在患有严重肺炎的患者中,Pneumocystis jirovecii与肺病毒相关
Yuanxiu Huang1, Xin Wei2, Xiaohan Huang3
1Department of Critical Care Medicine of First Affiliated Hospital, Zhejiang University, Hangzhou, China.
在免疫功能低下的患者中,Pneumocystis jirovecii会改变肺微生物组,特别是病毒多样性. 这种真菌可能代表一种影响肺炎结果和死亡率的中间状态.
科学领域:
- 医学微生物学 医学微生物学
- 肺部医学 肺部医学
- 传染性疾病 传染性疾病
背景情况:
- 肺囊 (P. jirovecii) 是免疫功能低下个体的一个重要病原体.
- 在复杂的肺微生物组中P. jirovecii的确切作用尚未完全理解.
- 调查P. jirovecii对病毒和真菌群落的影响对于了解肺炎病原体至关重要.
研究的目的:
- 为了阐明P. jirovecii对肺微生物组合的影响.
- 确定P. jirovecii状态与病毒多样性之间的关联.
- 评估P. jirovecii和患者死亡率之间的关系,特别是在细胞巨乳病毒阳性个体中.
主要方法:
- 从两个回顾性队列 (1,737名肺炎患者,72名ICU患者) 的支气管膜洗液的元基因组测序.
- 使用qPCR和临床数据将患者分为P. jirovecii感染,殖民或负组.
- 统计分析以调整免疫抑制和疾病严重程度等混因素.
主要成果:
- P. jirovecii的状态与肺病毒和真菌群体的显著变化有关,但与细菌群体无关.
- 与负对照相比,患有P. jirovecii的患者表现出较低的病毒多样性.
- 在细胞巨乳病毒阳性患者中,P. jirovecii的阳性与28天死亡率的增加相关.
结论:
- 在肺微生物生态系统中,P. jirovecii的殖民代表着一个独特的中间状态.
- P. jirovecii显著影响肺病毒组,独立于免疫抑制和疾病严重程度.
- P. jirovecii 状态是某些患者群体死亡率的潜在预后标志物,突出其临床相关性.
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