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

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Frontiers of Medicine 2022年第3期16卷 389-402页

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 China-Japan Friendship Hospital National Clinical Research Center for Respiratory DiseasesNational Center for Respiratory MedicineClinical Center for Pulmonary InfectionsCapital Medical UniversityBeijing 100029China Institute of Respiratory Medicine Chinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100029China Department of Pulmonary and Critical Care Medicine Center for Respiratory DiseasesChina-Japan Friendship HospitalBeijing 100029China Beijing University of Chinese Medicine Beijing 100029China Beijing Luhe Hospital Beijing 101100China Tsinghua University–Peking University Joint Center for Life Sciences Beijing 100084China

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 *** was performed at bedside within 48 h of ICU admission,and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage *** primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following ***-seven patients were *** 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 *** Cox regression showed that the increase inα-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical *** positive bacteria lab test results,AKI,and plasma MIP-1βlevel were associated with patients’lung microbiota composition on ICU *** 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

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