South Pest Central Hospital, National Institute of Hematology and Infectious Diseases, Budapest, Hungary.
Departmental Group of Infectious Diseases, Department of Haematology and Internal Medicine, Semmelweis University, Budapest, Hungary.
Front Cell Infect Microbiol. 2022 Dec 13;12:1067476. doi: 10.3389/fcimb.2022.1067476. eCollection 2022.
Characteristics of the blood microbiota among adult patients with community-acquired sepsis are poorly understood. Our aim was to analyze the composition of blood microbiota in adult patients with community-acquired sepsis, and correlate changes with non-septic control patients.
A prospective observational study was carried out by including adult patients hospitalized for community-acquired sepsis at our center between January and November 2019, by random selection from a pool of eligible patients. Study inclusion was done on the day of sepsis diagnosis. Community acquisition was ascertained by exclusion criteria; sepsis was defined according to the SEPSIS-3 definitions. Each included patient was matched with non-septic control patients by age and gender in a 1:1 fashion enrolled from the general population. Conventional culturing with BacT/ALERT system and 16S rRNA microbiota analysis were performed from blood samples taken in a same time from a patient. Abundance data was analyzed by the Microbiome software.
Altogether, 13 hospitalized patients were included, 6/13 (46.2%) with sepsis and 7/13 (53.8%) with septic shock at diagnosis. The most prevalent etiopathogen isolated from blood cultures was , patients mostly had intraabdominal septic source. At day 28, mortality was 15.4% (2/13). Compared to non-septic control patients, a relative scarcity of , and genera, with an abundance of , and genera was observed among septic patients. Relative differences between septic vs. non-septic patients were more obvious at the phylum level, mainly driven by (25.7% vs. 63.1%; p<0.01) and (36.9% vs. 16.6%; p<0.01). The alpha diversity, quantified by the index showed statistically significant difference between septic vs. non-septic patients (126 ± 51 vs. 66 ± 26; p<0.01). The Bray-Curtis beta diversity, reported by principal coordinate analysis of total hit frequencies, revealed 2 potentially separate clusters among septic vs. non-septic patients.
In adult patients with community-acquired sepsis, specific changes in the composition and abundance of blood microbiota could be detected by 16S rRNA metagenome sequencing, compared to non-septic control patients. Traditional blood culture results only partially correlate with microbiota test results.
成人社区获得性脓毒症患者血液微生物群的特征尚不清楚。我们的目的是分析成人社区获得性脓毒症患者血液微生物群的组成，并与非脓毒症对照患者进行相关性分析。
通过随机选择符合条件的患者，对 2019 年 1 月至 11 月在我院住院的成人社区获得性脓毒症患者进行前瞻性观察性研究。研究纳入是在脓毒症诊断当天进行的。通过排除标准确定社区获得性感染；根据 SEPSIS-3 定义确定脓毒症。从每位患者同一时间采集的血液样本中，通过常规培养（BacT/ALERT 系统）和 16S rRNA 微生物群分析，对每个纳入患者进行匹配，按年龄和性别以 1:1 的比例匹配来自普通人群的非脓毒症对照患者。丰度数据由 Microbiome 软件进行分析。
共纳入 13 例住院患者，其中 6/13（46.2%）为脓毒症，7/13（53.8%）为脓毒性休克。从血培养中分离出最常见的病原体是 ，患者多有腹腔内感染源。在第 28 天，死亡率为 15.4%（2/13）。与非脓毒症对照患者相比，脓毒症患者中 、 、 属相对较少，而 、 、 属相对较多。与脓毒症患者相比，在门水平上观察到的属之间的相对差异更为明显，主要由 （25.7%比 63.1%；p<0.01）和 （36.9%比 16.6%；p<0.01）驱动。通过 指数量化的 alpha 多样性，在脓毒症与非脓毒症患者之间存在统计学显著差异（126±51比 66±26；p<0.01）。通过主坐标分析总命中频率报告的 Bray-Curtis beta 多样性，显示脓毒症与非脓毒症患者之间存在 2 个潜在的分离簇。
与非脓毒症对照患者相比，通过 16S rRNA 宏基因组测序可以检测到成人社区获得性脓毒症患者血液微生物群的组成和丰度的特定变化。传统的血液培养结果仅部分与微生物组测试结果相关。
