Dysbiosis of Gut Microbiota Is an Independent Risk Factor of Stroke-Associated Pneumonia: A Chinese Pilot Study
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Study information
-
Quality control
- Retracted paper
- Contamination issues suspected
- Batch effect issues suspected
- Uncontrolled confounding suspected
- Results are suspect (various reasons)
- Tags applied
study design
Citation
PMID PubMed identifier for scientific articles.
DOI Digital object identifier for electronic documents.
URI
Authors
Xia GH, Zhang MS, Wu QH, Wang HD, Zhou HW, He Y, Yin J
Journal
Frontiers in cellular and infection microbiology
Year
2021
Keywords:
gut microbiota, risk, short-chain fatty acids, stroke, stroke-associated pneumonia
BACKGROUND AND PURPOSE: Identifying risks of stroke-associated pneumonia (SAP) is important for clinical management. We aimed to evaluate the association between gut microbiome composition and SAP in patients with acute ischemic stroke (AIS). METHODS: A prospective observational study was conducted, and 188 AIS patients were enrolled as the training cohort. Fecal and serum samples were collected at admission. SAP was diagnosed by specialized physicians, and disease severity scores were recorded. Fecal samples were subjected to 16S rRNA V4 tag sequencing and analysed with QIIME and LEfSe. Associations between the most relevant taxa and SAP were analysed and validated with an independent cohort. Fecal short-chain fatty acid (SCFA), serum D-lactate (D-LA), intestinal fatty acid-binding protein (iFABP) and lipopolysaccharide binding protein (LBP) levels were measured. RESULTS: Overall, 52 patients (27.7%) had SAP in the training cohort. The gut microbiome differed between SAP and non-SAP patients; specifically, Roseburia depletion and opportunistic pathogen enrichment were noted in SAP patients, as confirmed in the validation cohort (n=144, 28 SAP [19.4%]). Based on multivariate analysis, Roseburia was identified as a protective factor against SAP in both cohorts (training, aOR 0.52; 95% CI, 0.30-0.90; validation, aOR 0.44; 95% CI, 0.23-0.85). The combination of these taxa into a microbial dysbiosis index (MDI) revealed that dysbiosis increased nearly 2 times risk of SAP (training, aOR 1.95; 95% CI, 1.19-3.20; validation, aOR 2.22; 95% CI, 1.15-4.26). Lower fecal SCFA levels and higher serum D-LA levels were observed in SAP patients. Furthermore, SAP was an independent risk factor of 30-day death and 90-day unfavorable outcome. CONCLUSION: We demonstrate that a microbial community with depleted Roseburia and enriched opportunistic pathogens is associated with increased risk of SAP among AIS patients. Gut microbiota screening might be useful for identifying patients at high risk for SAP and provide clues for stroke treatment.
Experiment 1
Subjects
- Location of subjects
- China
- Host species Species from which microbiome was sampled. Contact us to have more species added.
- Homo sapiens
- Body site Anatomical site where microbial samples were extracted from according to the Uber Anatomy Ontology
- Feces Cow dung,Cow pat,Droppings,Dung,Excrement,Excreta,Faeces,Fecal material,Fecal matter,Fewmet,Frass,Guano,Matières fécales@fr,Merde@fr,Ordure,Partie de la merde@fr,Piece of shit,Porción de mierda@es,Portion of dung,Portion of excrement,Portion of faeces,Portion of fecal material,Portion of fecal matter,Portion of feces,Portion of guano,Portion of scat,Portionem cacas,Scat,Spoor,Spraint,Stool,Teil der fäkalien@de,Feces,feces
- Condition The experimental condition / phenotype studied according to the Experimental Factor Ontology
- Stroke Acute Cerebrovascular Accident,Acute Cerebrovascular Accidents,Acute Stroke,Acute Strokes,Apoplexy,Apoplexy, Cerebrovascular,Brain Vascular Accident,Brain Vascular Accidents,cerebral infarction,Cerebral Stroke,Cerebral Strokes,Cerebrovascular Accident,cerebrovascular accident,Cerebrovascular accident (disorder),Cerebrovascular accident (disorder) [Ambiguous],CEREBROVASCULAR ACCIDENT, (CVA),cerebrovascular accident, (CVA),Cerebrovascular Accident, Acute,Cerebrovascular Accidents,Cerebrovascular Accidents, Acute,Cerebrovascular Apoplexy,Cerebrovascular Apoplexya,Cerebrovascular Stroke,Cerebrovascular Strokes,CVA,CVA (cerebral vascular accident),CVA (Cerebrovascular Accident),CVA - Cerebrovascular accident,CVA - Cerebrovascular accident unspecified,CVA, CEREBROVASCULAR ACCIDENT,CVA, cerebrovascular accident,CVAs (Cerebrovascular Accident),ischemic stroke,stroke,Stroke and cerebrovascular accident unspecified,Stroke and cerebrovascular accident unspecified (disorder),stroke disorder,Stroke NOS,Stroke NOS (disorder),STROKE SYNDROME,stroke syndrome,Stroke, Acute,Stroke, Cerebral,Stroke, Cerebrovascular,Stroke/CVA - undefined,Strokes,Strokes, Acute,Strokes, Cerebral,Strokes, Cerebrovascular,SYNDROME, STROKE,syndrome, stroke,undetermined stroke,Vascular Accident, Brain,Vascular Accidents, Brain,Stroke
- Group 0 name Corresponds to the control (unexposed) group for case-control studies
- Non-Stroke Associated Pneumonia (non-SAP) Training cohort
- Group 1 name Corresponds to the case (exposed) group for case-control studies
- Stroke Associated Pneumonia (SAP) Training cohort
- Group 1 definition Diagnostic criteria applied to define the specific condition / phenotype represented in the case (exposed) group
- Patients with acute ischemic stroke (AIS) as the Training cohort .
- Group 0 sample size Number of subjects in the control (unexposed) group
- 136
- Group 1 sample size Number of subjects in the case (exposed) group
- 52
- Antibiotics exclusion Number of days without antibiotics usage (if applicable) and other antibiotics-related criteria used to exclude participants (if any)
- 3 Month
Lab analysis
- Sequencing type
- 16S
- 16S variable region One or more hypervariable region(s) of the bacterial 16S gene
- V4
Statistical Analysis
- Data transformation Data transformation applied to microbial abundance measurements prior to differential abundance testing (if any).
- relative abundances
- Statistical test
- LEfSe
- Significance threshold p-value or FDR threshold used for differential abundance testing (if any)
- 0.05
- MHT correction Have statistical tests be corrected for multiple hypothesis testing (MHT)?
- No
- LDA Score above Threshold for the linear discriminant analysis (LDA) score for studies using the popular LEfSe tool
- 4.0
Signature 1
Source: FIG 2 (B)
Description: Comparison of the microbial communities of the SAP and non-SAP groups in the training cohort using LEfSe to identified the 13 most differentially abundant taxa.
Abundance in Group 1: increased abundance in Stroke Associated Pneumonia (SAP) Training cohort
Revision editor(s): Rahila
Signature 2
Source: FIG 2 (B)
Description: Comparison of the microbial communities of the SAP and non-SAP groups in the training cohort using LEfSe to identified the 13 most differentially abundant taxa.
Abundance in Group 1: decreased abundance in Stroke Associated Pneumonia (SAP) Training cohort
| NCBI | Quality Control | Links |
|---|---|---|
| Roseburia |
Revision editor(s): Rahila
Experiment 2
Differences from previous experiment shown
Subjects
- Group 0 name Corresponds to the control (unexposed) group for case-control studies
- Non-Stroke Associated Pneumonia (non-SAP) Validation cohort
- Group 1 name Corresponds to the case (exposed) group for case-control studies
- Stroke Associated Pneumonia (SAP) Validation cohort
- Group 1 definition Diagnostic criteria applied to define the specific condition / phenotype represented in the case (exposed) group
- Patients with acute ischemic stroke (AIS) as the Validation cohort .
- Group 0 sample size Number of subjects in the control (unexposed) group
- 116
- Group 1 sample size Number of subjects in the case (exposed) group
- 28
Lab analysis
Statistical Analysis
- LDA Score above Threshold for the linear discriminant analysis (LDA) score for studies using the popular LEfSe tool
- 2.0
Signature 1
Source: Figure (S2B)
Description: Comparison of the microbial communities of the SAP and non-SAP groups in the validation cohort using LEfSe to identified the most differentially abundant taxon between the two groups.
Abundance in Group 1: increased abundance in Stroke Associated Pneumonia (SAP) Validation cohort
| NCBI | Quality Control | Links |
|---|---|---|
| Desulfovibrio | ||
| Enterobacterales | ||
| Enterobacteriaceae | ||
| Gammaproteobacteria | ||
| Lactobacillales | ||
| Pseudomonadota | ||
| Rikenellaceae | ||
| Enterobacter | ||
| Lactobacillus | ||
| Lactobacillaceae |
Revision editor(s): Rahila
Signature 2
Source: Figure (S2B)
Description: Comparison of the microbial communities of the SAP and non-SAP groups in the validation cohort using LEfSe to identified the most differentially abundant taxon between the two groups.
Abundance in Group 1: decreased abundance in Stroke Associated Pneumonia (SAP) Validation cohort
Revision editor(s): Rahila
Experiment 3
Differences from previous experiment shown
Subjects
- Group 0 name Corresponds to the control (unexposed) group for case-control studies
- Non-Stroke Associated Pneumonia (non-SAP) subgroup in the training cohort
- Group 1 name Corresponds to the case (exposed) group for case-control studies
- Stroke Associated Pneumonia (SAP) subgroup in the training cohort
- Group 1 definition Diagnostic criteria applied to define the specific condition / phenotype represented in the case (exposed) group
- Patients with acute ischemic stroke (AIS) as the subgroup in the training cohort.
- Group 0 sample size Number of subjects in the control (unexposed) group
- 25
- Group 1 sample size Number of subjects in the case (exposed) group
- 25
Lab analysis
Statistical Analysis
Signature 1
Source: Figure (S5B)
Description: Comparison of the microbial communities of the SAP and non-SAP groups in the subset of the training cohort using LEfSe to identified the most differentially abundant taxon between the two groups.
Abundance in Group 1: increased abundance in Stroke Associated Pneumonia (SAP) subgroup in the training cohort
| NCBI | Quality Control | Links |
|---|---|---|
| Aeromonadales | ||
| Succinivibrio | ||
| Erwinia | ||
| Enterococcaceae | ||
| Enterococcus |
Revision editor(s): Rahila
Signature 2
Source: Figure (S5B)
Description: Comparison of the microbial communities of the SAP and non-SAP groups in the subset of the training cohort using LEfSe to identified the most differentially abundant taxon between the two groups.
Abundance in Group 1: decreased abundance in Stroke Associated Pneumonia (SAP) subgroup in the training cohort
| NCBI | Quality Control | Links |
|---|---|---|
| Faecalibacterium | ||
| Dehalobacterium | ||
| DehalobacteriaceaeDehalobacteriaceae | ||
| Roseburia |
Revision editor(s): Rahila
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