中国热带和北方地区稳定期支气管扩张症患者下呼吸道背景微生物分析

Background microorganisms in lower respiratory tract of patients with stable bronchiectasis in tropical region and northern China

目的研究不同地域支气管扩张症(简称支扩)患者下呼吸道背景微生物差异。方法收集2021年9月-2022年9月解放军总医院海南医院及解放军总医院第八医学中心收治的稳定期支扩患者75例的肺泡灌洗液进行宏基因组测序,并对结果进行对比分析。结果南、北支扩患者下呼吸道丰度最高的菌属是普氏菌属、奈瑟菌属和罗斯氏菌属,菌种是产黑色普雷沃菌、中间普雷沃菌和龋齿罗氏菌;不同地域支扩患者下呼吸道背景微生物存在差异,北方组丰度最高的菌属是普氏菌属、奈瑟菌属和罗斯氏菌属,菌种是产黑色普雷沃菌、黏滑罗氏菌和龋齿罗氏菌;南方组丰度最高的菌属是普氏菌属、奈瑟菌属和罗斯氏菌属,菌种是中间普雷沃菌、产黑色普雷沃菌和龋齿罗氏菌;以铜绿假单胞菌和流感嗜血杆菌为致病菌的背景菌群其α多样性无统计学差异。结论我国南北方稳定期支扩患者下呼吸道背景微生物存在差异,北方组产黑色普雷沃菌、黏滑罗氏菌、龋齿罗氏菌多见,南方组中间普雷沃菌、产黑色普雷沃菌、龋齿罗氏菌多见,该研究对支扩的治疗提供新思路。

OBJECTIVE To study the difference in the background microorganisms in lower respiratory tract of patients with bronchiectasis.METHODS A total of 75 patients with stable bronchiectasis who were treated in the Eighth Medical Center of Chinese PLA General Hospital from Sep 2021 to Sep 2022 were enrolled in the study,metagenomic sequencing was performed,and the result of sequencing was observed and compared.RESULTS Prevotella,Neisseria and Rothella were the most abundant genera in lower respiratory tract among the bronchiectasis patients in southern and northern China,Prevotella nigra,Prevotella intermedia and Rothella caries were the predominant species.There were significant differences in the background microorganisms in lower respiratory tract among the bronchiectasis patients in the different regions.Prevotella,Neisseria and Rothella were the most abundant genera among the northern group,and Prevotella nigriformis,Rosella sliviformis and R.caries were the predominant species.Prevotella,Neisseria and Rothella were the most abundant genera among the southern group,and P.intermedia,Prevotella melanogenes and R.caries were the predominant species.There was no significant difference in theαdiversity of Pseudomonas aeruginosa and Haemophilus influenzae as the background flora of pathogens.CONCLUSION There is significant difference in the background microorganisms in lower respiratory tract of the stable bronchiectasis patients between southern and northern China.P.nigriformis,R.sliviformis and R.caries are common in northern China;P.intermedia,P.melanogenes and R.caries are common in southern China.The study offers new ideas for treatment of the patients with bronchiectasis.