Clinical factors associated with composition of lung microbiota and important taxa predicting clinical prognosis in patients with severe community-acquired pneumonia
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 ($ R^{2} $ = 0.033; P = 0.018), followed by acute kidney injury (AKI; $ R^{2} $ = 0.032; P = 0.011) and plasma MIP-1β level ($ R^{2} $ = 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..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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| Enthalten in: |
Frontiers of medicine - 16(2021), 3 vom: 24. Juli, Seite 389-402 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Du, Sisi [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
7-category ordinal scale |
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| Anmerkungen: |
© Higher Education Press 2021 |
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| doi: |
10.1007/s11684-021-0856-3 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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OLC2131389957 |
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| 520 | |a 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 ($ R^{2} $ = 0.033; P = 0.018), followed by acute kidney injury (AKI; $ R^{2} $ = 0.032; P = 0.011) and plasma MIP-1β level ($ R^{2} $ = 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. | ||
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| 700 | 1 | |a Wu, Xiaojing |4 aut | |
| 700 | 1 | |a Li, Binbin |4 aut | |
| 700 | 1 | |a Wang, Yimin |4 aut | |
| 700 | 1 | |a Shang, Lianhan |4 aut | |
| 700 | 1 | |a Huang, Xu |4 aut | |
| 700 | 1 | |a Xia, Yudi |4 aut | |
| 700 | 1 | |a Yu, Donghao |4 aut | |
| 700 | 1 | |a Lu, Naicong |4 aut | |
| 700 | 1 | |a Liu, Zhibo |4 aut | |
| 700 | 1 | |a Wang, Chunlei |4 aut | |
| 700 | 1 | |a Liu, Xinmeng |4 aut | |
| 700 | 1 | |a Xiong, Zhujia |4 aut | |
| 700 | 1 | |a Zou, Xiaohui |4 aut | |
| 700 | 1 | |a Lu, Binghuai |4 aut | |
| 700 | 1 | |a Liu, Yingmei |4 aut | |
| 700 | 1 | |a Zhan, Qingyuan |4 aut | |
| 700 | 1 | |a Cao, Bin |4 aut | |
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