Microbial communities of the upper respiratory tract and otitis media in children.
Microbial communities of the upper respiratory tract and otitis media in children.
复制标题
DOI：
10.1128/mbio.00245-10
复制
发表时间：
2011-02-01
期刊：
影响因子：
6.4
通讯作者：
Pettigrew MM
中科院分区：
文献类型：
--
作者：
Laufer AS;Metlay JP;Gent JF;Fennie KP;Kong Y;Pettigrew MM
肺炎链球菌无症状地定植于儿童的上呼吸道，是中耳炎的常见原因。微生物定植模式可能影响肺炎链球菌定植和中耳炎的敏感性。这项研究比较了患有中耳炎和不患有中耳炎儿童的微生物群落。鼻拭子以及临床和人口学数据是在2008-2009年冬季呼吸道病毒季节对宾夕法尼亚州费城儿童(6至78个月)(n=108)的横断面研究中收集的。拭子培养肺炎链球菌。从拭子中提取DNA，用聚合酶链式反应扩增16S rRNA基因高变区(V1和V2)，用Roche/454生命科学焦磷酸测序仪进行测序。用香农多样性指数和均匀度指数描述微生物群落。利用主成分分析(PCA)将微生物群落类群划分为代表相关类群的4个因子。在108名儿童中，47名(44%)被肺炎链球菌定植，25名(23%)被诊断为中耳炎。带有肺炎链球菌的微生物群落多样性和均衡性明显降低。有两个PCA因素与肺炎球菌定植和中耳炎的风险降低相关，如下：一个因素包括潜在的保护性菌群(棒状杆菌和Dolosigranulum)，另一个因素包括丙酸杆菌、乳球菌和葡萄球菌。其余两个PCA因素与中耳炎风险增加相关。一个因素包括嗜血杆菌，最后一个因素包括放线菌、罗氏菌、奈瑟氏菌和韦隆氏菌。一般来说，这些分类群不被认为是中耳炎的病原体，但在病因途径中可能是重要的。增加对上呼吸道微生物群落的了解将有助于中耳炎治疗和预防策略的发展。中耳炎(中耳感染)是美国儿科就诊的最常见原因。肺炎链球菌是中耳炎的主要致病菌。肺炎沙门氏菌在感染中耳之前必须在上呼吸道定居，并与复杂的非致病细菌群落竞争。我们比较了患有中耳炎和没有中耳炎的儿童上呼吸道中的微生物群落。正常菌群的成员，即棒状杆菌和Dolosigranulum，对肺炎链球菌定植和中耳炎具有保护作用。正如预期的那样，嗜血杆菌属与中耳炎有关。令人惊讶的是，放线菌、罗氏菌、奈瑟氏菌和韦隆氏菌与中耳炎风险增加有关。这些细菌不是中耳炎的病原体，但可能与抗生素的使用有关，或者与致病的因果途径有关。增加对上呼吸道微生物群落的了解将导致预防中耳感染的新方法，包括益生菌。
Streptococcus pneumoniae asymptomatically colonizes the upper respiratory tract of children and is a frequent cause of otitis media. Patterns of microbial colonization likely influence S. pneumoniae colonization and otitis media susceptibility. This study compared microbial communities in children with and without otitis media. Nasal swabs and clinical and demographic data were collected in a cross-sectional study of Philadelphia, PA, children (6 to 78 months) (n = 108) during the 2008-2009 winter respiratory virus season. Swabs were cultured for S. pneumoniae. DNA was extracted from the swabs; 16S rRNA gene hypervariable regions (V1 and V2) were PCR amplified and sequenced by Roche/454 Life Sciences pyrosequencing. Microbial communities were described using the Shannon diversity and evenness indices. Principal component analysis (PCA) was used to group microbial community taxa into four factors representing correlated taxa. Of 108 children, 47 (44%) were colonized by S. pneumoniae, and 25 (23%) were diagnosed with otitis media. Microbial communities with S. pneumoniae were significantly less diverse and less even. Two PCA factors were associated with a decreased risk of pneumococcal colonization and otitis media, as follows: one factor included potentially protective flora (Corynebacterium and Dolosigranulum), and the other factor included Propionibacterium, Lactococcus, and Staphylococcus. The remaining two PCA factors were associated with an increased risk of otitis media. One factor included Haemophilus, and the final factor included Actinomyces, Rothia, Neisseria, and Veillonella. Generally, these taxa are not considered otitis media pathogens but may be important in the causal pathway. Increased understanding of upper respiratory tract microbial communities will contribute to the development of otitis media treatment and prevention strategies. Otitis media (middle ear infection) is the most common reason for pediatric sick visits in the United States. Streptococcus pneumoniae is a leading otitis media pathogen. S. pneumoniae must colonize the upper respiratory tract and compete with a complex community of nonpathogenic bacteria before infecting the middle ear. We compared microbial communities in the upper respiratory tract of children who had otitis media and those who did not. Members of the normal flora, i.e., Corynebacterium and Dolosigranulum, were protective for S. pneumoniae colonization and otitis media. As expected, the genera Haemophilus was associated with otitis media. Surprisingly, Actinomyces, Rothia, Neisseria, and Veillonella were associated with an increased risk of otitis media. These bacteria are not otitis media pathogens but may be associated with antibiotic use or involved in the causal pathway to disease. Increased understanding of upper respiratory tract microbial communities will lead to new ways to prevent middle ear infections, including probiotics.