2021 Fiscal Year Final Research Report
Research on the pathophysiology of lower respiratory tract infections caused by bacteria, acid-fast bacilli, and fungi, using 16S ribosomal RNA gene analysis
| Project/Area Number |
19K08639
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 53030:Respiratory medicine-related
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| Research Institution | University of Occupational and Environmental Health, Japan |
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Principal Investigator |
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| Project Period (FY) |
2019-04-01 – 2022-03-31
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| Keywords | 16S ribosomal RNA / 肺炎 / 慢性下気道感染症 / 非結核性抗酸菌症 / 嫌気性菌 |
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| Outline of Final Research Achievements |
We analyzed microbiome detected by the clone library method using the 16S rRNA gene sequencing in bronchoalveolar lavage fluid (BALF) directly obtained from pneumonia lesions in 294 pneumonia patients (120 with community-acquired pneumonia: CAP, 101 with healthcare-associated pneumonia: HCAP and 73 with hospital-acquired pneumonia: HAP) and 31 chronic lower respiratory tract infection patients. Then, we also evaluated lung microbiome in the patient characteristics.
More obligate anaerobes were detected in CAP patients than HCAP or HAP patients. More Corynebacterium species were detected in HAP patients than CAP or HCAP patients, and in patients with cerebrovascular diseases. Among chronic lower respiratory tract infection patients, a higher proportion of anaerobic bacteria (especially Prevotella species) was detected in 14 patients with nontuberculous mycobacteria (NTM) than 17 patients without NTM, and this result suggested the association between NTM and anaerobic bacteria.
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| Free Research Field |
呼吸器感染症
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| Academic Significance and Societal Importance of the Research Achievements |
医療ケア関連肺炎や院内肺炎は従来誤嚥の頻度が高く、嫌気性菌の関与が高い事が報告されてきたが、我々の解析結果では医療ケア関連肺炎や院内肺炎よりも市中肺炎において病巣部の細菌叢における嫌気性菌の検出頻度が高い事を示した。臨床において肺炎診療は原因菌がわかるまではガイドラインに基づいて抗菌薬選択が行われる場合が多いが、肺炎タイプ別、基礎疾患別の病巣部細菌叢の関わりが明らかになる事により、さらに基礎疾患を含めた患者背景まで考慮した抗菌薬選択を行うことでより正確な初期治療が可能になる可能性があり、社会的意義が深いと考えられる。
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