摘要
目的探究重症监护室(ICU)肺部感染患者的肠道菌群特征,为肺部感染的危重症患者微生态靶向治疗提供借鉴。方法收集2021年3-9月入住重庆高新区人民医院ICU的肺部感染患者粪便样本78例,ICU非肺部感染患者粪便样本22例,健康人群的粪便样本40例,采用16S rRNA测序技术对粪便菌群进行检测鉴定,通过生物信息学方法比较并分析ICU肺部感染患者肠道菌群结构特征。结果ICU肺部感染患者的肠道微生物与健康人群相比,alpha多样性显著降低。ICU肺部感染患者肠道菌群以厚壁菌门、拟杆菌门、普雷沃菌属和拟杆菌属为主。处于极度失调(单一菌群丰度>50%)的ICU肺部感染患者的肠道菌群主要富集了普雷沃菌属、拟杆菌属、肠球菌和埃希菌等细菌。LEfSe分析提示,疣微菌科是ICU肺部感染患者肠道菌群中的标志性微生物。ICU肺部感染患者与健康人群相比,糖类和氨基酸代谢通路有所降低。另外,患者年龄结构、体质量指数、急性生理与慢性健康评分系统Ⅱ评分和住院时间与部分肠道菌群存在紧密联系。结论ICU肺部感染患者与健康人群相比,肠道菌群多样性显著降低。ICU肺部感染患者中肠道菌群极度失调者,可能由于感染特殊菌属(普雷沃菌、肠球菌、埃希菌等)引起自身免疫系统失调并诱导炎症因子产生从而引起肺部炎症,提示肠道菌群与ICU肺部感染患者联系密切。肠道菌群中的疣微菌科及其代表菌属阿克曼菌可为ICU肺部感染患者微生态靶向治疗提供参考。
Objective To analyze the characteristics of intestinal microbiota in patients with pulmonary infection in ICU,and to provide suggestion for micro ecological targeted treatment of critically ill patients with pulmonary infection.Methods The fecal samples of 78 patients with pulmonary infection and 22 patients with non pulmonary infection in ICU were collected from March to September 2021.Meanwhile,40 fecal samples from healthy people were collected as the control.Those fecal samples were detected and identified by 16S rRNA sequencing technology.Characteristics of intestinal microbiota of patients with ICU pulmonary infection were analyzed by bioinformatics methods.Results The intestinal microbiota of patients with pulmonary infection in ICU were analyzed.Compared with healthy people,alpha diversity was significantly reduced.The intestinal microbiota of patients with pulmonary infection in ICU were dominated by Firmicutes,Bacteroidetes,Prevotella and Bacteroides.However,The intestinal microbiota of patients with pulmonary infection in ICU who were in extreme disorder(single flora abundance>50%)were mainly enriched with Prevotella,Bacteroides,Enterococcus and Escherichia.LEfSe analysis indicated that verrucomicrobiaceae was a marker microorganism in patients with pulmonary infection in ICU.Compared with healthy people,patients with pulmonary infection in ICU have lower carbohydrate and amino acid metabolic pathways.The patient′s age structure,BMI,APACHEⅡscore and length of stay were closely related to some intestinal flora.Conclusion The intestinal microbiota diversities of patients with pulmonary infection in ICU were significantly lower than those of normal people.The extreme imbalance of intestinal microbiota in patients with pulmonary infection in ICU may be caused by disorder of autoimmune system and the production of inflammatory factors caused by special bacteria(Prevotella,Enterococcus,Escherichia,etc.).Those results suggest that intestinal flora is closely related to patients with pulmonary infection in ICU.Verrucomicobiaceae,such as akkermansia in intestinal flora can provide candidate for micro ecological targeted treatment of patients with pulmonary infection in ICU.
作者
文杨
蒋小艳
王浩园
范文辉
周茂霖
周强
WEN Yang;JIANG Xiaoyan;WANG Haoyuan;FAN Wenhui;ZHOU Maolin;ZHOU Qiang(Department of Critical Care Medicine,People′s Hospital of Gaoxin District,Chongqing 400039,China;Department of Neurology,Chongqing Ninth People′s Hospital,Chongqing 400799,China;College of Pharmacy and Bioengineering,Chongqing University of Technology,Chongqing 400054,China)
出处
《国际检验医学杂志》
CAS
2023年第17期2101-2107,共7页
International Journal of Laboratory Medicine
基金
重庆市科卫联合医学科研项目(2021MSXM125)
重庆市北碚区基础研究与前沿探索(2020-24)。
关键词
危重症患者
肺部感染
肠道菌群
16S
rRNA测序
菌群多样性
critically ill patient
pulmonary infection
intestinal flora
16S rRNA sequencing
bacterial diversity
作者简介
文杨,男,副主任医师,主要从事重症医学的治疗和研究工作;通信作者:周强,E-mail:77713088qq.com。
