groups,accounting for 49.22％and 43.12％in observation group and 49.47％and 42.01％in control group,respectively.At the genus level,Bacteroides predominated,comprising 8.69％and 9.68％of the total,respectively.Multivariate Logistic regression analysis showed that Actinobacteria(95％CI:0.015-0.391,P=0.002),Lactobacillus(95％CI:0.224-0.577,P＜0.001),Bifidobacterium(95％CI:0.150-0.933,P=0.035),and Streptococcus(95％CI:0.256-0.687,P-0.001)were negatively associated with the occurrence of CRF in the elderly,whereas Clostridium(95％CI:2.176-15.047,P＜0.001)and Enterococcus(95％CI:1.579-7.224,P=0.002)were positively associated.Conclusion Changes in gut microbiota are closely related to the development of CRF in the elderly.Clinically,attention should be paid to the cultivation and identification of gut microbiota in this population,in order to provide guidance for the diagnosis and treatment of intestinal flora disorders in patients with CRF,guide probiotic application,and formulate microecological regulation programs.

Objective To explore the correlation between changes in gut microbiota and the occurrence of chronic renal failure(CRF)in elderly patients,providing theoretical evidence for the prevention and treatment of CRF in the elderly.Methods A total of 57 elderly patients with CRF admitted to Department of Nephrology,Jilin People's Hospital from June 2021 to June 2023 were selected as observation group,while 65 healthy individuals who underwent physical examinations at the same hospital during the same period were chosen as control group.Baseline data,gut microbiota composition,and biochemical indicators were compared between two groups.Results The levels of γ-glutamyl transferase,creatinine,urea,uric acid,N-terminal pro-brain natriuretic peptide,parathyroid hormone,hypersensitive C-reactive protein,and serum phosphorus were higher in observation group than those in control group,whereas serum calcium was lower;all differences were statistically significant(P＜0.05).Firmicutes and Bacteroidetes were dominant in two groups,accounting for 49.22％and 43.12％in observation group and 49.47％and 42.01％in control group,respectively.At the genus level,Bacteroides predominated,comprising 8.69％and 9.68％of the total,respectively.Multivariate Logistic regression analysis showed that Actinobacteria(95％CI:0.015-0.391,P=0.002),Lactobacillus(95％CI:0.224-0.577,P＜0.001),Bifidobacterium(95％CI:0.150-0.933,P=0.035),and Streptococcus(95％CI:0.256-0.687,P-0.001)were negatively associated with the occurrence of CRF in the elderly,whereas Clostridium(95％CI:2.176-15.047,P＜0.001)and Enterococcus(95％CI:1.579-7.224,P=0.002)were positively associated.Conclusion Changes in gut microbiota are closely related to the development of CRF in the elderly.Clinically,attention should be paid to the cultivation and identification of gut microbiota in this population,in order to provide guidance for the diagnosis and treatment of intestinal flora disorders in patients with CRF,guide probiotic application,and formulate microecological regulation programs.

Objective:To investigate the distribution and clinical characteristics of pathogenic bacteria following hematopoietic stem cell transplantation (HSCT), as well as to provide a preliminary research foundation for key microbial monitoring, and clinical diagnosis and treatment of infections after HSCT in hematological patients.Methods:We retrospectively analyzed the clinical data of 190 patients who tested positive for microbial testing [G-bacteria blood culture and/or carbapenem-resistant organism (CRO) screening of perianal swabs] at our center from January 2018 to December 2022. Patients were divided into blood culture positive, perianal swab positive, and double positive groups based on the testing results. The three patient groups underwent statistical analysis and comparison.Results:The top four pathogenic bacteria isolated from sixty-three patients with G-bacteria bloodstream infection (BSI) were Escherichia coli (28 strains, 43.75% ), Klebsiella pneumonia (26 strains, 40.63% ), Pseudomonas aeruginosa (3 strains, 4.69% ), and Enterobacter cloacae (3 strains, 4.69% ). The top three pathogenic bacteria isolated from 147 patients with CRO perianal colonization were carbapenem-resistant Klebsiella pneumoniae (58 strains, 32.58% ), carbapenem-resistant Escherichia coli (49 strains, 27.53% ), and carbapenem-resistant Enterobacter cloacae (20 strains, 11.24% ). The 3-year disease-free survival (DFS ) and overall survival (OS) of double positive group patients were significantly lower compared to those in the blood culture and perianal swab positive groups (DFS: 35.6% vs 53.7% vs 68.6%, P=0.001; OS: 44.4% vs 62.4% vs 76.9%, P<0.001), while non-relapse mortality (NRM) was significantly higher (50.0% vs 34.9% vs 10.6%, P<0.001). Failed engraftment of platelets and BSI are independent risk factors for NRM ( P<0.001). Using polymyxin and/or ceftazidime-avibactam for more than 7 days is an independent protective factor for NRM ( P=0.035) . Conclusion:This study suggests that the occurrence of BSI significantly increases the NRM after HSCT in patients with hematological diseases; CRO colonization into the bloodstream has a significant impact on the DFS and OS of HSCT patients.