剖宫产术后的肠道菌群失调会促使婴儿体内产毒素的产气荚膜梭菌的定植增加。

Gut dysbiosis following C-section instigates higher colonisation of toxigenic Clostridium perfringens in infants.

作者信息

Nagpal R, Tsuji H, Takahashi T, Nomoto K, Kawashima K, Nagata S, Yamashiro Y

机构信息

1 Laboratory for Probiotics Research (Yakult), Juntendo University, Graduate School of Medicine, Hongo 2-9-8-3F, Bunkyo-ku, Tokyo 113-0033, Japan.

2 Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan.

出版信息

Benef Microbes. 2017 May 30;8(3):353-365. doi: 10.3920/BM2016.0216. Epub 2017 May 15.

DOI:10.3920/BM2016.0216

PMID:28504574

Abstract

Herein we investigated the intestinal carriage of α-toxigenic and enterotoxigenic Clostridium perfringens during infancy, focusing on its association with other gut microbes and mode of delivery and feeding. Faecal samples from 89 healthy term infants were collected at age 7 days, 1 month, 3 months, 6 months and 3 years. C. perfringens was quantified by qPCR; other gut bacteria were quantified by reverse-transcription-qPCR. Alpha-toxigenic C. perfringens was detected in 3.4% infants at day 7 but was present in 35-40% infants at subsequent time-points, with counts ranging from 10-10 cells/g faeces. Enterotoxigenic C. perfringens remained undetected at day 7 but was detected in 1.1, 4.5, 10.1 and 4.5% infants at 1 month, 3 months, 6 months and 3 years, respectively. Intriguingly, infants carrying α-toxigenic C. perfringens had lower levels of Bacteroides fragilis group, bifidobacteria, lactobacilli and organic acids as compared to non-carriers. Further analyses revealed that, compared to vaginally-born infants, caesarean-born infants had higher carriage of C. perfringens and lower levels of B. fragilis group, bifidobacteria, lactobacilli and faecal organic acids during first 6 months. Compared to formula-fed infants, breast-fed infants were slightly less often colonised with C. perfringens; and within caesarean-born infants, breast-fed infants had slightly lower levels of C. perfringens and higher levels of B. fragilis group, bifidobacteria, and lactobacilli than formula-fed infants. This study demonstrates the quantitative dynamics of toxigenic C. perfringens colonisation in infants during the early years of life. Caesarean-born infants acquire a somewhat perturbed microbiota, and breast-feeding might be helpful in ameliorating this dysbiosis. Higher carriage of toxigenic C. perfringens in healthy infants is intriguing and warrants further investigation of its sources and clinical significance in infants, particularly the caesarean-born who may represent a potential reservoir of this opportunistic pathogen and might be more prone to associated illnesses.

摘要

在此，我们研究了婴儿期产α毒素和产肠毒素的产气荚膜梭菌在肠道中的携带情况，重点关注其与其他肠道微生物以及分娩方式和喂养方式的关联。收集了89名足月健康婴儿在7日龄、1月龄、3月龄、6月龄和3岁时的粪便样本。通过qPCR对产气荚膜梭菌进行定量；通过逆转录-qPCR对其他肠道细菌进行定量。7日龄时，3.4%的婴儿检测到产α毒素的产气荚膜梭菌，但在随后的时间点，35%-40%的婴儿携带该菌，粪便中菌数范围为10⁴-10⁷个/克。7日龄时未检测到产肠毒素的产气荚膜梭菌，但在1月龄、3月龄、6月龄和3岁时分别在1.1%、4.5%、10.1%和4.5%的婴儿中检测到。有趣的是，与未携带产α毒素产气荚膜梭菌的婴儿相比，携带该菌的婴儿脆弱拟杆菌群、双歧杆菌、乳酸杆菌和有机酸水平较低。进一步分析表明，与阴道分娩的婴儿相比，剖宫产出生的婴儿在出生后头6个月产气荚膜梭菌携带率更高，而脆弱拟杆菌群、双歧杆菌、乳酸杆菌和粪便有机酸水平较低。与人工喂养的婴儿相比，母乳喂养的婴儿产气荚膜梭菌定植的频率略低；在剖宫产出生的婴儿中，母乳喂养的婴儿产气荚膜梭菌水平略低，而脆弱拟杆菌群、双歧杆菌和乳酸杆菌水平高于人工喂养的婴儿。本研究揭示了生命早期婴儿中产毒素产气荚膜梭菌定植的定量动态变化。剖宫产出生的婴儿获得的微生物群有所紊乱，母乳喂养可能有助于改善这种生态失调。健康婴儿中产毒素产气荚膜梭菌携带率较高这一现象很有趣，值得进一步研究其在婴儿中的来源和临床意义，尤其是剖宫产出生的婴儿，他们可能是这种机会性病原体的潜在储存宿主，可能更容易患相关疾病。