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气道"抵抗型"和支气管切除症的临床结果
Micheál Mac Aogáin1,2,3, Fransiskus Xaverius Ivan3, Tavleen Kaur Jaggi3
1Biochemical Genetics Laboratory, Department of Biochemistry, St. James's Hospital, Dublin, Ireland.
American journal of respiratory and critical care medicine
|January 25, 2024
概括
支气管切除症中的呼吸道微生物组包含一种独特的抗菌素耐药性基因配置. 这些"抗原型"与临床结果有关,并且可以通过向性抗生素治疗来改变.
科学领域:
- 微生物学 微生物学
- 基因组学就是基因组学.
- 肺部病理学 肺部病理学
背景情况:
- 慢性感染和炎症显著影响 bronchiectasis 患者的呼吸道微生物群.
- 呼吸道抵抗体,包括抗微生物耐药性基因,为微生物,耐药性和临床结果之间的相互作用提供了洞察力.
- 支气管炎症中多样化的抗微生物耐药性基因池的临床意义在很大程度上仍然不清楚.
研究的目的:
- 应用全基因组猎枪元基因组学来分析气道微生物组和支气管切除症的抗体组.
- 为了确定支气管炎症耐药性组内独特的抗菌素耐药性基因配置文件.
- 调查支气管阻断症与临床结果之间的关联,包括恶化和肺功能.
主要方法:
- 预计将280名支气管切除症患者招募到横截面和纵向队列中.
- 包括国际多中心的亚洲和匹配的欧洲支气管切开症队列2 (CAMEB 2) 研究.
- 唾液样本的元基因组测序,以评估与临床数据和宿主微生物组相关的支气管切除症耐药性.
主要成果:
- 支气管切除症耐药组表现出一种独特的特征,具有增加的氨基糖化物,自行车菌素,芬尼科尔, triclosan 和多药耐药基因.
- 耐药性概况显示患者内部的稳定性随着时间的推移和恶化期间,尽管患者之间的异质性.
- 确定了不同的抗体原型 (抗体型),其中一种 (RT2) 与不良的临床结果,增加的多药性耐药性和*Pseudomonas aeruginosa*殖民有关.
结论:
- 支气管切除症抗体与临床结果,地理来源和宿主微生物组有关.
- 已识别的支气管切除症抵抗型 (RT1和RT2) 与临床疾病严重程度相关.
- 向抗菌疗法可以修改抵抗型,可能改善临床结果,如在P. aeruginosa*根除后从RT2逆转为RT1所证明的那样.
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