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Respiratory microbiome profiles differ by recent hospitalization and nursing home residence in patients on mechanical ventilation
HCAP

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Authors
Baek, Min-gyung; Woo, Seong Ji; Kim, Nam Eun; Baek, Chaeyun; Won, Sungho; Kim, Youngmi; Lee, Jae Jun; Yi, Hana; Hong, Ji Young
Issue Date
2020-12-07
Publisher
BMC
Citation
Journal of Translational Medicine. 2020 Dec 07;18(1):464
Keywords
HCAPMicrobiomePneumoniaMechanical ventilation
Abstract
Background
Healthcare-associated pneumonia (HCAP) is a heterogeneous disease. We redefined nursing-home- and hospital-associated infections (NHAI) group by revising existing HCAP risk factors. The NHAI group comprised nursing home residents with a poor functional status, or recent (past 90 days) hospitalization or recent (past 180 days) antibiotic therapy. Our aim was to determine whether respiratory microbiota profiles are related to newly defined NHAI group in critically ill patients on mechanical ventilation.

Methods
The 180 endotracheal aspirates (ETAs) from 60 mechanically ventilated ICU patients (NHAI group, n = 24; non-NHAI group, n = 36) were prospectively collected on days 1, 3 and 7 in a university hospital. The bacterial community profiles of the ETAs were explored by 16S rRNA gene sequencing. A phylogenetic-tree-based microbiome association test (TMAT), generalized linear mixed models (GLMMs), the Wilcoxon test and the reference frame method were used to analyze the association between microbiome abundance and disease phenotype.

Results
The relative abundance of the genus Corynebacterium was significantly higher in the pneumonia than in the non-pneumonia group. The microbiome analysis revealed significantly lower α-diversity in the NHAI group than in the non-NHAI group. In the analysis of β-diversity, the structure of the microbiome also differed significantly between the two groups (weighted UniFrac distance, Adonis, p < 0.001). The abundance of Corynebacterium was significantly higher, and the relative abundances of Granulicatella, Staphylococcus, Streptococcus and Veillonella were significantly lower, in the NHAI group than in the non-NHAI group.

Conclusions
The microbiota signature of the ETAs distinguished between patients with and without risk factors for NHAI. The lung microbiome may serve as a therapeutic target for NHAI group.
ISSN
1479-5876
Language
English
URI
https://hdl.handle.net/10371/173441
DOI
https://doi.org/10.1186/s12967-020-02642-z
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Graduate School of Public Health (보건대학원)Dept. of Public Health (보건학과)Journal Papers (저널논문_보건학과)
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