Bacterial and Fungal Microbiota Changes Distinguish C. difficile Infection from Other Forms of Diarrhea: Results of a Prospective Inpatient Study
Bacterial and Fungal Microbiota Changes Distinguish C. difficile Infection from Other Forms of Diarrhea: Results of a Prospective Inpatient Study
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DOI：
10.1096/fasebj.31.1_supplement.940.8
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发表时间：
2017-04
期刊：
影响因子：
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通讯作者：
J. Hackman;W. Sangster;J. Hegarty;K. Schieffer;Justin R. Wright;David R. Toole;Rebecca Drucker;D. Stewart;Regina Lamendella
中科院分区：
文献类型：
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作者：
J. Hackman;W. Sangster;J. Hegarty;K. Schieffer;Justin R. Wright;David R. Toole;Rebecca Drucker;D. Stewart;Regina Lamendella
本研究旨在描述腹泻住院患者中与艰难梭菌感染（CDI）相关的细菌和真菌微生物群变化，以进一步解释这种感染的发病机制，并可能指导新的CDI治疗。24例腹泻住院患者入组，其中12例有CDI。每例患者在接受艰难导向抗生素治疗前（适当时）接受粪便CDI检测。临床数据从病历中获得，而每份粪便样本都进行了细菌和真菌成分的16 S rRNA和ITS测序。还进行了与CDI种群不同的微生物群落结构的分析。结果表明，CDI和非CDI队列之间在任何先前报告的CDI风险因素方面没有差异。产酪菌在CDI和非CDI患者中均富集。在CDI患者中观察到了先前未报告的嗜粘蛋白阿克曼氏菌数量增加的发现，这是一种降解粘蛋白的微生物，因此可能为CDI提供选择性优势。青霉属的真菌成分在CDI中占主导地位;这些生物体产生抗菌化学物质，可能会抵抗健康微生物群的恢复。最常见的CDI微生物群落网络涉及消化链球菌科和肠球菌属，拟杆菌属的种群密度降低。在这项研究中还提出了细菌和真菌群落之间的相互作用。这些结果表明，CDI的发展与人类受试者中与CDI一致相关的微生物群变化相关。这些肠道分类群导致了与C.艰难感染
This study sought to characterize the bacterial and fungal microbiota changes associated with Clostridium difficile infection (CDI) among inpatients with diarrhea, in order to further explain the pathogenesis of this infection as well as to potentially guide new CDI therapies. Twenty-four inpatients with diarrhea were enrolled, 12 of whom had CDI. Each patient underwent stool testing for CDI prior to being treated with difficile-directed antibiotics, when appropriate. Clinical data was obtained from the medical record, while each stool sample underwent 16S rRNA and ITS sequencing for bacterial and fungal elements. An analysis of microbial community structures distinct to the CDI population was also performed. The results demonstrated no difference between the CDI and non-CDI cohorts with respect to any previously reported CDI risk factors. Butyrogenic bacteria were enriched in both CDI and non-CDI patients. A previously unreported finding of increased numbers of Akkermansia muciniphila in CDI patients was observed, an organism which degrades mucin and which therefore may provide a selective advantage toward CDI. Fungal elements of the genus Penicillium were predominant in CDI; these organisms produce antibacterial chemicals which may resist recovery of healthy microbiota. The most frequent CDI microbial community networks involved Peptostreptococcaceae and Enterococcus, with decreased population density of Bacteroides. Also presented in this study is the interaction among the bacterial and fungal communities. These results suggest that the development of CDI is associated with microbiota changes which are consistently associated with CDI in human subjects. These gut taxa contribute to the intestinal dysbiosis associated with C. difficile infection.