Patterned progression of gut microbiota associated with necrotizing enterocolitis and late onset sepsis in preterm infants: a prospective study in a Chinese neonatal intensive care unit
Patterned progression of gut microbiota associated with necrotizing enterocolitis and late onset sepsis in preterm infants: a prospective study in a Chinese neonatal intensive care unit
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早产儿坏死性小肠结肠炎和迟发性败血症相关的肠道菌群模式进展：中国新生儿重症监护病房的一项前瞻性研究
DOI：
10.7717/peerj.7310
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发表时间：
2019-07-22
期刊：
影响因子：
2.7
通讯作者：
Hong, Li
中科院分区：
文献类型：
--
作者：
Liu, Jiayi;Li, Yuqing;Hong, Li
坏死性小肠结肠炎(NEC)和迟发性败血症(LOS)是两种常见的早产并发症，发病率和死亡率都很高。欧洲和美国最近的研究将肠道微生物区系失调与其病因联系起来。然而，在亚洲人群中进行的类似研究仍然很少。在这项初步研究中，我们描述了24名中国早产儿从出生到死亡或从NICU出院的肠道微生物区系。其中4人发展为NEC，3人发展为LOS。出乎意料的是，我们在所有患者出生后不久就检测到了成分相似的高度多样化的微生物群。然而，随着患者年龄的增长，病例组与对照组的微生物多样性明显不同。这些差异在出生第三天后出现，并在NEC和LOS的整个过程中持续存在。使用具有随机效应的零膨胀贝塔回归模型，我们在NEC和LOS发病前检测到较高的芽孢杆菌(p=0.032)和梭状芽孢杆菌(p=0.047)。在NEC进展过程中，肠球菌、链球菌和消化梭菌是优势菌群，而在LOS进展过程中，克雷伯菌属是唯一一种诊断血培养也检出的优势菌属。这些结果值得进一步研究，以确定致病微生物模式和潜在机制。
Necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) are two common premature birth complications with high morbidity and mortality. Recent studies in Europe and America have linked gut microbiota dysbiosis to their etiology. However, similar studies in Asian populations remain scant. In this pilot study, we profiled gut microbiota of 24 Chinese preterm infants from birth till death or discharge from NICU. Four of them developed NEC and three developed LOS. Unexpectedly, we detected highly-diversified microbiota with similar compositions in all patients shortly after birth. However, as patients aged, the microbial diversities in case groups differed significantly from that of the control group. These differences emerged after the third day of life and persisted throughout the course of both NEC and LOS. Using a Zero-Inflated Beta Regression Model with Random Effects (ZIBR), we detected higher Bacillus (p = 0.032) and Solibacillus (p = 0.047) before the onset of NEC and LOS. During NEC progression, Enterococcus, Streptococcus and Peptoclostridium were the dominant genera while during LOS progression; Klebsiella was the only dominant genus that was also detected by the diagnostic hemoculture. These results warrant further studies to identify causative microbial patterns and underlying mechanisms.