Infection and drug resistance · 2026
Bronchoalveolar Lavage Microbiota in Critically Ill Patients with Aspiration Pneumonia: An Exploratory Comparison with Community-Acquired Pneumonia and Analysis of Gemella Detection and Mortality.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wang Runze, Shao Yiru, Zhang Lin, Zhang Chen, Shen Meili, Mo Weichun, Zhang Feng, Shen Jie
Аннотация
BACKGROUND: Aspiration pneumonia (AP) is a common and severe infection among critically ill older adults, but its lower respiratory tract microbiota and clinical associations remain incompletely characterized.
METHODS: This single-center retrospective exploratory study included 72 intensive care unit patients, comprising 49 patients with AP and 23 with community-acquired pneumonia (CAP). Bronchoalveolar lavage fluid (BALF) microbiota were profiled using metagenomic next-generation sequencing (mNGS). Alpha and beta diversity, taxonomic composition, differential abundance, and associations between bacterial taxa and clinical or peripheral immune markers were analyzed. Within the AP cohort, the association between Gemella detection and in-hospital mortality was evaluated using Firth's penalized logistic regression.
RESULTS: AP patients had higher Shannon and Simpson diversity than CAP patients. Overall community composition did not differ significantly between the groups based on Bray-Curtis dissimilarity and PERMANOVA (R2=0.022, P=0.066). Streptococcus and Rothia showed nominally higher relative abundances in AP, whereas Acinetobacter and Stenotrophomonas showed nominally lower relative abundances. Only Acinetobacter remained more abundant in CAP after FDR correction (FDR-adjusted P=0.032). Nominal correlations between bacterial taxa and clinical or immune variables were not significant after FDR correction. Gemella was detected in 9 AP patients, including 8 of 26 non-survivors and 1 of 23 survivors (P=0.026). In the unadjusted Firth model, Gemella detection was associated with mortality (OR=6.892, 95% CI 1.360-69.062; P=0.018), but the association was attenuated and non-significant after adjustment for APACHE II score (OR=4.708, 95% CI 0.859-48.395; P=0.076).
CONCLUSION: AP was associated with higher alpha diversity. Selected oral-associated taxonomic patterns and their immune-cell percentages correlations were exploratory and were not confirmed after multiple-testing correction. The association between Gemella detection and mortality was imprecise and sensitive to sparse data and model specification, requiring validation in larger prospective studies.
METHODS: This single-center retrospective exploratory study included 72 intensive care unit patients, comprising 49 patients with AP and 23 with community-acquired pneumonia (CAP). Bronchoalveolar lavage fluid (BALF) microbiota were profiled using metagenomic next-generation sequencing (mNGS). Alpha and beta diversity, taxonomic composition, differential abundance, and associations between bacterial taxa and clinical or peripheral immune markers were analyzed. Within the AP cohort, the association between Gemella detection and in-hospital mortality was evaluated using Firth's penalized logistic regression.
RESULTS: AP patients had higher Shannon and Simpson diversity than CAP patients. Overall community composition did not differ significantly between the groups based on Bray-Curtis dissimilarity and PERMANOVA (R2=0.022, P=0.066). Streptococcus and Rothia showed nominally higher relative abundances in AP, whereas Acinetobacter and Stenotrophomonas showed nominally lower relative abundances. Only Acinetobacter remained more abundant in CAP after FDR correction (FDR-adjusted P=0.032). Nominal correlations between bacterial taxa and clinical or immune variables were not significant after FDR correction. Gemella was detected in 9 AP patients, including 8 of 26 non-survivors and 1 of 23 survivors (P=0.026). In the unadjusted Firth model, Gemella detection was associated with mortality (OR=6.892, 95% CI 1.360-69.062; P=0.018), but the association was attenuated and non-significant after adjustment for APACHE II score (OR=4.708, 95% CI 0.859-48.395; P=0.076).
CONCLUSION: AP was associated with higher alpha diversity. Selected oral-associated taxonomic patterns and their immune-cell percentages correlations were exploratory and were not confirmed after multiple-testing correction. The association between Gemella detection and mortality was imprecise and sensitive to sparse data and model specification, requiring validation in larger prospective studies.