在患有恶性瘤的患者中,免疫功能低下的主体肺炎的临床特征,病原体和预后
Xiang-Zhi Fang1, Zi-Han Liu1, Li-Min Duan1
1Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
肺炎的癌症患者具有独特的病原体简介,通过元基因组测序来识别. 病原体的高联合检测率与这些免疫受损个体的死亡风险增加有关.
科学领域:
- 肺部医学 肺部医学
- 传染性疾病 传染性疾病
- 在瘤学瘤学.
- 微生物学 微生物学
背景情况:
- 由于免疫抑制和癌症治疗,癌症患者容易发生严重的肺部感染.
- 关于癌症患者这些感染的具体原因和预后因素的数据有限.
研究的目的:
- 通过临床转基因组学研究癌症患者肺部感染的微生物特征.
- 识别病原体并评估它们与免疫性减弱宿主肺炎 (ICHP) 的临床结果的关联.
主要方法:
- 针对115名患有ICHP的癌症患者进行了前性队列研究.
- 支气管洗液 (BALF) 在标准微生物学测试 (SMT) 与标准微生物学测试 (mNGS) 一起进行临床元基因组下一代测序.
- 用CT成像和临床数据进行全面评估.
主要成果:
- 在80%的患者中检测到病原体,并确定了158种潜在的病原体.
- 最常见的是Pneumocystis jirovecii,SARS-CoV-2,Aspergillus fumigatus,Klebsiella pneumoniae和Haemophilus influenzae,它们是最常见的.
- 共感染发生在36.5%的患者中,与较高的血管压缩剂使用有关;侵入性机械呼吸,血管压缩剂使用和较高的APACHE II分数预测了28天死亡率的增加.
结论:
- 对BALF的基因组测序揭示了肺部感染的癌症患者的独特微生物特征.
- 观察到高率的病原体共同检测,并与28天所有原因死亡率的增加有关.
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