摘要
目的通过宏基因组二代测序(mNGS)分析单纯肺炎和慢性阻塞性肺疾病(简称慢阻肺)合并下呼吸道感染支气管肺泡灌洗液(BALF)中微生物菌群差异。方法纳入新疆医科大学第一附属医院2021年12月—2023年3月间住院的肺炎患者,根据是否合并慢阻肺分为单纯肺炎组和慢阻肺合并下呼吸道感染组,应用mNGS技术检测BALF微生物,分析两组的菌群分布特征。结果共纳入97例患者,其中80例患者(81.82%)微生物检测结果为阳性。慢阻肺合并下呼吸道感染组的吸烟指数显著高于单纯肺炎组(t=-3.62,P=0.001)。两组菌群分布存在差异,在属水平检测上,在单纯肺炎组检出19种微生物,其中细菌8种(42.11%)、真菌2种(10.53%)、病毒3种(15.79%)、其他类型微生物6种(31.58%);而慢阻肺合并下呼吸道感染组检测出22种微生物,细菌10种(47.62%)、真菌3种(14.29%)、病毒4种(19.05%)、其他类型微生物4种(19.05%)。两组RPM值也存在差异,细菌RPM值在非重症肺炎时,慢阻肺合并下呼吸道感染组细菌RPM值在属水平显著高于与单纯肺炎组(Z=-2.706,P=0.007)。单纯肺炎患者为重症感染时,RPM值在属和种水平均显著高于与非重症感染(Z=-2.202,P=0.028;Z=-2.141,P=0.032)。慢阻肺合并重症肺炎时,细菌RPM值只有在种水平显著高于非重症肺炎(Z=-2.367,P=0.017)。结论慢阻肺合并下呼吸道感染患者和单纯肺炎患者BALF菌群在属和种分布特征不同,细菌为最主要的微生物类型,但两组优势细菌类型不同。单纯肺炎以细菌、病毒和其他类型微生感染为主,而慢阻肺合并下呼吸道感染以真菌和细菌感染为主。RPM值可能成为提示肺炎严重程度的指标之一。
Objective To analyze the differences in microbial communities in bronchoalveolar lavage fluid(BALF)from patients with simple pneumonia versus those with chronic obstructive pulmonary disease(COPD)combined with lower respiratory tract infection using metagenomic next-generation sequencing(mNGS).Methods Patients hospitalized for pulmonary infections at the First Affiliated Hospital of Xinjiang Medical University between December 2021 and March 2023 were included.Based on the presence of COPD,the patients were divided into two groups:those with simple pneumonia and those with COPD combined with lower respiratory tract infection.mNGS was employed to detect microbes in BALF,and the microbial community distribution characteristics of the two groups were analyzed.Results A total of 97 patients were included,of whom 80(81.82%)had positive microbial detection results.The smoking index in COPD group with lower respiratory tract infection was significantly higher than that in the group with simple pneumonia(t=−3.62,P=0.001).Differences in microbial community distributions were observed between the groups.At the genus level,19 species of microorganisms were detected in the simple pneumoniapulmonary infection group,including 8 bacteria(42.11%),2 fungi(10.53%),3 viruses(15.79%),and 6 other types of microorganisms(31.58%).In contrast,22 types of microbes were detected in COPD group with lower respiratory tract infection,including 10 bacteria(47.62%),3 fungi(14.29%),4 viruses(19.05%),and 4 other types of microorganisms(19.05%).Differences were also noted in reads per million(RPM)values;bacterial RPM values at the genus level were significantly higher in the COPD group during non-severe pneumonia compared to the simple pneumonia group(Z=-2.706,P=0.007).In the patients with severe pneumonia,RPM values at the genus and species levels were significantly higher than those in nonsevere pneumonia(Z=−2.202,P=0.028;Z=−2.141,P=0.032).In COPD combined with severe pneumonia,bacterial RPM values were significantly higher at the species level compared to non-severe pneumonia(Z=−2.367,P=0.017).Conclusions There are differences in the distribution of microbial communities at the genus and species levels in BALF from patients with COPD combined with lower respiratory tract infection compared to those with simple pulmonary pneumonia.Bacteria are the predominant microbial type in both groups,but the dominant bacterial species differ between them.Simple pneumonia are primarily associated with bacterial,viral,and other types of microbial infections,while COPD combined with lower respiratory tract infection is predominantly associated with fungal and bacterial infections.RPM values may serve as an indicator of the severity of pneumonia.
作者
夏宇
考吾沙尔·巴合提江
XIA Yu;KAWSAR BAHETJAN(Second Ward,Respiratory and Respiratory Critical Care Center,First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,P.R.China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
2024年第6期414-422,共9页
Chinese Journal of Respiratory and Critical Care Medicine
基金
省部共建中亚高发病成因与防治国家重点实验室开放课题(KL-HIDCA-2021-JH4)
关键词
慢性阻塞性肺疾病
宏基因组二代测序
菌群分布
每百万有效测序序列数
Chronic obstructive pulmonary disease
metagenomic next-generation sequencing
microbial community distribution
reads per million
