肠道微生物组动态和关联与危急病患者的死亡率
Tarik J Salameh1, Katharine Roth2, Lisa Schultz1
1Division of Pulmonary and Critical Care Medicine, Milton S. Hershey Medical Center, Hershey, Penn State, PA, 17033, USA.
Gut pathogens
|December 20, 2023
概括
危急病患者肠道微生物组的变化与死亡率的增加有关. 一个新的微生物群死亡指数 (MMI) 识别了高风险患者,提供了潜在的治疗点.
科学领域:
- 微生物学 微生物学
- 临界护理医学 临界护理医学
- 基因组学就是基因组学.
背景情况:
- 重症监护室 (ICU) 停留导致肠道微生物组发生显著变化.
- 这些肠道微生物组变化的临床影响对患者的结果尚未完全理解.
- 这项研究调查了特定肠道微生物转移预测严重病患者的死亡率的假设.
研究的目的:
- 为了确定特定的肠道微生物组成,与严重病情的成年人28天死亡率增加有关.
- 根据肠道微生物群的个人资料,开发一种基于死亡风险的预测指数.
- 探索肠道失生症作为一个独立的风险因素,在ICU死亡率.
主要方法:
- 一项前性队列研究,涉及52名患重病的成年患者.
- 使用16S rRNA基因测序分析直肠拭子,以评估肠道微生物组合.
- 机器学习 (selbal) 用于识别与28天死亡率相关的微生物种群比率.
主要成果:
- 四种微生物的特定比率,称为微生物群死亡指数 (MMI),预测了28天的死亡率 (p=0.02).
- 患有高MMI的患者表现出明显更高的死亡率 (HR 2.2,95% CI 1.1-4.3),即使对ARDS和APACHE II评分进行调整 (HR 2.5,95% CI 1.4-4.7).
- 高死亡率与Anaerococcus和Enterobacteriaceae有关,而低死亡率与Parasutterella和Campylobacter有关.
结论:
- 肠道功能失调是重症患者28天死亡率的独立预测因素.
- 微生物群死亡指数 (MMI) 在风险分层方面表现有前途.
- 针对肠道失调症是未来ICU干预的潜在途径.
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