Intestinal microbiome disruption in patients in a long-term acute care hospital: A case for development of microbiome disruption indices to improve infection prevention.
Intestinal microbiome disruption in patients in a long-term acute care hospital: A case for development of microbiome disruption indices to improve infection prevention.
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DOI：
10.1016/j.ajic.2016.01.003
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发表时间：
2016-07-01
影响因子：
4.9
通讯作者：
McDonald LC
中科院分区：
文献类型：
--
作者：
Halpin AL;de Man TJ;Kraft CS;Perry KA;Chan AW;Lieu S;Mikell J;Limbago BM;McDonald LC
肠道微生物群落(微生物区系)的组成和多样性被普遍认为是不良结果的风险因素；然而，我们还不能利用这些信息来防止不良结果。粪便来自8名长期急性护理医院(LTACH)腹泻患者和2名粪便微生物区系移植供者；对16S rDNA V1-V2高变区进行了测序。描述了每个样品的组成和多样性。对粪便进行艰难梭菌、耐万古霉素肠球菌(VRE)和碳青霉烯类耐药肠杆菌的检测。分析了微生物区系多样性与人口统计学和临床特征之间的关系，包括抗生素的使用。抗生素暴露和查尔森共病指数与多样性呈负相关(Spearman=−0.7)。2例VRE阳性，均以粪肠球菌为主，占菌群总数的67-84%。抗生素暴露与多样性相关；然而，在临床环境中不易获得的其他环境和宿主因素也已知会影响微生物区系。因此，通过测序直接测量微生物组的破坏，而不是依赖替代标记，可能是最能预测不利结果的方法。如果微生物组特征成为一种标准的诊断测试，提高我们对微生物组动力学的理解将允许解释结果，以改善患者的预后。
Composition and diversity of intestinal microbial communities (microbiota) are generally accepted as a risk factor for poor outcomes; however, we cannot yet use this information to prevent adverse outcomes. Stool was collected from eight long-term acute care hospital (LTACH) patients experiencing diarrhea and two fecal microbiota transplant donors; 16S rDNA V1-V2 hypervariable regions were sequenced. Composition and diversity of each sample were described. Stool was also tested for Clostridium difficile, vancomycin-resistant enterococci (VRE), and carbapenem-resistant Enterobacteriaceae. Associations between microbiota diversity and demographic and clinical characteristics, including antibiotic use, were analyzed. Antibiotic exposure and Charlson Comorbidity Index were inversely correlated with diversity (Spearman = −0.7). Two patients were positive for VRE; both had microbiomes dominated by Enterococcus faecium, accounting for 67–84% of their microbiome. Antibiotic exposure correlated with diversity; however, other environmental and host factors not easily obtainable in a clinical setting are also known to impact the microbiota. Therefore, direct measurement of microbiome disruption by sequencing, rather than reliance on surrogate markers, might be most predictive of adverse outcomes. If and when microbiome characterization becomes a standard diagnostic test, improving our understanding of microbiome dynamics will allow for interpretation of results to improve patient outcomes.
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影响因子：
3.7
作者：
Biagi E;Nylund L;Candela M;Ostan R;Bucci L;Pini E;Nikkïla J;Monti D;Satokari R;Franceschi C;Brigidi P;De Vos W
通讯作者：
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影响因子：
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作者：
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影响因子：
11.8
作者：
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van Wijngaarden, Edwin
影响因子：
4.5
作者：
Gould, Carolyn V.;Rothenberg, Richard;Steinberg, James P.
通讯作者：
Steinberg, James P.
DOI：
10.1073/pnas.0804812105
发表时间：
2008-10-28
影响因子：
11.1
作者：
Sokol, Harry;Pigneur, Benedicte;Langella, Philippe
通讯作者：
Langella, Philippe