高 HIV 流行地区非洲母婴的母乳和肠道微生物群。
Breast milk and gut microbiota in African mothers and infants from an area of high HIV prevalence.
机构信息
Barcelona Centre for International Heath Research (CRESIB, Hospital Clínic -Universitat de Barcelona), Barcelona, Spain ; Manhiça Health Research Centre (CISM), Maputo, Mozambique.
出版信息
PLoS One. 2013 Nov 26;8(11):e80299. doi: 10.1371/journal.pone.0080299. eCollection 2013.
BACKGROUND
Human milk and infant gut microbiota are essential for the immune system maturation and protection against infections. There is scarce information on the microbiological composition of breast milk in general, and none from developing countries. The objective of the study was to characterize the breast milk and gut microbiota from mothers and infants from southern Mozambique, where infections and breastfeeding are prevalent.
METHODS
A community-based study was undertaken among 121 pairs of women and infants. Breast milk and infant's faeces were analyzed by bacterial culture and molecular methods. Breast milk samples were screened for HIV RNA by RT-PCR.
RESULTS
The most frequent bacterial groups isolated by culture media in breast milk were Staphylococci (96.4%), Streptococci (92.7%) and Lactobacilli (56.4%). HIV RNA was detected in 24% of the samples. Staphylococcus hominis, S. aureus, and S.parasanguis were more frequently isolated in infants ≤14 days of life. Women on exclusive breastfeeding presented higher proportion of S. parasanguis in breast milk than those on mixed infant feeding (36.4% versus 11.1%, p = 0.035). Bacterial diversity (mean number of bacterial species isolated by sample: 10.4 versus 8.5; p = 0.004) and the frequency of Lactobacillus spp (75.9% versus 36%, p = 0.003) were higher in the specimens with HIV RNA than in those without it. The main bacterial groups found in infant's faeces were Bifidobacterium, Streptococci and Enterococci.
CONCLUSIONS
Women with HIV RNA in breast milk had a different pattern of microbiological composition, suggesting specific immunopathological phenomena in HIV-infected women. Both breast milk and faecal microbiota composition varied with lactation period, which might be related to changes in the type of feeding over time and/or in the milk's biochemical characteristics. These findings provide insights into interactions between commensal bacteria and HIV infection in human milk and the role of these bacteria in mucosal protection against infections in breastfed infants.
背景
人乳和婴儿肠道微生物群对于免疫系统成熟和预防感染至关重要。关于一般母乳的微生物组成的信息很少，来自发展中国家的信息则更少。本研究的目的是描述莫桑比克南部母乳和婴儿肠道微生物群，因为那里感染和母乳喂养都很普遍。
方法
在 121 对母婴中进行了一项基于社区的研究。通过细菌培养和分子方法分析母乳和婴儿粪便。通过 RT-PCR 检测母乳样本中的 HIV RNA。
结果
通过培养介质在母乳中分离的最常见细菌群是葡萄球菌（96.4%）、链球菌（92.7%）和乳酸杆菌（56.4%）。24%的样本中检测到 HIV RNA。在 14 天以下的婴儿中，更常分离出表皮葡萄球菌、金黄色葡萄球菌和中间葡萄球菌。纯母乳喂养的女性母乳中 S. parasanguis 的比例高于混合喂养的女性（36.4%比 11.1%，p=0.035）。具有 HIV RNA 的样本的细菌多样性（通过样本分离的细菌种类的平均数量：10.4 比 8.5；p=0.004）和乳酸杆菌属的频率（75.9%比 36%，p=0.003）均高于没有 HIV RNA 的样本。婴儿粪便中主要的细菌群是双歧杆菌、链球菌和肠球菌。
结论
母乳中含有 HIV RNA 的女性的微生物组成模式不同，表明 HIV 感染女性存在特定的免疫病理现象。母乳和粪便微生物群组成随哺乳期而变化，这可能与随着时间的推移母乳喂养类型的变化和/或母乳生化特性的变化有关。这些发现为共生细菌与母乳中 HIV 感染的相互作用以及这些细菌在预防母乳喂养婴儿感染中的黏膜保护作用提供了新的见解。
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