The high prevalence of Clostridioides difficile among nursing home elders associates with a dysbiotic microbiome.
The high prevalence of Clostridioides difficile among nursing home elders associates with a dysbiotic microbiome.
复制标题
DOI：
10.1080/19490976.2021.1897209
复制
发表时间：
2021-01
期刊：
影响因子：
12.2
通讯作者：
Bucci V
中科院分区：
文献类型：
--
作者：
Haran JP;Ward DV;Bhattarai SK;Loew E;Dutta P;Higgins A;McCormick BA;Bucci V
艰难梭菌对养老院 (NH) 中老年人的影响尤为严重。我们的目的是探索新罕布什尔州老年人中艰难梭菌随时间的流行情况，并确定微生物组或其他临床因素是否与艰难梭菌定植相关。我们从新罕布什尔州居民那里收集了一系列粪便样本。通过定量聚合酶链反应检测毒素基因 tcdA 和 tcdB 来确定艰难梭菌患病率；通过鸟枪法宏基因组测序确定微生物组组成。我们使用混合效应随机森林建模机来确定其丰度与艰难梭菌患病率相关的细菌分类单元，同时控制临床协变量，包括人口统计、药物治疗和既往病史。我们招募了 167 名 NH 长者，他们提供了 506 份粪便样本。在提供多份样本的 123 名长者中，30 名（24.4%）长者提供了多份检测到艰难梭菌的样本，78 名（46.7%）长者至少有一份艰难梭菌阳性样本。患有艰难梭菌阳性样本的老年人的特征是致病性或炎症相关细菌类群丰度增加，而具有抗炎或共生特性的类群丰度较低。质子泵抑制剂 (PPI) 的使用与艰难梭菌患病率较低相关（优势比 0.46；95%CI，0.22-0.99），并且具有已知有益作用的细菌种类丰度在 PPI 使用者中较高，而在艰难梭菌患病率较高的老年人中则明显较低。艰难梭菌在新罕布什尔州老年人中普遍存在，肠道微生物群失调与艰难梭菌定植状态相关。操纵肠道微生物组可能被证明是减少 NH 中艰难梭菌的关键策略。
Clostridioides difficile disproportionally affects the elderly living in nursing homes (NHs). Our objective was to explore the prevalence of C. difficile in NH elders, over time and to determine whether the microbiome or other clinical factors are associated with C. difficile colonization. We collected serial stool samples from NH residents. C. difficile prevalence was determined by quantitative polymerase-chain reaction detection of Toxin genes tcdA and tcdB; microbiome composition was determined by shotgun metagenomic sequencing. We used mixed-effect random forest modeling machine to determine bacterial taxa whose abundance is associated with C. difficile prevalence while controlling for clinical covariates including demographics, medications, and past medical history. We enrolled 167 NH elders who contributed 506 stool samples. Of the 123 elders providing multiple samples, 30 (24.4%) elders yielded multiple samples in which C. difficile was detected and 78 (46.7%) had at least one C. difficile positive sample. Elders with C. difficile positive samples were characterized by increased abundances of pathogenic or inflammatory-associated bacterial taxa and by lower abundances of taxa with anti-inflammatory or symbiotic properties. Proton pump inhibitor (PPI) use is associated with lower prevalence of C. difficile (Odds Ratio 0.46; 95%CI, 0.22–0.99) and the abundance of bacterial species with known beneficial effects was higher in PPI users and markedly lower in elders with high C. difficile prevalence. C. difficile is prevalent among NH elders and a dysbiotic gut microbiome associates with C. difficile colonization status. Manipulating the gut microbiome may prove to be a key strategy in the reduction of C. difficile in the NH.
登录
查看更多内容
影响因子：
64.8
作者：
Devkota, Suzanne;Wang, Yunwei;Musch, Mark W.;Leone, Vanessa;Fehlner-Peach, Hannah;Nadimpalli, Anuradha;Antonopoulos, Dionysios A.;Jabri, Bana;Chang, Eugene B.
通讯作者：
Chang, Eugene B.
影响因子：
2.3
作者：
Finegold, SM;Lawson, PA;Collins, MD
通讯作者：
Collins, MD
影响因子：
64.8
作者：
Claesson, Marcus J.;Jeffery, Ian B.;O'Toole, Paul W.
通讯作者：
O'Toole, Paul W.
影响因子：
9.4
作者：
FALSEN, E;KAIJSER, B;SVEDHEM, A
通讯作者：
SVEDHEM, A
影响因子：
5.2
作者：
Davis-Richardson AG;Ardissone AN;Dias R;Simell V;Leonard MT;Kemppainen KM;Drew JC;Schatz D;Atkinson MA;Kolaczkowski B;Ilonen J;Knip M;Toppari J;Nurminen N;Hyöty H;Veijola R;Simell T;Mykkänen J;Simell O;Triplett EW
通讯作者：
Triplett EW