Penders John, Thijs Carel, Vink Cornelis, Stelma Foekje F, Snijders Bianca, Kummeling Ischa, van den Brandt Piet A, Stobberingh Ellen E
Department of Epidemiology, Nutrition and Toxicology Research Institute Maastricht, Maastricht University, PO Box 616, 6200 MD Maastricht, Netherlands.
Pediatrics. 2006 Aug;118(2):511-21. doi: 10.1542/peds.2005-2824.
The aim of this study was to examine the contribution of a broad range of external influences to the gut microbiotic composition in early infancy.
Fecal samples from 1032 infants at 1 month of age, who were recruited from the KOALA Birth Cohort Study in the Netherlands, were subjected to quantitative real-time polymerase chain reaction assays for the enumeration of bifidobacteria, Escherichia coli, Clostridium difficile, Bacteroides fragilis group, lactobacilli, and total bacterial counts. Information on potential determinants of the gut microbiotic composition was collected with repeated questionnaires. The associations between these factors and the selected gut bacteria were analyzed with univariate and multivariate analyses.
Infants born through cesarean section had lower numbers of bifidobacteria and Bacteroides, whereas they were more often colonized with C difficile, compared with vaginally born infants. Exclusively formula-fed infants were more often colonized with E coli, C difficile, Bacteroides, and lactobacilli, compared with breastfed infants. Hospitalization and prematurity were associated with higher prevalence and counts of C difficile. Antibiotic use by the infant was associated with decreased numbers of bifidobacteria and Bacteroides. Infants with older siblings had slightly higher numbers of bifidobacteria, compared with infants without siblings.
The most important determinants of the gut microbiotic composition in infants were the mode of delivery, type of infant feeding, gestational age, infant hospitalization, and antibiotic use by the infant. Term infants who were born vaginally at home and were breastfed exclusively seemed to have the most "beneficial" gut microbiota (highest numbers of bifidobacteria and lowest numbers of C difficile and E coli).
本研究旨在探讨多种外部因素对婴儿早期肠道微生物组成的影响。
从荷兰考拉出生队列研究中招募了1032名1月龄婴儿，采集其粪便样本，采用定量实时聚合酶链反应法检测双歧杆菌、大肠杆菌、艰难梭菌、脆弱拟杆菌群、乳酸杆菌以及总细菌数量。通过重复问卷调查收集肠道微生物组成潜在决定因素的信息。采用单因素和多因素分析方法分析这些因素与所选肠道细菌之间的关联。
与顺产婴儿相比，剖宫产出生的婴儿双歧杆菌和拟杆菌数量较少，而感染艰难梭菌的情况更为常见。与母乳喂养的婴儿相比，完全配方奶喂养的婴儿感染大肠杆菌、艰难梭菌、拟杆菌和乳酸杆菌的情况更为常见。住院和早产与艰难梭菌的高患病率和高数量有关。婴儿使用抗生素与双歧杆菌和拟杆菌数量减少有关。与没有兄弟姐妹的婴儿相比，有哥哥姐姐的婴儿双歧杆菌数量略高。
婴儿肠道微生物组成的最重要决定因素是分娩方式、婴儿喂养类型、胎龄、婴儿住院情况以及婴儿使用抗生素情况。在家中顺产并完全母乳喂养的足月儿似乎拥有最“有益”的肠道微生物群（双歧杆菌数量最多，艰难梭菌和大肠杆菌数量最少）。
