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在静脉静脉外体膜氧化中表征微生物组变化:多药耐药细菌病例报告
Zachary S Jarrett1,2, Hui Xia3, Erika R O'Neil4,2
1From the Pulmary and Critical Care Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas.
ASAIO journal (American Society for Artificial Internal Organs : 1992)
|June 17, 2025
概括
下一代元基因组学测序 (mNGS) 揭示了体外膜氧化 (ECMO) 患者显著的微生物组和抗菌素耐药性变化. 这些变化,包括增加的Pseudomonas aeruginosa,在败血症之前,突出了ECMO电路之外的潜在感染储库.
科学领域:
- 关键护理医学 关键护理医学
- 微生物学 微生物学
- 基因组学就是基因组学.
背景情况:
- 身体外膜氧化 (ECMO) 是严重呼吸衰竭的生命支持措施.
- 使用元基因组学下一代测序 (mNGS) 的微生物组分析在ECMO患者中很少被应用.
- 了解微生物组的动态对于治疗重症患者的感染至关重要.
研究的目的:
- 在接受静脉静脉 (VV) ECMO的患者中调查微生物组和抗菌素耐药性基因配置文件.
- 为了确定潜在的微生物储库和抵抗机制,在ECMO期间促进败血症的发展.
主要方法:
- 针对多创伤和急性呼吸困扰综合征的VV ECMO治疗单一患者进行了研究.
- 尸体部位样本是在ECMO管时收集的,然后每周一次.
- 进行了16S rRNA测序和mNGS,以表征微生物组和抗菌素耐药性基因.
主要成果:
- 在ECMO过程中观察到微生物组和抗菌素耐药性基因的显著变化.
- 由Pseudomonas aeruginosa (PsA) 增加的口腔殖民和抗性基因 (KPC,OXA-50) 的扩张之前发生了败血症休克.
- 多药耐药 (MDR) PsA和Enterobacter cloacae复合体 (ECC) 在死亡前的气管吸附物和血液培养物中被确定.
结论:
- 微生物组和抗菌素耐药性分析可以检测ECMO患者的先变化.
- 这些发现表明,ECMO电路之外的感染储库,例如口腔.
- 需要进一步研究应用这些方法,以指导ECMO患者的感染预防策略.
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