Acta microbiologica et immunologica Hungarica最新文献

{"title":"New insights into Salmonella virulence: Detection of spvB and spvR genes in avian and human isolates from northeastern Algeria.","authors":"Amira Kout, Radia Boufermes, Rania Laouar, Rachid Elgroud, Bariş Binay, Douadi Khelifi, Hajira Berredjem","doi":"10.1556/030.2026.02914","DOIUrl":"10.1556/030.2026.02914","url":null,"abstract":"<p><p>The emergence of highly virulent and multidrug-resistant Salmonella strains continues to pose a major global public health concern. Building on our previous investigation of 80 Salmonella isolates obtained from avian and human sources in northeastern Algeria (Annaba and Constantine) over a three-year period (2017-2019), in which their resistance profiles to 15 antimicrobial agents were assessed, the present study further explores the molecular features of virulence by targeting two additional plasmid-encoded genes, spvB and spvR. All isolates were subjected to polymerase chain reaction (PCR) amplification using gene-specific primers. The results revealed that spvB was detected in 86.25% of isolates, while spvR was identified in 73.75%, suggesting a strong association with strains capable of causing severe systemic infections. When compared with previous reports, notable geographical variations were observed, which may reflect differences in host reservoirs, ecological conditions, and selective pressures arising from antimicrobial use. The coexistence of spv virulence genes and multidrug-resistant (MDR) phenotypes in our isolates underscores the substantial risk of dissemination of highly pathogenic and resistant Salmonella strains between animals and humans. These findings highlight the need to integrate virulence gene surveillance into existing antimicrobial resistance monitoring programs to better understand and manage the zoonotic transmission dynamics of Salmonella in Algeria.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"340-347"},"PeriodicalIF":1.5,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148269978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative analysis of the gut-liver-heart axis in coronary artery disease: From chronic metabolic dysbiosis to acute cardiogenic shock.","authors":"Muhammad Salman Khan, Muhammad Naveed Khan, Syed Muhammad Umair, Suxin Luo, Bi Huang","doi":"10.1556/030.2026.02892","DOIUrl":"10.1556/030.2026.02892","url":null,"abstract":"<p><p>The complex interplay between chronic metabolic disorders and acute cardiovascular decompensation represents a critical frontier in cardiology. This integrative research program conducted at Chongqing Medical University systematically examines the gut-liver-heart axis across the cardiovascular disease spectrum through three interconnected studies. First, a case-control investigation of coronary artery disease (CAD) patients with and without nonalcoholic fatty liver disease (NAFLD) revealed distinct intestinal dysbiosis patterns characterized by increased Coprococcus and Veillonella alongside decreased Parabacteroides, Bacteroides fragilis, and Bifidobacterium longum, with these microbial alterations correlating significantly with body mass index, triglyceride levels, and hepatic transaminases. Second, a retrospective cohort study of acute myocardial infarction complicated by cardiogenic shock demonstrated that elevated admission bilirubin (HR = 1.020, P = 0.003) and alanine aminotransferase independently predicted 30-day mortality, while serum albumin exerted protective effects (HR = 0.955, P < 0.001). Third, analysis of a comprehensive clinical registry illuminated the systemic clustering of metabolic, renal, and inflammatory abnormalities that underpin both chronic cardiometabolic disease and acute cardiovascular collapse. Collectively, these findings establish a pathogenic continuum wherein chronic intestinal dysbiosis and subclinical hepatic dysfunction create a vulnerable substrate that amplifies injury during acute ischemic events. This research framework provides mechanistic insights into the gut-liver-heart axis and proposes integrated biomarker panels for risk stratification across cardiovascular disease stages.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"388-395"},"PeriodicalIF":1.5,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular epidemiology and prognostic impact of lower respiratory tract infections during immune checkpoint inhibitor therapy in advanced non-small cell lung cancer: A retrospective cohort study.","authors":"Ning Xu, Chao Li","doi":"10.1556/030.2026.02970","DOIUrl":"10.1556/030.2026.02970","url":null,"abstract":"<p><p>Patients with advanced non-small cell lung cancer (NSCLC) are prone to lower respiratory tract infection (LRTI) during immune checkpoint inhibitor (ICI) treatment, but the pathogen spectrum and clinical impact remain unclear. This study provides comprehensive microbiological characterization of pathogen spectrum, molecular resistance mechanisms, and prognostic significance of LRTI during ICI treatment in patients with advanced NSCLC. A single-center retrospective cohort design was adopted, and 903 patients with advanced NSCLC who first received PD-1 or PD-L1 inhibitor treatment between January 1, 2019 and November 30, 2023 were included. Molecular characterization of resistant isolates was performed using PCR and sequencing for ESBL genes (blaCTX-M, blaSHV, blaTEM), carbapenemase genes (blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48, blaOXA-23), and mecA, with multilocus sequence typing (MLST) for clonality analysis. Competing risk models estimated cumulative incidence of first LRTI; time-dependent Cox models evaluated associations with overall survival (OS) and progression-free survival (PFS). Among 903 patients, 176 (19.49%) developed LRTI during ICI treatment. Among 243 infection episodes, any phenotypic resistance was identified in 31 episodes (12.76%). Of 24 available resistant isolates, molecular characterization revealed blaCTX-M-15 as the predominant ESBL determinant (87.5%), blaKPC-2 and blaNDM-1 in CRE, blaVIM-2 and blaIMP-4 in CRPA, and blaOXA-23 in CRAB. MLST identified high-risk clones: K. pneumoniae ST11 (n = 3) and ST15 (n = 2), E. coli ST131 (n = 2), Pseudomonas aeruginosa ST235 (n = 3), A. baumannii ST2 (n = 6), and MRSA ST239 (n = 2). Older age, male sex, higher ECOG score, stage IV disease, COPD, ILD, baseline corticosteroid exposure, and higher NLR were associated with increased infection risk (all P < 0.05). First LRTI was independently associated with worse OS (HR = 1.78) and PFS (HR = 1.41). Fungal infection (HR = 2.48), mixed infection (HR = 2.34), resistance-associated infection (HR = 2.61), and severe infection (HR = 2.96) indicated worst prognosis. LRTI during ICI treatment in advanced NSCLC carries substantial burden and is associated with poor prognosis. Molecular characterization reveals that resistant infections are driven by established epidemic clones (ST2 CRAB, ST11 CRKP, ST235 CRPA, ST131 ESBL-EC), highlighting the need for enhanced infection control and targeted antimicrobial strategies in this vulnerable population.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"348-362"},"PeriodicalIF":1.5,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the gut-lung axis in post-liver transplant acute lung injury: A multi-omics approach.","authors":"Abdul Ahad Mehboob, Remsha Fatima, Saadia Kanwal, Muhammad Ali, Mona Karim, Sampana Fatima","doi":"10.1556/030.2026.02911","DOIUrl":"10.1556/030.2026.02911","url":null,"abstract":"<p><p>Acute lung injury (ALI) is a significant post-operative complication of liver transplant (LT), with mounting evidence suggesting a role for the gut-lung axis. However, the mechanistic link between gut microbiota dysbiosis and ALI pathogenesis in LT recipients remains poorly understood. This hybrid translational investigation integrates transcriptomic profiling (bulk and single-cell RNA-seq), immune infiltration analysis, fecal microbiota composition (16S rRNA), and predictive functional profiling in ALI vs. non-ALI (NALI) LT patients. Machine learning algorithms (LASSO, SVM-RFE, Random Forest) were used to identify key gene biomarkers. Microbiota-host gene correlations and canonical correspondence analysis (CCA) were performed to evaluate multi-omic relationships. ALI patients exhibited reduced gut microbial diversity and increased abundance of Enterococcus and Escherichia-Shigella, alongside a depletion of beneficial taxa (Faecalibacterium, Bacteroides). CXCL3, CD48, and IRAK3 were identified as robust ALI biomarkers (Area Under the Curve >0.83), validated in both serum and Bronchoalveolar Lavage Fluid. These genes correlated positively with pro-inflammatory microbes and immune cell infiltration. Functional prediction revealed enrichment in lipopolysaccharide biosynthesis, Toll-like receptor signaling, and bacterial chemotaxis. CCA confirmed that microbiota variation significantly explained host transcriptomic variance. Our study uncovers a functional gut-lung immunological axis in post-LT ALI. Gut dysbiosis modulates immune gene expression and lung inflammation, suggesting that the microbiome serves as a potential source of diagnostic biomarkers and therapeutic targets in transplant-associated lung injury.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"375-387"},"PeriodicalIF":1.5,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive whole-genome sequencing reveals the resistome, virulome, and mobile genetic architecture of multidrug-resistant Acinetobacter baumannii.","authors":"Kannika Parameshwari Kannan, A S Smiline Girija","doi":"10.1556/030.2026.02983","DOIUrl":"10.1556/030.2026.02983","url":null,"abstract":"<p><p>Acinetobacter baumannii is a major cause of hospital-acquired infections and has emerged as a critical multidrug-resistant (MDR) pathogen with limited therapeutic options. In this study, two MDR clinical isolates from a tertiary care hospital in Chennai, India, selected based on their strong biofilm-producing capacity, were subjected to whole-genome sequencing (WGS) to characterize their resistome, virulome, and genomic features. Both isolates exhibited resistance to β-lactams, carbapenems, aminoglycosides, fluoroquinolones, and trimethoprim-sulfamethoxazole, while remaining susceptible to tigecycline and colistin. Genomic analysis identified key carbapenemase genes blaOXA-23, blaOXA-51, and blaOXA-144 along with additional resistance determinants including blaADC-76 and blaPER-7, aminoglycoside-modifying enzymes (ant(3″)-Ia and aph(6)), tetracycline resistance genes (tet(A), tet(B), and tet(R)), macrolide resistance gene msr(E), sulfonamide resistance gene sul1, and chloramphenicol efflux gene cmlA5. Fluoroquinolone resistance was associated with mutations in the quinolone resistance determining regions, including an S81L substitution in gyrA and multiple substitutions in parC. Virulence profiling revealed biofilm-associated genes, including bap and the pgaABC operon, along with genes linked to motility and metabolic fitness. Phylogenomic analysis showed close relatedness between the isolates and reference strains, and multilocus sequence typing (MLST) assigned both isolates to sequence type ST1051, indicating a shared clonal background. The genomes also harbored diverse mobile genetic elements, prophage regions, and siderophore-associated biosynthetic gene clusters, reflecting high genomic plasticity. Overall, this study highlights the coexistence of multiple resistance and virulence determinants in biofilm-forming MDR A. baumannii, emphasizing the importance of genome-based surveillance for monitoring high-risk strains in clinical settings.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"168-181"},"PeriodicalIF":1.5,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148025778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiota: The hidden hallmark of aging.","authors":"Kimaya Kaushik, Mihir Sharma, Ritik Sharma, Asif Reza, Geetansh Sharma, Saetukrit Panwar, Rupak Nagraik, Poonam Negi, Avinash Sharma","doi":"10.1556/030.2026.02808","DOIUrl":"10.1556/030.2026.02808","url":null,"abstract":"<p><p>Aging is the natural process of changes that are accumulated over time and are responsible for the ever-increasing susceptibility to diseases and death. Extensive research has been done to understand the role of gut microbiota in aging, however, limited progress has been made. Thus, considering the need of the hour we have tried to give a new perspective to this body of research by delving deep into all major factors that are associated with gut microbiome and aging. This review presents a holistic view of the relation between gut microbiome and aging starting from hallmarks of aging and evolution of gut microbiome over lifespan to intricate mechanisms like inflammaging, immunosenescence, gut-brain axis, mitochondrial dysfunction, nutrient imbalance and cardiac implications. In addition, it highlights different therapies like fecal microbiota transplantation, omics and metabolomics studies, and gut modulation therapies that show a promising future towards regulation of gut microbiota for aging interventions. More importantly, this review is an addition to the existing literature which advocates gut microbiome as an additional hallmark of aging, summarising the known status of the research in this field, contributing to developing gut microbiota targeted healthy aging.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"257-278"},"PeriodicalIF":1.5,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of baseline lower respiratory tract microbiota composition and bacterial load with the risk of PD-1/PD-L1 inhibitor-associated immune-related pneumonitis: A single-center prospective cohort study.","authors":"Yun Wang, Xuefeng Wang, Henggen Zhou","doi":"10.1556/030.2026.02909","DOIUrl":"10.1556/030.2026.02909","url":null,"abstract":"<p><p>Immune checkpoint inhibitors improve outcomes in solid tumors, but immune-related pneumonitis (irP) can lead to treatment interruption and even death; current stratification mainly relies on medical history and imaging, lacking reproducible organ-specific biomarkers. This prospective cohort study evaluated the association of baseline lower respiratory tract microbiota features and bacterial load with the risk of PD-1/PD-L1-related irP. Bronchoalveolar lavage was performed before immunotherapy; 16S sequencing derived the Pathogen-Enrichment Score (PES), and quantitative PCR quantified total bacterial load. The primary endpoint was first occurrence of grade ≥2 irP within 6 months. Firth-corrected multivariable logistic regression adjusted for prior thoracic radiotherapy, baseline interstitial lung disease, and recent antibiotic use. Of 294 evaluable cases, 34 developed grades ≥2 irP. Baseline total bacterial load was significantly higher in patients who later developed irP, showing a monotonic dose-response relationship with risk (nonlinearity P = 0.183); adjusted odds ratio = 1.58 per 1 log10 copies/mL (P = 0.024). PES was also elevated (adjusted odds ratio = 1.43 per 1 SD, P = 0.033). The dysbiotic phenotype was characterized by reduced diversity and enrichment of Streptococcus, Veillonella, and Haemophilus, genera commonly associated with oral microbiota and aspiration. Adding PES and bacterial load to a clinical model improved discrimination (AUC 0.81 vs 0.73, P = 0.019) and reclassification (categorical NRI = 0.24, P = 0.004). Event rates across risk strata were 2.24, 13.46, and 32.65%. Baseline lower respiratory tract dysbiosis and elevated bacterial load indicate higher irP risk; adding these microbiologic measures to a clinical model improves prediction and risk stratification.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"363-374"},"PeriodicalIF":1.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of rectal screening for Carbapenem-resistant Enterobacterales in adult patients in intensive care unit: Colonization risk factors and impact on survival: A retrospective cohort study.","authors":"Fatma Meral İnce, Özge Alkan Bilik","doi":"10.1556/030.2026.02973","DOIUrl":"10.1556/030.2026.02973","url":null,"abstract":"<p><p>Carbapenem-resistant Enterobacterales (CRE) infections are difficult to treat and are associated with high morbidity and mortality. Therefore, it is important to rapidly identify the carriers. This study aimed to investigate the clinical and microbiological risk factors associated with CRE colonization, infection, and mortality rates in adult intensive care unit (ICU) patients. A retrospective cohort analysis was performed in the adult ICU of Selahaddin Eyyubi State Hospital, Diyarbakır, Türkiye, between October 2022 and February 2024. Rectal swabs were obtained at ICU admission and weekly thereafter. Based on clinical, laboratory, and microbiological findings, the patients were categorized into colonized or infected groups. Demographic parameters, comorbidities, device use, previous antibiotic exposure, and mortality were analyzed using logistic regression, Kaplan-Meier survival estimates, and Cox proportional hazard modeling. Of the 420 patients, 69 (16.4%) were CRE-positive, 46 (66.7%) remained colonized, and 23 (33.3%) developed infections. The most frequent isolates were Klebsiella pneumoniae (63.8%) and Escherichia coli (36.2%). Independent risk factors for colonization included male sex, prolonged hospitalization, pulmonary or cerebrovascular disease, and prior exposure to β-lactam/β-lactamase inhibitors or cephalosporin antibiotics. CRE infection was related to prior β-lactam/β-lactamase inhibitor and carbapenem use. Mortality was 65.2% in the colonized-infected group versus 13% in those with colonization alone (P < 0.001). Overall survival was similar for CRE-positive and CRE-negative patients, but infected patients had higher mortality rates than colonized patients. CRE colonization in ICU patients poses a substantial risk once infection develops and is closely associated with broad-spectrum antibiotic exposure. These findings support routine rectal CRE screening as a key tool for identifying high-risk patients and informing antibiotic stewardship strategies aimed at preventing progression to fatal infections and improving survival.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"186-193"},"PeriodicalIF":1.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro activity of ceftazidime-avibactam, imipenem-cilastatin-relebactam, meropenem-vaborbactam, cefiderocol, and plazomicin against non-fermenting Gram-negative isolates obtained from Bulgarian inpatients.","authors":"Tanya Strateva, Slavil Peykov, Nikolay Kalvatchev, Emma Keuleyan, Alexander Stratev","doi":"10.1556/030.2026.02958","DOIUrl":"10.1556/030.2026.02958","url":null,"abstract":"<p><p>The present study aimed to evaluate the in vitro activity of ceftazidime-avibactam (CZA), imipenem-cilastatin-relebactam (IMR), meropenem-vaborbactam (MEV), cefiderocol (CFDC), and plazomicin (PLZ), against nosocomial carbapenem-resistant Pseudomonas aeruginosa (CRPA) (n = 40), carbapenem-resistant Acinetobacter baumannii (CRAB) (n = 56), and Stenotrophomonas maltophilia (n = 50) isolates from Bulgaria (2014-2023). Antimicrobial susceptibility testing, polymerase chain reaction screening for antimicrobial resistance (AMR) determinants, and whole-genome sequencing were performed. In CRPA, blaNDM-1 (20%), blaVIM-2 (5%), and blaVIM-4 (2.5%) metallo-β-lactamase (MBL)-encoding genes were detected. Both P. aeruginosa and S. maltophilia showed absolute susceptibility to CFDC, and 78.6% of the tested A. baumannii isolates were also susceptible. All CFDC-resistant (MIC values in the range of 4-64 mg L-1) CRAB isolates (12 out of 56) were positive for blaPER-1 (n = 12) and acquired class D carbapenemase genes, as follows: blaOXA-23-like (n = 7), blaOXA-24/40-like (n = 1), and blaOXA-23-like + blaOXA-24/40-like (n = 4). Only 22.5-25% of CRPA isolates revealed susceptibility to the combined β-lactam (BL)-β-lactamase inhibitor (BLI) antimicrobials. Equal PLZ MIC50 values were reported against P. aeruginosa and A. baumannii (8 mg L-1), but higher MIC90 values against CRAB (>256 vs. 16 mg L-1). MBL-producing CRPA demonstrated absolute resistance to all BL-BLI preparations, whereas non-MBL-producing isolates possessed significantly higher susceptibility (P < 0.05), ranging from 31% (for CZA and IMR) to 34.5% (MEV). In conclusion, the emergence of MBL-positive P. aeruginosa and the associated ineffectiveness of the novel BL-BLI combinations, as well as the relatively high proportion of CFDC-resistant A. baumannii isolates, are alarming. Therefore, continuous surveillance of AMR concerning newly approved antibiotics should be the mainstay of multifaceted global and national \"One Health\" strategies and infection control stewardship practices in hospital settings.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"157-167"},"PeriodicalIF":1.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incremental value of a gut microbiome score (M-score) for predicting stroke-associated pneumonia beyond the clinical A2DS2 score: A nested case-control study.","authors":"Yidan Zhang, Qi Dong, Wenbin Li","doi":"10.1556/030.2026.02907","DOIUrl":"10.1556/030.2026.02907","url":null,"abstract":"<p><p>Stroke-associated pneumonia (SAP) is a major complication of acute ischemic stroke. The brain-gut-lung axis suggests that post-stroke gut dysbiosis may offer independent risk information beyond clinical scores like A2DS2. The aim of this study was to evaluate the incremental predictive value of early post-stroke gut microbiome biomarkers for SAP and to construct a simplified microbiome risk score (M-score). In a prospective nested case-control study, we identified 63 SAP cases from a cohort of 551 patients with acute ischemic stroke and stool samples were collected 24-72 h post-admission. Cases were matched 1:2 (age, sex) to 126 controls. Gut microbiota was profiled via 16S rRNA sequencing. Three differentially abundant genera (prevalence ≥20%, FDR q < 0.10) were used to construct an M-score via bootstrapped regression. Independent associations were assessed with conditional logistic regression. Incremental value over the A2DS2 score was evaluated using AUC, continuous net reclassification improvement (NRI), and the Brier score. SAP cases exhibited reduced α-diversity and distinct β-diversity (both P < 0.01). Cases had higher Enterococcus and Streptococcus and lower Faecalibacterium levels (all q < 0.05). The M-score was independently associated with SAP (adjusted OR per 1-SD: 1.76, 95% CI: 1.30-2.39, P = 0.001). Adding the M-score to A2DS2 significantly improved prediction: AUC increased from 0.76 to 0.84 (ΔAUC = 0.08, P = 0.009), NRI was 0.31 (95% CI: 0.12-0.51), and the Brier score decreased from 0.18 to 0.16. Results were robust in sensitivity analyses. A gut microbiome score based on three genera provides significant independent and incremental predictive value for SAP over the A2DS2 score, enabling more precise early risk stratification after stroke.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"235-244"},"PeriodicalIF":1.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}