Association of Chorioamnionitis with Aberrant Neonatal Gut Colonization and Adverse Clinical Outcomes.
Association of Chorioamnionitis with Aberrant Neonatal Gut Colonization and Adverse Clinical Outcomes.
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DOI：
10.1371/journal.pone.0162734
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Kallapur SG
中科院分区：
文献类型：
--
作者：
Puri K;Taft DH;Ambalavanan N;Schibler KR;Morrow AL;Kallapur SG
绒毛膜炎（胎盘和胎膜炎症）和异常胃肠道定植与早产儿败血症和死亡风险增加相关，但绒毛膜炎是否会导致婴儿异常先锋胃肠道定植尚不清楚。我们确定了绒毛膜炎、婴儿粪便微生物组改变（表明胃肠道定植异常）与不良结局之间的关系。出生时≤ 28周的早产儿从辛辛那提、俄亥俄州和伯明翰、亚拉巴马的3个III级NICU入组。对出生后前3周的粪便样本进行16 S微生物基因测序。绒毛膜炎由胎盘组织学诊断。分析了迟发性脓毒症和死亡结局与粪便微生物群和绒毛膜炎（伴或不伴脐带炎）的关系。在106名入组婴儿中，48名婴儿无绒毛膜炎，32名婴儿有绒毛膜炎但无精索炎（AC），26名婴儿有绒毛膜炎伴精索炎（ACF）。出生7天采集的ACF婴儿粪便样本中支原体科（Tenericutes门）、普雷沃氏菌属（拟杆菌门）和Sneathia属（梭菌门）的相对丰度较高。此外，AC和ACF婴儿的迟发性脓毒症/死亡的发生率较高，作为一个组合的结果。粪便样本中特定分支的存在，特别是梭杆菌目、Sneathia属或支原体科，与败血症或死亡的高风险显著相关。研究结果支持了这一假设，即由绒毛膜炎诱导的开创性婴儿胃肠道微生物群的特定改变易导致新生儿败血症或死亡。
Chorioamnionitis (inflammation of the placenta and fetal membranes) and abnormal gastrointestinal colonization have been associated with an increased risk of sepsis and death in preterm infants, but whether chorioamnionitis causes abnormal pioneering gastrointestinal colonization in infants is not known. We determined the relationship between chorioamnionitis, altered infant fecal microbiome indicating abnormal gastrointestinal colonization, and adverse outcomes. Preterm infants ≤ 28 weeks at birth were enrolled from 3 level III NICUs in Cincinnati, Ohio and Birmingham, Alabama. Sequencing for 16S microbial gene was performed on stool samples in the first 3 weeks of life. Chorioamnionitis was diagnosed by placental histology. Late onset sepsis and death outcomes were analyzed in relation to fecal microbiota and chorioamnionitis with or without funisitis (inflammation of the umbilical cord). Of the 106 enrolled infants, 48 infants had no chorioamnionitis, 32 infants had chorioamnionitis but no funisitis (AC), and 26 infants had chorioamnionitis with funisitis (ACF). The fecal samples from ACF infants collected by day of life 7 had higher relative abundance of family Mycoplasmataceae (phylum Tenericutes), genus Prevotella (phylum Bacteroidetes) and genus Sneathia (phylum Fusobacteria). Further, AC and ACF infants had higher incidence of late-onset sepsis/death as a combined outcome. Presence of specific clades in fecal samples, specifically, order Fusobacteria, genus Sneathia or family Mycoplasmataceae, were significantly associated with higher risk of sepsis or death. The results support the hypothesis that specific alterations in the pioneering infant gastrointestinal microbiota induced by chorioamnionitis predispose to neonatal sepsis or death.
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DOI：
10.1136/fetalneonatal-2011-301373
发表时间：
2012-11
期刊：
Archives of disease in childhood. Fetal and neonatal edition
影响因子：
--
作者：
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DOI：
10.1073/pnas.1002601107
发表时间：
2010-06-29
影响因子：
11.1
作者：
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Knight, Rob
DOI：
10.1073/pnas.1502875112
发表时间：
2015-09-01
影响因子：
11.1
作者：
DiGiulio, Daniel B.;Callahan, Benjamin J.;Relman, David A.
通讯作者：
Relman, David A.
影响因子：
5.1
作者：
Kuppala, Venkata S.;Meinzen-Derr, Jareen;Morrow, Ardythe L.;Schibler, Kurt R.
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Schibler, Kurt R.
影响因子：
17.1
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Versalovic J