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随着时间的推移,对被直管的儿童的呼吸道微生物群进行映射
Keiko M Tarquinio1, Jennifer Farrell2,3, John J Varga2
1Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Microbiology spectrum
|October 20, 2025
概括
重症儿童经常因呼吸道中的机会性病原体而接受不必要的抗生素. 纵向气道微生物组分析显示患者之间的显著差异,影响治疗策略和抗菌药物管理.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 微生物学和传染病.
- 基因组学和生物信息学
背景情况:
- 需要输管治疗的重症儿童经常接受经验性抗生素.
- 这种做法有助于过度使用抗生素,并挑战了抗菌药物管理.
- 机会性病原体通常存在于呼吸道,使治疗决策复杂化.
研究的目的:
- 调查以前的肺部疾病是否会增加儿童呼吸道中的机会性病原体.
- 为了对被直管儿童的气管吸附体 (TA) 微生物组进行前性分析.
- 为了比较以前患有和没有肺部疾病的儿童之间的微生物组合.
主要方法:
- 从13名儿科重症监护病房患者中收集的纵向气管吸血液 (TA) 样本.
- 使用16S rDNA测序和常规培养的分析.
- 与电子病历中的患者人口统计和临床数据的相关性.
主要成果:
- 确定了98个细菌属,其中Pseudomonas和Streptococcus占主导地位.
- 观察到TA微生物组结构的显著患者间变异.
- 患者身份,而不是临床类别或输管以来的时间,是微生物组变化的关键决定因素.
结论:
- 呼吸道微生物群的实质性患者间变异性限制了临床因素的影响.
- 对于某些细菌 (例如Streptococcus) 的培养和测序之间发现了差异.
- 未来的大规模研究应考虑抗生素暴露和宿主因素,以有针对性的小儿呼吸道感染管理.
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