Study of the effect of enteral tube feeding on oral flora

将卧床不起的老年受试者（n=98）分为管饲摄入受试者组和口服营养摄入受试者组，并分析其舌苔的微生物群组成。由于通过Hae III消化的T-RFLP分析图谱在管饲摄入组和口服营养摄入组之间差异很大，因此假定两组之间的微生物群组成存在显著差异。然后，构建通过Rsa I、Msp I和HhaI而不是Hae III的限制性内切酶消化获得的两个或更多个T-RFLP峰图谱，并通过使用预先独特开发的计算机软件用峰型的组合重新分析细菌组成。然而，由于与口服营养摄入受试者相比，在管饲摄入受试者中特异性检测到的TRF都不对应于HOMD中登记的口腔细菌菌种。因此，在卧床不起的口服营养摄入受试者中选择17名管饲摄入受试者和17名口服营养摄入受试者作为Pyro序列分析的候选者。作为分析所获得的DNA序列的结果，清楚的是，在健康口腔中通常检测不到的无乳链球菌和纹状体棒状杆菌在管饲摄入受试者中以高比率被检测到。此外，由于仅在管饲组中也检测到了肺部问题的病原菌流感嗜血杆菌和铜绿假单胞菌，因此认为管饲摄入对口腔微生物群造成了很大的干扰。此外，还进行了关于管饲摄入受试者的细菌种类特征与全身健康的相关性的研究。然而，没有发现有意显示与临床症状独立相关的细菌种类。

Bedridden elderly subjects (n=98) were divided into the tube feeding ingestion subject group and the oral nutrition ingestion subject group and composition of microbiota of their tongue coating was analyzed. Since the T -RFLP analysis patterns by HaeIII digestion differed greatly between the tube feeding ingestion group and the oral nutrition ingestion group, the distinct difference in microbiota composition between two groups was assumed.Then, two or more T-RFLP peak patterns obtained by digestion of the restriction enzyme of RsaI, MspI and HhaI other than HaeIII constructed, and bacterial composition was re-analyzed with the combination of peak patterns by using the computer software uniquely developed beforehand. However, since TRFs which were specifically detected in the tube feeding ingestion subjects as compared with the oral nutrition ingestion subjects all did not correspond to the oral bacterial species registered into HOMD. Therefore, 17 tube feeding ingestion subjects and 17 oral nutrition ingestion subjects were selected among bedridden oral nutrition ingestion subjects as the candidates of pyro sequence analysis. As the result of having analyzed the obtained DNA sequence, it became clear that Streptococcus agalactiae and Corynebacterium striatum which are not usually detected in the healthy oral cavity were detected by a high ratio in the tube feeding ingestion subjects. Furthermore, since Haemophilus influenza and Pseudomonas aeruginosa which are pathogenic bacteria of pulmonary problems were also detected by only the tube feeding group, oral microbiota is thought to be greatly disturbed by the tube feeding ingestion.Furthermore, examination about the relevance of bacterial species characteristic of tube feeding ingestion subjects to systemic health was progressed. However, the bacterial species which showed independent relevance to clinical symptoms intentionally was not found.