[Characteristics and Influencing Factors of Pathogenic Bacteria in Lung Cancer Chemotherapy Combined with Nosocomial Pulmonary Infection]

Establishment and Validation of Models for the Risk of Multi-Drug Resistant Bacteria Infection and Prognosis in Elderly Patients with Pulmonary Infection: A Multicenter Retrospective Study

Purpose

The aim of this study was to establish risk prediction and prognosis models for multidrug-resistant bacterial infections (MDRB) in elderly patients with pulmonary infections in a multicenter setting.

Patients and Methods

This study is a retrospective cohort analysis in Anhui province of China. Data dimension reduction and feature selection were performed using the lasso regression model. Multifactorial regression analysis to identify risk factors associated with MDRB infection and prognosis. The relevant risks of each patient in the prognostic training cohort were scored based on prognostic independent risk factors. Subsequently, patients were classified into high-risk and low-risk groups, and survival differences were compared between them. Finally, models were established based on independent risk factors for infection, risk groups, and independent prognostic factors, and were presented on nomograms. The predictive accuracy of the model was assessed using corresponding external validation set data.

Results

The study cohort comprised 994 elderly patients with pulmonary infection. Multivariate analysis revealed that endotracheal intubation, previous antibiotic use beyond 2 weeks, and concurrent respiratory failure or cerebrovascular disease were independent risk factors associated with the incidence of MDRB infection. Cox regression analysis identified respiratory failure, malnutrition, an APACHE II score of at least 20, and higher blood creatinine levels as independent prognostic risk factors. The models were validated using an external validation dataset from multiple centers, which demonstrated good diagnostic ability and a good fit with a fair benefit.

Conclusion

In conclusion, our study provides an appropriate and generalisable assessment of risk factors affecting infection and prognosis in patients with MDRB, contributing to improved early identification of patients at higher risk of infection and death, and appropriately guiding clinical management.

[Analysis of Pulmonary Microbial Diversity in Patients with Advanced Lung Cancer Based on High-throughput Sequencing Technology]

背景与目的

肺部微生物组与肺部疾病的发生密切相关，微生物可从多方面促进肿瘤的发生与发展。既往研究证实肺癌患者肺部微生物组较健康人发生了变化，但关于不同类型肺癌患者中肺部微生物组的微生物组成尚未明确。本研究旨在探讨不同组织学类型肺癌间的微生物组相关性及差异性。

方法

采用Illumina HiSeq高通量测序技术对晚期肺癌患者痰样本进行细菌V3-V4区的16S rDNA测序及生物信息学分析。

结果

经物种分类分析发现肺癌患者痰样本中以链球菌属、奈瑟氏菌属、普雷沃氏菌属为主。腺癌（adenocarcinoma, AD）组以链球菌属及奈瑟氏菌属为主，小细胞肺癌（small cell lung cancer, SCLC）组以奈瑟氏菌属为主，鳞状细胞癌（squamous cell carcinoma, SCC）组以链球菌属为主，混合型小细胞肺癌（combined small cell lung cancer, C-SCLC）组以链球菌属为主。

结论

不同组织学类型肺癌的肺部细菌微生物组结构及组成存在差异性，不同组织学类型肺癌间优势菌群有所不同，本研究丰富了肺癌肺部细菌微生物组学数据。