Study of the effect of enteral tube feeding on oral flora

将98例卧床老人分为管饲摄食组和口腔营养摄食组，分析其舌苔菌群组成。由于HaeIII消化的T -RFLP分析模式在管饲摄食组和口服营养摄食组之间存在较大差异，因此假设两组之间的微生物群组成存在明显差异。然后，构建除HaeIII外的RsaI、MspI和HhaI酶切得到的两个或两个以上的T-RFLP峰型，并利用事先专门开发的计算机软件结合峰型重新分析细菌组成。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TRFs均与登记在HOMD中的口腔细菌种类不一致。因此，在卧床口服营养摄入受试者中选取17例管饲摄入受试者和17例口服营养摄入受试者作为热序列分析的候选对象。对获得的DNA序列进行分析，发现在健康口腔中不常见的无乳链球菌和纹状棒状杆菌在管饲摄食对象中检出率很高。此外，由于流感嗜血杆菌和铜绿假单胞菌这两种肺部疾病的致病菌也仅在管饲组中检测到，因此口腔微生物群被认为受到管饲摄入的极大干扰。此外，研究了管饲摄食对象的细菌种类特征与全身健康的相关性。然而，没有发现与临床症状有独立相关性的细菌种类。

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.