Gut microbial colonisation in premature neonates predicts neonatal sepsis.
Gut microbial colonisation in premature neonates predicts neonatal sepsis.
复制标题
DOI：
10.1136/fetalneonatal-2011-301373
复制
发表时间：
2012-11
期刊：
影响因子：
--
通讯作者：
Hibberd PL
中科院分区：
文献类型：
--
作者：
Madan JC;Salari RC;Saxena D;Davidson L;O'Toole GA;Moore JH;Sogin ML;Foster JA;Edwards WH;Palumbo P;Hibberd PL
肠道细菌易位引起的新生儿败血症是新生儿发病率和死亡率的主要原因。了解早产儿肠道的微生物定植可能会预测败血症的风险，以指导未来操纵微生物组的策略。早产儿前瞻性纵向研究。每周采集一次粪便样本。提取DNA，扩增16S rRNA的V6高变区，然后进行高通量焦磷酸测序，比较有无脓毒症的受试者。6名新生儿出生时妊娠24-27周，对18份样本进行了分析。两名受试者在研究期间没有脓毒症，两名患者出现迟发的培养阳性脓毒症，两名患者出现培养阴性的全身炎症。共获得324350条序列。胎粪不是无菌的，以乳杆菌、葡萄球菌和肠杆菌为主。总体而言，患有败血症的婴儿出生时微生物多样性较低，并以葡萄球菌为主，而健康婴儿的微生物多样性和优势菌较多，主要为梭状芽胞杆菌、克雷伯氏菌和韦洛氏菌。在极低出生体重的婴儿中，作者发现胎粪并不是无菌的，在将发展为晚发型败血症的婴儿中，胎粪与出生时的差异较小。经验性的、长期的抗生素大大减少了微生物的多样性，促进了微生物区系的形成，这不仅与新生儿败血症有关，而且与以前在微生物群中发现的主要病原体有关。我们的数据表明，极早产儿中可能存在一种“健康的微生物群”，可能会改善败血症的风险。需要更多的研究来确定改变后的抗生素、益生菌或其他新的疗法是否可以在新生儿中重建健康的微生物群。
Neonatal sepsis due to intestinal bacterial translocation is a major cause of morbidity and mortality. Understanding microbial colonisation of the gut in prematurity may predict risk of sepsis to guide future strategies to manipulate the microbiome. Prospective longitudinal study of premature infants. Stool samples were obtained weekly. DNA was extracted and the V6 hypervariable region of 16S rRNA was amplified followed by high throughput pyrosequencing, comparing subjects with and without sepsis. Six neonates were 24–27 weeks gestation at birth and had 18 samples analysed. Two subjects had no sepsis during the study period, two developed late-onset culture-positive sepsis and two had culture-negative systemic inflammation. 324 350 sequences were obtained. The meconium was not sterile and had predominance of Lactobacillus, Staphylococcus and Enterobacteriales. Overall, infants who developed sepsis began life with low microbial diversity, and acquired a predominance of Staphylococcus, while healthy infants had more diversity and predominance of Clostridium, Klebsiella and Veillonella. In very low birth weight infants, the authors found that meconium is not sterile and is less diverse from birth in infants who will develop late-onset sepsis. Empiric, prolonged antibiotics profoundly decrease microbial diversity and promote a microbiota that is associated not only with neonatal sepsis, but the predominant pathogen previously identified in the microbiome. Our data suggest that there may be a ‘healthy microbiome’ present in extremely premature neonates that may ameliorate risk of sepsis. More research is needed to determine whether altered antibiotics, probiotics or other novel therapies can re-establish a healthy microbiome in neonates.
登录
查看更多内容
影响因子：
12.3
作者：
Huse SM;Huber JA;Morrison HG;Sogin ML;Welch DM
通讯作者：
Welch DM
影响因子：
64.8
作者：
Arumugam, Manimozhiyan;Raes, Jeroen;Pelletier, Eric;Le Paslier, Denis;Yamada, Takuji;Mende, Daniel R.;Fernandes, Gabriel R.;Tap, Julien;Bruls, Thomas;Batto, Jean-Michel;Bertalan, Marcelo;Borruel, Natalia;Casellas, Francesc;Fernandez, Leyden;Gautier, Laurent;Hansen, Torben;Hattori, Masahira;Hayashi, Tetsuya;Kleerebezem, Michiel;Kurokawa, Ken;Leclerc, Marion;Levenez, Florence;Manichanh, Chaysavanh;Nielsen, H. Bjorn;Nielsen, Trine;Pons, Nicolas;Poulain, Julie;Qin, Junjie;Sicheritz-Ponten, Thomas;Tims, Sebastian;Torrents, David;Ugarte, Edgardo;Zoetendal, Erwin G.;Wang, Jun;Guarner, Francisco;Pedersen, Oluf;de Vos, Willem M.;Brunak, Soren;Dore, Joel;Weissenbach, Jean;Ehrlich, S. Dusko;Bork, Peer
通讯作者：
Bork, Peer
影响因子：
4.2
作者：
Duffy, LC
通讯作者：
Duffy, LC
影响因子：
2.6
作者：
Jimenez, Esther;Marin, Maria L.;Rodriguez, Juan M.
通讯作者：
Rodriguez, Juan M.
影响因子：
3
作者：
Henneke, Philipp;Berner, Reinhard
通讯作者：
Berner, Reinhard