Department of Life Sciences, National Chung Hsing University, 145 Xingda Rd., South Dist., Taichung, 402, Taiwan.
Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 407, Taiwan.
Sci Rep. 2020 Jul 6;10(1):11046. doi: 10.1038/s41598-020-68100-4.
Little is known about the composition and clinical implications of lung microbiome in patients with chronic obstructive pulmonary disease (COPD) and community-acquired pneumonia requiring invasive mechanical ventilation and intensive care unit admission. Therefore, this study aimed to explore the longitudinal changes in microbial airway composition and its variations between COPD patients with different weaning outcomes. Fifty-one endotracheal aspirate samples from 21 participants and 5 saline samples were collected as the patient and control group, respectively. Sequence analysis revealed significant increases and upward trends in the relative abundance of the Acinetobacter genus and Acinetobacter baumannii complex species in paired comparisons of sampling points and over time, respectively, in patients with failed weaning (p for trend = 0.012 and 0.012, respectively) but not in those with successful weaning (p for trend = 0.335 and 0.426, respectively). Furthermore, significant changes in the composition of the bacterial community were observed in paired comparisons of sampling points in patients with failed weaning compared with those with successful weaning. The alpha diversity did not differ between the patients with different weaning outcomes. These results further the understanding of longitudinal airway microbiome structure analysis and its clinical implications when managing critically ill patients with and without COPD.
关于慢性阻塞性肺疾病（COPD）患者和需要有创机械通气和入住重症监护病房的社区获得性肺炎患者的肺部微生物组的组成和临床意义知之甚少。因此，本研究旨在探讨微生物气道组成的纵向变化及其在不同撤机结局 COPD 患者之间的差异。从 21 名参与者中采集了 51 份气管内抽吸样本和 5 份生理盐水样本，分别作为患者组和对照组。序列分析显示，在撤机失败患者的采样点配对比较和随时间的变化中，不动杆菌属和鲍曼不动杆菌复合体的相对丰度分别呈显著增加和上升趋势（趋势 p 值分别为 0.012 和 0.012），但在撤机成功患者中无此趋势（趋势 p 值分别为 0.335 和 0.426）。此外，在撤机失败患者的采样点配对比较中观察到细菌群落组成的显著变化，与撤机成功患者相比。不同撤机结局患者的 alpha 多样性无差异。这些结果进一步了解了管理有和无 COPD 的危重症患者时的纵向气道微生物组结构分析及其临床意义。
