Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Kyushu University Faculty of Dental Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Appl Environ Microbiol. 2011 Oct;77(19):6739-45. doi: 10.1128/AEM.00651-11. Epub 2011 Aug 5.
Enteral tube feeding is widely used to maintain nutrition for elderly adults with eating difficulties, but its long-term use alters the environment of the oral ecosystem. This study characterized the tongue microbiota of tube-fed elderly adults by analyzing the 16S rRNA gene. The terminal restriction fragment length polymorphism (T-RFLP) profiles of 44 tube-fed subjects were compared with those of 54 subjects fed orally (average age, 86.4 ± 6.9 years). Bar-coded pyrosequencing data were also obtained for a subset of the subjects from each group (15 tube-fed subjects and 16 subjects fed orally). The T-RFLP profiles demonstrated that the microbiota of the tube-fed subjects was distinct from that of the subjects fed orally (permutational multivariate analysis of variance [perMANOVA], P < 0.001). The pyrosequencing data revealed that 22 bacterial genera, including Corynebacterium, Peptostreptococcus, and Fusobacterium, were significantly more predominant in tube-fed subjects, whereas the dominant genera in the subjects fed orally, such as Streptococcus and Veillonella, were present in much lower proportions. Opportunistic pathogens rarely detected in the normal oral microbiota, such as Corynebacterium striatum and Streptococcus agalactiae, were often found in high proportions in tube-fed subjects. The oral indigenous microbiota is disrupted by the use of enteral feeding, allowing health-threatening bacteria to thrive.
肠内管饲被广泛用于维持有进食困难的老年患者的营养，但长期使用会改变口腔生态系统的环境。本研究通过分析 16S rRNA 基因来描述经肠饲管喂养的老年患者的舌微生物群。将 44 名经肠饲管喂养的患者的末端限制性片段长度多态性（T-RFLP）图谱与 54 名经口喂养的患者的图谱进行了比较（平均年龄为 86.4±6.9 岁）。还对每组的一部分患者（15 名经肠饲管喂养患者和 16 名经口喂养患者）进行了带有条形码的焦磷酸测序数据的获取。T-RFLP 图谱表明，经肠饲管喂养患者的微生物群与经口喂养患者的微生物群明显不同（置换多元方差分析[perMANOVA]，P<0.001）。焦磷酸测序数据显示，22 个细菌属，包括 Corynebacterium、Peptostreptococcus 和 Fusobacterium，在经肠饲管喂养的患者中更为显著，而经口喂养的患者中的主要属，如 Streptococcus 和 Veillonella，比例则低得多。在正常口腔微生物群中很少检测到的机会性病原体，如 Corynebacterium striatum 和 Streptococcus agalactiae，在经肠饲管喂养的患者中常常以高比例存在。经肠喂养会破坏口腔固有微生物群，使威胁健康的细菌得以大量繁殖。
