Assessment of Microbiome Variation During the Perioperative Period in Liver Transplant Patients: a Retrospective Analysis
Assessment of Microbiome Variation During the Perioperative Period in Liver Transplant Patients: a Retrospective Analysis
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DOI：
10.1007/s00248-013-0211-6
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发表时间：
2013-04-01
影响因子：
3.6
通讯作者：
Li, Lanjuan
中科院分区：
文献类型：
--
作者：
Lu, Haifeng;He, Jianqing;Li, Lanjuan
了解肝移植患者肠道微生物群的组成对预防术后感染很重要。我们研究了围手术期内术后感染风险与主要粪便微生物组成变化之间的关系。我们前瞻性地分析了5名无症状成人B型肝炎病毒携带者（作为对照，不使用任何抗生素）的主要肠道微生物组，这些患者在4周随访访视时和12名患者术前以及术后第一个月内3周随访访视时。通过变性梯度凝胶电泳（DGGE）和测序进行分析，并使用BioNumerics软件对DGGE图谱进行数字处理。我们的研究结果表明，在围手术期的8例患者中，主要肠道微生物多样性大幅下降。其中，5名患者术后住院超过30天，发生感染。其余4例术后住院时间较短的患者仅显示出与无症状对照组相似的主要肠道细菌组成和时间稳定性的轻微变化。术后粪便DGGE图谱显示大部分条带归属于拟杆菌属和厚壁菌属。我们的结论是，经验性的预防策略，破坏肠道微生态平衡将不会有效地降低术后感染的风险。相反，肠道微生物群的破坏可能导致机会致病菌的出现，如牙双歧杆菌，其很少出现在正常人的肠道DGGE图谱中。认识围手术期肠道微生物的变化是肝移植受者护理的一个关键方面。
Understanding the composition of the microbial populations in the intestines of liver transplant patients is important to preventing postoperative infection. We investigated the relationship between the risk of postoperative infection and variation in the predominant fecal microbial composition during the perioperative period. We prospectively analyzed the predominant intestinal microbiome of five asymptomatic adult carriers of hepatitis B virus (as controls without any antibiotics) at four weekly follow-up visits and 12 patients before operation and at three weekly postoperative follow-up visits within the first month. Analysis was by denaturing gradient gel electrophoresis (DGGE) and sequencing with digital processing of DGGE profiles using BioNumerics software. Our results showed that the predominant intestinal microbial diversity decreased substantially in eight patients during the perioperative period. Among these, five patients experienced infection with a postoperative hospital stay of more than 30 days. The rest of the four patients who experienced shorter postoperative hospital stays showed only slight variation in predominant intestinal bacterial composition and temporal stability similar to asymptomatic controls. Postoperative fecal DGGE profiles showed mostly bands assigned to Bacteroides and Firmicutes. We conclude that an empiric prophylaxis strategy that destructs gut microecological balance will not be effective in reducing the risk of postoperative infection. Instead, the destruction of intestinal microbiota might result in the appearance of opportunistic pathogens such as Bifidobacterium dentium which rarely appears in the intestinal DGGE profiles of normal humans. Cognizance of the variation of intestinal microbial profiles during the perioperative period is a critical aspect of caring for liver transplant recipients.