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已发表论文
长期机械通气老年患者的呼吸道微生物组：一项前瞻性多中心观察性研究
Authors Wang Y, Wu J, Wang Y, Jiang W, Wang D, Zhao J, Qin X, Yuan Y, Zhang H, Wang J, Zhen J, Du Y, Mu X, Li L, Wang T, Zou L, Fang X, Sun B, Li H
Received 21 August 2025
Accepted for publication 13 December 2025
Published 27 December 2025 Volume 2025:20 Pages 2705—2716
DOI https://doi.org/10.2147/CIA.S553377
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Nandu Goswami
Yang Wang,1,* Jionghe Wu,1,2,* Yajuan Wang,1,* Wei Jiang,1 Dan Wang,1 Jing Zhao,1 Xuebing Qin,1 Yaping Yuan,1,2 Hongyun Zhang,1 Jing Wang,3 Jie Zhen,4 Yuguo Du,5 Xiangdong Mu,6 Li Li,6 Ting Wang,7 Lin Zou,1 Xiangqun Fang,1 Baojun Sun,1 Hongxia Li1
1Department of Pulmonary and Critical Care Medicine, the Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100000, People’s Republic of China; 2Chinese PLA Medical School, Beijing, 100000, People’s Republic of China; 3Emergency Department, Xuanwu Hospital, Capital Medical University, Beijing, 100000, People’s Republic of China; 4Intensive Care Unit, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100000, People’s Republic of China; 5Geriatrics Department, the Seventh Medical Center, Chinese PLA General Hospital, Beijing, 100000, People’s Republic of China; 6Department of Pulmonary and Critical Care Medicine, Beijing Tsinghua Changgung Hospital, Beijing, 100000, People’s Republic of China; 7Department of Pulmonary and Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Baojun Sun, Email 301sbj@sina.com Hongxia Li, Email lhxia301@126.com
Purpose: The purpose of this study was to explore dynamic changes of respiratory microbiome in elderly patients undergoing prolonged mechanical ventilation (PMV) by isothermal microfluidic amplification chip technology (IAMC).
Methods: The study enrolled patients in six general hospitals in Beijing. Patients who developed Ventilator-associated pneumonia (VAP) within the observation period were enrolled in the VAP group, while those without VAP were categorized in non-VAP group. The study adopted IAMC technology to dynamically monitor the differences in the detection rates of bacteria, fungi, and viruses in the two groups. The conventional microbiological tests (CMT) were performed to clarify the correlation between KPC and drug resistance phenotype of K. pneumoniae.
Results: Among 218 patients, 78 were diagnosed with VAP. The pulmonary microbiota composition of patients without VAP was relatively stable. Compared with the non-VAP group, the detection rates of Enterococcus faecalis, Epstein–Barr virus, and Herpes simplex virus were significantly increased in the VAP group, whereas those of Haemophilus influenzae and Serratia marcescens were significantly reduced. In the VAP group, the detection rates of Enterococcus faecalis and Epstein–Barr virus were higher after the occurrence of VAP than before. A high correlation was observed between the KPC genotype of K. pneumoniae and its resistance phenotype.
Conclusion: Viruses and Gut microbes might be closely related to the development of VAP in elderly undergoing PMV. The detection of the KPC gene of K. pneumoniae can guide antibiotic selection, and IAMC can aid in quickly identifying pathogens and facilitate targeted treatment.
Clinical Trial Registration Number: ChiCTR2100051343.
Keywords: respiratory microbiome, elderly patients, VAP, PMV
1Department of Pulmonary and Critical Care Medicine, the Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100000, People’s Republic of China; 2Chinese PLA Medical School, Beijing, 100000, People’s Republic of China; 3Emergency Department, Xuanwu Hospital, Capital Medical University, Beijing, 100000, People’s Republic of China; 4Intensive Care Unit, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100000, People’s Republic of China; 5Geriatrics Department, the Seventh Medical Center, Chinese PLA General Hospital, Beijing, 100000, People’s Republic of China; 6Department of Pulmonary and Critical Care Medicine, Beijing Tsinghua Changgung Hospital, Beijing, 100000, People’s Republic of China; 7Department of Pulmonary and Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Baojun Sun, Email 301sbj@sina.com Hongxia Li, Email lhxia301@126.com
Purpose: The purpose of this study was to explore dynamic changes of respiratory microbiome in elderly patients undergoing prolonged mechanical ventilation (PMV) by isothermal microfluidic amplification chip technology (IAMC).
Methods: The study enrolled patients in six general hospitals in Beijing. Patients who developed Ventilator-associated pneumonia (VAP) within the observation period were enrolled in the VAP group, while those without VAP were categorized in non-VAP group. The study adopted IAMC technology to dynamically monitor the differences in the detection rates of bacteria, fungi, and viruses in the two groups. The conventional microbiological tests (CMT) were performed to clarify the correlation between KPC and drug resistance phenotype of K. pneumoniae.
Results: Among 218 patients, 78 were diagnosed with VAP. The pulmonary microbiota composition of patients without VAP was relatively stable. Compared with the non-VAP group, the detection rates of Enterococcus faecalis, Epstein–Barr virus, and Herpes simplex virus were significantly increased in the VAP group, whereas those of Haemophilus influenzae and Serratia marcescens were significantly reduced. In the VAP group, the detection rates of Enterococcus faecalis and Epstein–Barr virus were higher after the occurrence of VAP than before. A high correlation was observed between the KPC genotype of K. pneumoniae and its resistance phenotype.
Conclusion: Viruses and Gut microbes might be closely related to the development of VAP in elderly undergoing PMV. The detection of the KPC gene of K. pneumoniae can guide antibiotic selection, and IAMC can aid in quickly identifying pathogens and facilitate targeted treatment.
Clinical Trial Registration Number: ChiCTR2100051343.
Keywords: respiratory microbiome, elderly patients, VAP, PMV