Risk factors and intestinal microbiota: Clostridioides difficile infection in patients receiving enteral nutrition at Intensive Care Units
Risk factors and intestinal microbiota: Clostridioides difficile infection in patients receiving enteral nutrition at Intensive Care Units
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危险因素和肠道微生物群：在重症监护病房接受肠内营养的患者中艰难梭菌感染
DOI：
10.1186/s13054-020-03119-7
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发表时间：
2020-07
期刊：
影响因子：
15.1
通讯作者：
Yibing Peng
中科院分区：
文献类型：
--
作者：
Daosheng Wang;Danfeng Dong;Chen Wang;Yingchao Cui;Cen Jiang;Qi Ni;Tongxuan Su;Guanzheng Wang;Enqiang Mao;Yibing Peng
抽象。背景艰难梭菌感染（CDI）是医院内腹泻的主要原因。在重症监护室（ICU）接受肠内营养（EN）的患者可能存在CDI的高风险。在本研究中，我们评估了患者的危险因素和肠道微生物组，以更好地了解CDI的发生和发展。方法.对患者进行C.并收集患者的临床资料进行危险因素分析。使用16 S rRNA测序分析粪便样品以评估肠道微生物群。结果CDI的总体发生率为10.7%（18/168例患者）。脑梗死史与CDI发生显著相关（OR，9.759; 95%CI，2.140-44.498），甲硝唑治疗被确定为保护性的（OR，0.287; 95%CI，0.091-0.902）。EN患者的细菌丰富度和多样性较低，并伴有拟杆菌、普雷沃菌_9、瘤胃球菌科和毛螺菌科的丰度显著下降。在这些患者中，C. difficile导致微生物多样性的短暂增加，沿着一些细菌分类群的比例的一致改变，特别是瘤胃球菌科和毛螺菌科。开始EN时，C.艰难梭菌随后显示类杆菌的负荷增加，这与C.当CDI发展的时候，结论接受EN的ICU患者CDI的患病率较高，肠道微生物环境脆弱。脑梗死史和甲硝唑治疗史分别被认为是重要的危险因素和保护因素。我们认为，CDI的出现可能会导致肠道微生物群的保护性改变。此外，拟杆菌的负荷似乎与CDI的发生和发展密切相关。
Abstract. Background. Clostridioides difficile infection (CDI) is a leading cause of nosocomial diarrhea. Patients receiving enteral nutrition (EN) in the intensive care unit (ICU) are potentially at high risk of CDI. In the present study, we assessed the risk factors and intestinal microbiome of patients to better understand the occurrence and development of CDI.. Methods. Patients were screened for C. difficile every week after starting EN, and their clinical records were collected for risk factor identification. Fecal samples were analyzed using 16S rRNA sequencing to evaluate the intestinal microbiota.. Results. Overall incidence of CDI was 10.7% (18/168 patients). History of cerebral infarction was significantly associated with CDI occurrence (OR, 9.759; 95% CI, 2.140–44.498), and treatment with metronidazole was identified to be protective (OR, 0.287; 95% CI, 0.091–0.902). Patients with EN had lower bacterial richness and diversity, accompanied by a remarkable decrease in the abundance of Bacteroides, Prevotella_9, Ruminococcaceae, and Lachnospiraceae. Of these patients, acquisition of C. difficile resulted in a transient increase in microbial diversity, along with consistent alterations in the proportion of some bacterial taxa, especially Ruminococcaceae and Lachnospiraceae. Upon initiation of EN, patients who were positive for C. difficile later showed an enhanced load of Bacteroides, which was negatively correlated with the abundance of C. difficile when CDI developed.. Conclusion. ICU patients receiving EN have a high prevalence of CDI and a fragile intestinal microbial environment. History of cerebral infarction and prior treatment with metronidazole are considered as vital risk and protective factors, respectively. We propose that the emergence of CDI could cause a protective alteration of the intestinal microbiota. Additionally, Bacteroides loads seem to be closely related to the occurrence and development of CDI.
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肠道微生物群形成短链脂肪酸及其对人代谢的影响。
影响因子：
12.2
作者：
Morrison DJ;Preston T
通讯作者：
Preston T
DOI：
10.1096/fasebj.31.1_supplement.940.8
发表时间：
2017-04
期刊：
The FASEB Journal
影响因子：
--
作者：
J. Hackman;W. Sangster;J. Hegarty;K. Schieffer;Justin R. Wright;David R. Toole;Rebecca Drucker;D. Stewart;Regina Lamendella
通讯作者：
J. Hackman;W. Sangster;J. Hegarty;K. Schieffer;Justin R. Wright;David R. Toole;Rebecca Drucker;D. Stewart;Regina Lamendella
影响因子：
4.2
作者：
Guh, Alice Y.;Adkins, Susan Hocevar;McDonald, L. Clifford
通讯作者：
McDonald, L. Clifford
影响因子：
6.4
作者：
Lee, Yeon Joo;Arguello, Esther S.;Taur, Ying
通讯作者：
Taur, Ying
影响因子：
11.8
作者：
Dubberke, Erik R.;Reske, Kimberly A.;Fraser, Victoria J.
通讯作者：
Fraser, Victoria J.