The Potential of Gut Microbiota in Prediction of Stroke-Associated Pneumonia
Zhongyuan Li1, Mengmeng Gu1, Huanhuan Sun2
1Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68, Changle Road, Nanjing 210006, China.
Background:
Stroke-associated pneumonia (SAP) is a common stroke complication, and the changes in the gut microbiota composition may play a role. Our study aimed to evaluate the predictive ability of gut microbiota for SAP.
Methods:
Acute ischemic stroke patients were prospectively enrolled and divided into two groups based on the presence or absence of SAP. The composition of gut microbiota was characterized by the 16S RNA Miseq sequencing. The gut microbiota that differed significantly between groups were incorporated into the conventional risk scores, the Acute Ischemic Stroke-Associated Pneumonia Score (AIS-APS), and the Age, Atrial fibrillation, Dysphagia, Sex, Stroke Severity Score (A2DS2). The predictive performances were assessed in terms of the area under the curve (AUC), the Net Reclassification Improvement (NRI), and the Integrated Discrimination Improvement (IDI) indices.
Results:
A total of 135 patients were enrolled, of whom 43 had SAP (31%). The short-chain fatty acids (SCFAs)-producing bacteria, such as Bacteroides, Fusicatenibacter, and Butyricicoccus, were decreased in the SAP group. The integrated models showed better predictive ability for SAP (AUC = 0.813, NRI = 0.333, p = 0.052, IDI = 0.038, p = 0.018, for AIS-APS; AUC = 0.816, NRI = 0.575, p < 0.001, IDI = 0.043, p = 0.007, for A2DS2) in comparison to the differential genera (AUC = 0.699) and each predictive score (AUCAISAPS = 0.777; AUCA2DS2 = 0.777).
Conclusions:
The lower abundance of SCFAs-producing gut microbiota after acute ischemic stroke was associated with SAP and may play a role in SAP prediction.
Insights
Gut microbiota changes, specifically lower levels of short-chain fatty acids (SCFAs)-producing bacteria, can predict stroke-associated pneumonia (SAP). This finding offers new insights into SAP prediction after acute ischemic stroke.
Area of Science:
- Microbiome research
- Neurology
- Infectious disease
Background:
- Stroke-associated pneumonia (SAP) is a frequent complication following stroke.
- Gut microbiota alterations are implicated in the pathogenesis of SAP.
Purpose of the Study:
- To assess the predictive value of gut microbiota composition for SAP development.
- To integrate gut microbiota data with existing clinical scores for improved SAP prediction.
Main Methods:
- Prospective enrollment of acute ischemic stroke patients.
- 16S rRNA sequencing to characterize gut microbiota composition.
- Comparison of predictive models incorporating microbiota data versus conventional scores (AIS-APS, A2DS2).
Main Results:
- A decrease in SCFAs-producing bacteria (e.g., Bacteroides, Fusicatenibacter, Butyricicoccus) was observed in patients with SAP.
- Integrated models combining microbiota and clinical data demonstrated superior predictive performance (AUCs ranging from 0.813 to 0.816) compared to models using only differential genera or clinical scores.
Conclusions:
- Reduced abundance of SCFAs-producing gut bacteria post-stroke is linked to SAP.
- Gut microbiota analysis holds potential for enhancing SAP prediction accuracy.
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