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真菌培养阳性和阴性脓毒症合并慢性阻塞性肺疾病患者的预后分析 被引量:2
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作者 文莎 邹志业 +3 位作者 何习斯 张帆 孟新科 冯永文 《中国急救医学》 CAS CSCD 2021年第10期867-873,共7页
比较脓毒症合并慢性阻塞性肺疾病(COPD)患者中真菌培养阳性与真菌培养阴性脓毒症的特征和预后。方法通过大数据分析的方法进行回顾性分析。选择重症监护医学信息数据库-Ⅲ(MIMIC-Ⅲ)数据库内的入院诊断脓毒症合并COPD、年龄>18岁的... 比较脓毒症合并慢性阻塞性肺疾病(COPD)患者中真菌培养阳性与真菌培养阴性脓毒症的特征和预后。方法通过大数据分析的方法进行回顾性分析。选择重症监护医学信息数据库-Ⅲ(MIMIC-Ⅲ)数据库内的入院诊断脓毒症合并COPD、年龄>18岁的患者作为研究对象。根据患者入住ICU后真菌培养(标本类型:呼吸道标本,如痰、支气管吸取物、肺泡灌洗液等)是否阳性分为真菌培养阳性组和真菌培养阴性组,分析两组患者的人口统计学(年龄、性别、种族、身高、体质量等)、合并症、入院24 h的生命体征、病情严重程度,采用Kaplan-Meier生存曲线比较真菌培养阳性和真菌培养阴性患者的生存率。用倾向性评分匹配组间差异。结果共1041例ICU脓毒症合并COPD患者纳入最终分析,真菌培养阳性组134例,真菌培养阴性组907例。真菌培养阳性组较真菌培养阴性组既往合并肾衰竭患者更少,入院第1天的心率更快[次/min:114(95,126)vs.108(93,123),P=0.03]、呼吸频率更高[次/min:29(26,35)vs.28(24,33),P=0.02],序贯器官衰竭评分(sequential organ failure assessment,SOFA)更高[分:8(5,10)vs.5(3,8),P<0.001],真菌培养阳性组较真菌培养阴性组机械通气时间更长[h:171.2(60.2,323.5)vs.105.0(25.6,256.8),P<0.001],住院日更长[d:12.4(7.6,23.7)vs.10.6(5.9,19.1),P=0.016],ICU住院时间更长[d:8.4(3.9,16.2)vs.3.4(1.8,9.3),P<0.001],病死率更高[28 d:38.1%vs.26.6%,P=0.006,60 d:39.6%vs.27.0%,P=0.003,90 d:40.3%vs.27.0%,P=0.002]。经倾向性匹配后,共102对匹配成功,真菌培养阳性组较真菌培养阴性组住院期间机械通气时间更长[h:173.5(57.0,305.3)vs.105.0(19.7,252.0),P=0.01],ICU住院天数更长[d:8.4(3.8,16.2)vs.3.7(1.9,10.4),P<0.001],病死率更高[28 d:38.2%vs.24.5%,P=0.035,60 d:39.2%vs.25.5%,P=0.036,90 d:39.2%vs.25.5%,P=0.036]。Kaplan-Meier生存曲线分析显示,脓毒症合并COPD患者真菌培养阴性组患者60 d累积生存率明显高于真菌培养阳性组(Log-rank检验:χ2=4.88,P=0.03)。结论真菌培养阳性的脓毒症合并COPD患者与预后不良相关,病情更严重,住院时间更长,病死率更高。 展开更多
关键词 脓毒症(sepsis) 慢性阻塞性肺疾病(COPD) 真菌培养(fungal culture) 重症监护医学信息数据库-Ⅲ(MIMIC-Ⅲ) 预后
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Fungal diversity in major oil-shale mines in China 被引量:4
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作者 Shaoyan Jiang Wenxing Wang +2 位作者 Xiangxin Xue Chengyou Cao Ying Zhang 《Journal of Environmental Sciences》 SCIE EI CAS CSCD 2016年第3期81-89,共9页
As an insufficiently utilized energy resource,oil shale is conducive to the formation of characteristic microbial communities due to its special geological origins.However,little is known about fungal diversity in oil... As an insufficiently utilized energy resource,oil shale is conducive to the formation of characteristic microbial communities due to its special geological origins.However,little is known about fungal diversity in oil shale.Polymerase chain reaction cloning was used to construct the fungal ribosomal deoxyribonucleic acid internal transcribed spacer(r DNA ITS)clone libraries of Huadian Mine in Jilin Province,Maoming Mine in Guangdong Province,and Fushun Mine in Liaoning Province.Pure culture and molecular identification were applied for the isolation of cultivable fungi in fresh oil shale of each mine.Results of clone libraries indicated that each mine had over 50% Ascomycota(58.4%–98.9%)and 1.1%–13.5%unidentified fungi.Fushun Mine and Huadian Mine had 5.9% and 28.1% Basidiomycota,respectively.Huadian Mine showed the highest fungal diversity,followed by Fushun Mine and Maoming Mine.Jaccard indexes showed that the similarities between any two of three fungal communities at the genus level were very low,indicating that fungi in each mine developed independently during the long geological adaptation and formed a community composition fitting the environment.In the fresh oil-shale samples of the three mines,cultivable fungal phyla were consistent with the results of clone libraries.Fifteen genera and several unidentified fungi were identified as Ascomycota and Basidiomycota using pure culture.Penicillium was the only genus found in all three mines.These findings contributed to gaining a clear understanding of current fungal resources in major oil-shale mines in China and provided useful information for relevant studies on isolation of indigenous fungi carrying functional genes from oil shale. 展开更多
关键词 Oil shale fungal diversity Clone library rDNA ITS Pure culture
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