Université Paris Descartes, EA4065, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France.
PLoS One. 2012;7(1):e30594. doi: 10.1371/journal.pone.0030594. Epub 2012 Jan 26.
Although premature neonates (PN) gut microbiota has been studied, data about gut clostridial colonization in PN are scarce. Few studies have reported clostridia colonization in PN whereas Bacteroides and bifidobacteria have been seldom isolated. Such aberrant gut microbiota has been suggested to be a risk factor for the development of intestinal infections. Besides, PN are often treated by broad spectrum antibiotics, but little is known about how antibiotics can influence clostridial colonization based on their susceptibility patterns. The aim of this study was to report the distribution of Clostridium species isolated in feces from PN and to determine their antimicrobial susceptibility patterns. Additionally, clostridial colonization perinatal determinants were analyzed.
Of the 76 PN followed until hospital discharge in three French neonatal intensive care units (NICUs), 79% were colonized by clostridia. Clostridium sp. colonization, with a high diversity of species, increased throughout the hospitalization. Antibiotic courses had no effect on the clostridial colonization incidence although strains were found susceptible (except C. difficile) to anti-anaerobe molecules tested. However, levels of colonization were decreased by either antenatal or neonatal (during more than 10 days) antibiotic courses (p = 0.006 and p = 0.001, respectively). Besides, incidence of colonization was depending on the NICU (p = 0.048).
This study shows that clostridia are part of the PN gut microbiota. It provides for the first time information on the status of clostridia antimicrobial susceptibility in PN showing that strains were susceptible to most antibiotic molecules. Thus, the high prevalence of this genus is not linked to a high degree of resistance to antimicrobial agents or to the use of antibiotics in NICUs. The main perinatal determinant influencing PN clostridia colonization appears to be the NICU environment.
尽管已经研究了早产儿（PN）肠道微生物群，但关于 PN 肠道梭菌定植的数据却很少。很少有研究报告过 PN 中梭菌的定植，而双歧杆菌和拟杆菌很少被分离出来。这种异常的肠道微生物群被认为是肠道感染发展的一个危险因素。此外，PN 经常接受广谱抗生素治疗，但关于抗生素如何根据其药敏模式影响梭菌定植知之甚少。本研究旨在报告从 PN 粪便中分离出的梭菌属的分布，并确定其抗菌药物敏感性模式。此外，还分析了围产期决定梭菌定植的因素。
在法国三家新生儿重症监护病房（NICU）中，对 76 名接受住院治疗的 PN 进行了随访，其中 79%的 PN 被梭菌定植。随着住院时间的延长，梭菌属的定植率逐渐升高，定植种类也越来越多样化。虽然测试的抗厌氧菌药物（除艰难梭菌外）对分离株均敏感，但抗生素疗程对梭菌定植的发生率没有影响。然而，无论是产前还是新生儿期（超过 10 天）的抗生素疗程都会降低定植水平（p=0.006 和 p=0.001）。此外，定植的发生率还取决于 NICU（p=0.048）。
本研究表明，梭菌是 PN 肠道微生物群的一部分。首次提供了有关 PN 梭菌抗菌药物敏感性状况的信息，表明菌株对大多数抗生素药物敏感。因此，该属的高流行率与对抗生素药物的高耐药率或 NICU 中抗生素的使用无关。影响 PN 梭菌定植的主要围产期决定因素似乎是 NICU 环境。
