PDF(Pubmed)
Abstract：
BACKGROUND: Community-acquired pneumonia (CAP) is a common and serious condition that can be caused by a variety of pathogens. However, much remains unknown about how these pathogens interact with the lower respiratory commensals, and whether any correlation exists between the dysbiosis of the lower respiratory microbiota and disease severity and prognosis.
METHODS: We conducted a retrospective cohort study to investigate the composition and dynamics of sputum microbiota in patients diagnosed with CAP. In total, 917 sputum specimens were collected consecutively from 350 CAP inpatients enrolled in six hospitals following admission. The V3-V4 region of the 16 S rRNA gene was then sequenced.
RESULTS: The sputum microbiota in 71% of the samples were predominately composed of respiratory commensals. Conversely, 15% of the samples demonstrated dominance by five opportunistic pathogens. Additionally, 5% of the samples exhibited sterility, resembling the composition of negative controls. Compared to non-severe CAP patients, severe cases exhibited a more disrupted sputum microbiota, characterized by the highly dominant presence of potential pathogens, greater deviation from a healthy state, more significant alterations during hospitalization, and sparser bacterial interactions. The sputum microbiota on admission demonstrated a moderate prediction of disease severity (AUC = 0.74). Furthermore, different pathogenic infections were associated with specific microbiota alterations. Acinetobacter and Pseudomonas were more abundant in influenza A infections, with Acinetobacter was also enriched in Klebsiella pneumoniae infections.
CONCLUSIONS: Collectively, our study demonstrated that pneumonia may not consistently correlate with severe dysbiosis of the respiratory microbiota. Instead, the degree of microbiota dysbiosis was correlated with disease severity in CAP patients.
METHODS: We conducted a retrospective cohort study to investigate the composition and dynamics of sputum microbiota in patients diagnosed with CAP. In total, 917 sputum specimens were collected consecutively from 350 CAP inpatients enrolled in six hospitals following admission. The V3-V4 region of the 16 S rRNA gene was then sequenced.
RESULTS: The sputum microbiota in 71% of the samples were predominately composed of respiratory commensals. Conversely, 15% of the samples demonstrated dominance by five opportunistic pathogens. Additionally, 5% of the samples exhibited sterility, resembling the composition of negative controls. Compared to non-severe CAP patients, severe cases exhibited a more disrupted sputum microbiota, characterized by the highly dominant presence of potential pathogens, greater deviation from a healthy state, more significant alterations during hospitalization, and sparser bacterial interactions. The sputum microbiota on admission demonstrated a moderate prediction of disease severity (AUC = 0.74). Furthermore, different pathogenic infections were associated with specific microbiota alterations. Acinetobacter and Pseudomonas were more abundant in influenza A infections, with Acinetobacter was also enriched in Klebsiella pneumoniae infections.
CONCLUSIONS: Collectively, our study demonstrated that pneumonia may not consistently correlate with severe dysbiosis of the respiratory microbiota. Instead, the degree of microbiota dysbiosis was correlated with disease severity in CAP patients.
摘要：
背景：社区获得性肺炎（CAP）是一种常见且严重的疾病，可由多种病原体引起。然而,关于这些病原体如何与下呼吸道共生相互作用，以及下呼吸道微生物群的生态失调与疾病严重程度和预后之间是否存在任何相关性。
方法：我们进行了一项回顾性队列研究，以调查诊断为CAP患者的痰菌群组成和动态。总的来说,从入院后在六家医院注册的350名CAP住院患者中连续收集917份痰标本。然后对16SrRNA基因的V3-V4区进行测序。
结果：71％的样本中的痰菌群主要由呼吸道共生组成。相反，15％的样品显示出五种机会病原体的优势。此外,5%的样品表现出不育，类似于阴性对照的组成。与非重度CAP患者相比，严重病例表现出更多的痰菌群中断，以潜在病原体的高度显性存在为特征，与健康状态的偏差更大，住院期间发生更显著的变化，和稀疏的细菌相互作用。入院时的痰菌群显示出疾病严重程度的中度预测（AUC=0.74）。此外，不同的病原感染与特定的微生物群改变相关.不动杆菌和假单胞菌在甲型流感感染中更为丰富，不动杆菌也富集在肺炎克雷伯菌感染中。
结论：总的来说，我们的研究表明,肺炎可能与呼吸道微生物群的严重菌群失调并不一致.相反，CAP患者菌群失调程度与疾病严重程度相关。
方法：我们进行了一项回顾性队列研究，以调查诊断为CAP患者的痰菌群组成和动态。总的来说,从入院后在六家医院注册的350名CAP住院患者中连续收集917份痰标本。然后对16SrRNA基因的V3-V4区进行测序。
结果：71％的样本中的痰菌群主要由呼吸道共生组成。相反，15％的样品显示出五种机会病原体的优势。此外,5%的样品表现出不育，类似于阴性对照的组成。与非重度CAP患者相比，严重病例表现出更多的痰菌群中断，以潜在病原体的高度显性存在为特征，与健康状态的偏差更大，住院期间发生更显著的变化，和稀疏的细菌相互作用。入院时的痰菌群显示出疾病严重程度的中度预测（AUC=0.74）。此外，不同的病原感染与特定的微生物群改变相关.不动杆菌和假单胞菌在甲型流感感染中更为丰富，不动杆菌也富集在肺炎克雷伯菌感染中。
结论：总的来说，我们的研究表明,肺炎可能与呼吸道微生物群的严重菌群失调并不一致.相反，CAP患者菌群失调程度与疾病严重程度相关。
