重症腹腔感染合并ARDS患者肺部微生态对预后的影响
Effect of Lung Microbiota on Prognosis in Patients with Severe Intra-Abdominal Infection Complicated with ARDS
DOI: 10.12677/acm.2025.1541139, PDF,   
作者: 杨奋明：青岛大学青岛医学部，山东 青岛；曲 彦, 谢伟峰*：青岛市市立医院重症医学科，山东 青岛
关键词: 腹腔感染；急性呼吸窘迫综合征；肺部微生态；Intra-Abdominal Infection； Acute Respiratory Distress Syndrome； Lung Microbiome
摘要: 目的：探讨青岛地区人群重症腹腔感染合并急性呼吸窘迫综合征(ARDS)患者肺部微生态对预后的影响。方法：收集符合纳入标准的2021年6月至2022年5月青岛市立医院东院区重症监护室重症腹腔感染合并急性呼吸窘迫综合征患者肺泡灌洗液，采用2bRAD-M微生物多样性分析技术对样本进行基因检测，与2bRAD数据库对比，分析肺部微生态对预后的影响。结果：依照纳入和排除标准，共11例腹腔脓毒症患者纳入分析。根据患者预后情况分为3组：A组(存活组4例)，B组(放弃治疗组3例)，C组(死亡组4例)。结论：通过比较重症腹腔感染合并ARDS患者A组与C组发现，两组患者肺部微生态存在差异，并且存活组相较于死亡组肺部微生态结构较复杂。
Abstract: Objective: To investigate the effect of lung microbiota on the prognosis of patients with severe abdominal infection complicated with acute respiratory distress syndrome (ARDS) in Qingdao. Methods: Alveolar lavage fluid from patients with severe abdominal infection complicated with acute respiratory distress syndrome in the intensive care unit of Qingdao Municipal Hospital East Campus from June 2021 to May 2022 who met the inclusion criteria were collected, and the samples were genetically tested using 2bRAD-M microbial diversity analysis technology, and compared with the 2bRAD database, the impact of lung microbiota on prognosis was analyzed. Results: According to the inclusion and exclusion criteria, a total of 11 patients with intra-abdominal sepsis were included in the analysis. According to the prognosis of the patients, they were divided into three groups: group A (4 cases in the survival group), group B (3 cases in the abandonment group), and group C (4 cases in the death group). Conclusion: By comparing group A and group C of patients with severe abdominal infection complicated with ARDS, it was found that there were differences in the lung microbiota between the two groups, and the lung microbiota structure of the survival group was more complex than that of the death group.
文章引用：杨奋明, 曲彦, 谢伟峰. 重症腹腔感染合并ARDS患者肺部微生态对预后的影响[J]. 临床医学进展, 2025, 15(4): 1926-1935. https://doi.org/10.12677/acm.2025.1541139

参考文献

[1] Banavasi, H., Nguyen, P., Osman, H. and Soubani, A.O. (2021) Management of ARDS—What Works and What Does Not. The American Journal of the Medical Sciences, 362, 13-23. [Google Scholar] [CrossRef] [PubMed]
[2] Matthay, M.A., Arabi, Y., Arroliga, A.C., Bernard, G., Bersten, A.D., Brochard, L.J., et al. (2024) A New Global Definition of Acute Respiratory Distress Syndrome. American Journal of Respiratory and Critical Care Medicine, 209, 37-47. [Google Scholar] [CrossRef] [PubMed]
[3] Xu, H., Sheng, S., Luo, W., Xu, X. and Zhang, Z. (2023) Acute Respiratory Distress Syndrome Heterogeneity and the Septic ARDS Subgroup. Frontiers in Immunology, 14, Article 1277161. [Google Scholar] [CrossRef] [PubMed]
[4] Li, X., Jamal, M., Guo, P., Jin, Z., Zheng, F., Song, X., et al. (2019) Irisin Alleviates Pulmonary Epithelial Barrier Dysfunction in Sepsis-Induced Acute Lung Injury via Activation of AMPK/SIRT1 Pathways. Biomedicine & Pharmacotherapy, 118, Article 109363. [Google Scholar] [CrossRef] [PubMed]
[5] Dickson, R.P., Erb-Downward, J.R. and Huffnagle, G.B. (2015) Homeostasis and Its Disruption in the Lung Microbiome. American Journal of Physiology-Lung Cellular and Molecular Physiology, 309, L1047-L1055. [Google Scholar] [CrossRef] [PubMed]
[6] Dickson, R.P., Singer, B.H., Newstead, M.W., Falkowski, N.R., Erb-Downward, J.R., Standiford, T.J., et al. (2016) Enrichment of the Lung Microbiome with Gut Bacteria in Sepsis and the Acute Respiratory Distress Syndrome. Nature Microbiology, 1, Article No. 16113. [Google Scholar] [CrossRef] [PubMed]
[7] Lodise, T.P., McKinnon, P.S., Swiderski, L. and Rybak, M.J. (2003) Outcomes Analysis of Delayed Antibiotic Treatment for Hospital-Acquired Staphylococcus Aureus Bacteremia. Clinical Infectious Diseases, 36, 1418-1423. [Google Scholar] [CrossRef] [PubMed]
[8] Singer, M., Deutschman, C.S., Seymour, C.W., Shankar-Hari, M., Annane, D., Bauer, M., et al. (2016) The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 315, 801-810. [Google Scholar] [CrossRef] [PubMed]
[9] Li, C.X., Liu, H.Y., Lin, Y.X., Pan, J.B. and Su, J. (2020) The Gut Microbiota and Respiratory Diseases: New Evidence. Journal of Immunology Research, 2020, Article ID: 2340670. [Google Scholar] [CrossRef] [PubMed]
[10] Ren, Z., Zheng, Z. and Feng, X. (2024) Role of Gut Microbes in Acute Lung Injury/acute Respiratory Distress Syndrome. Gut Microbes, 16, Article 2440125. [Google Scholar] [CrossRef] [PubMed]
[11] Kelly, B.J., Imai, I., Bittinger, K., Laughlin, A., Fuchs, B.D., Bushman, F.D., et al. (2016) Composition and Dynamics of the Respiratory Tract Microbiome in Intubated Patients. Microbiome, 4, Article No. 7. [Google Scholar] [CrossRef] [PubMed]
[12] Zakharkina, T., Martin-Loeches, I., Matamoros, S., Povoa, P., Torres, A., Kastelijn, J.B., et al. (2017) The Dynamics of the Pulmonary Microbiome during Mechanical Ventilation in the Intensive Care Unit and the Association with Occurrence of Pneumonia. Thorax, 72, 803-810. [Google Scholar] [CrossRef] [PubMed]
[13] Dickson, R.P., Schultz, M.J., van der Poll, T., Schouten, L.R., Falkowski, N.R., Luth, J.E., et al. (2020) Lung Microbiota Predict Clinical Outcomes in Critically Ill Patients. American Journal of Respiratory and Critical Care Medicine, 201, 555-563. [Google Scholar] [CrossRef] [PubMed]
[14] Budden, K.F., Shukla, S.D., Rehman, S.F., Bowerman, K.L., Keely, S., Hugenholtz, P., et al. (2019) Functional Effects of the Microbiota in Chronic Respiratory Disease. The Lancet Respiratory Medicine, 7, 907-920. [Google Scholar] [CrossRef] [PubMed]
[15] Kullberg, R.F.J., de Brabander, J., Boers, L.S., Biemond, J.J., Nossent, E.J., Heunks, L.M.A., et al. (2022) Lung Microbiota of Critically Ill Patients with COVID-19 Are Associated with Nonresolving Acute Respiratory Distress Syndrome. American Journal of Respiratory and Critical Care Medicine, 206, 846-856. [Google Scholar] [CrossRef] [PubMed]
[16] Mac Aogáin, M., Chandrasekaran, R., Lim, A.Y.H., Low, T.B., Tan, G.L., Hassan, T., et al. (2018) Immunological Corollary of the Pulmonary Mycobiome in Bronchiectasis: The CAMEB Study. European Respiratory Journal, 52, Article 1800766. [Google Scholar] [CrossRef] [PubMed]
[17] Larsen, J.M., Musavian, H.S., Butt, T.M., Ingvorsen, C., Thysen, A.H. and Brix, S. (2015) Chronic Obstructive Pulmonary Disease and Asthma‐Associated Proteobacteria, but Not Commensal Prevotella spp., Promote Toll‐Like Receptor 2‐Independent Lung Inflammation and Pathology. Immunology, 144, 333-342. [Google Scholar] [CrossRef] [PubMed]
[18] Brown, R.L., Sequeira, R.P. and Clarke, T.B. (2017) The Microbiota Protects against Respiratory Infection via GM-CSF Signaling. Nature Communications, 8, Article No. 1512. [Google Scholar] [CrossRef] [PubMed]
[19] Robak, O.H., Heimesaat, M.M., Kruglov, A.A., Prepens, S., Ninnemann, J., Gutbier, B., et al. (2018) Antibiotic Treatment-Induced Secondary IgA Deficiency Enhances Susceptibility to Pseudomonas aeruginosa Pneumonia. Journal of Clinical Investigation, 128, 3535-3545. [Google Scholar] [CrossRef] [PubMed]
[20] Segal, L.N., Clemente, J.C., Tsay, J.J., Koralov, S.B., Keller, B.C., Wu, B.G., et al. (2016) Enrichment of the Lung Microbiome with Oral Taxa Is Associated with Lung Inflammation of a Th17 Phenotype. Nature Microbiology, 1, Article No. 16031. [Google Scholar] [CrossRef] [PubMed]
[21] Schiavi, E., Plattner, S., Rodriguez-Perez, N., Barcik, W., Frei, R., Ferstl, R., et al. (2018) Exopolysaccharide from Bifidobacterium Longum Subsp. Longum 35624™ Modulates Murine Allergic Airway Responses. Beneficial Microbes, 9, 761-774. [Google Scholar] [CrossRef] [PubMed]
[22] Bok, J.W., Chung, D., Balajee, S.A., Marr, K.A., Andes, D., Nielsen, K.F., et al. (2006) Gliz, a Transcriptional Regulator of Gliotoxin Biosynthesis, Contributes to Aspergillus fumigatus Virulence. Infection and Immunity, 74, 6761-6768. [Google Scholar] [CrossRef] [PubMed]
[23] Yu, W., Pan, Z., Zhu, Y., An, F. and Lu, Y. (2017) Fumigaclavine C Exhibits Anti-Inflammatory Effects by Suppressing High Mobility Group Box Protein 1 Relocation and Release. European Journal of Pharmacology, 812, 234-242. [Google Scholar] [CrossRef] [PubMed]

为你推荐