Tidjani Alou Maryam, Million Matthieu, Traore Sory I, Mouelhi Donia, Khelaifia Saber, Bachar Dipankar, Caputo Aurelia, Delerce Jeremy, Brah Souleymane, Alhousseini Daouda, Sokhna Cheikh, Robert Catherine, Diallo Bouli A, Diallo Aldiouma, Parola Philippe, Golden Michael, Lagier Jean-Christophe, Raoult Didier
URMITE, Aix Marseille Université, UM63, Centre National de la Recherche Scientifique 7278, IRD 198, Institut National de la Santé Et de la Recherche Médicale 1095, IHU-Méditerranée InfectionMarseille, France.
Laboratoire de Microbiologie, Département de Biologie, Université Abdou Moumouni de NiameyNiamey, Niger.
Front Microbiol. 2017 May 23;8:899. doi: 10.3389/fmicb.2017.00899. eCollection 2017.
Severe acute malnutrition is the world-leading cause of children under-five's death. Recent metagenomics studies have established a link between gut microbiota and severe acute malnutrition, describing an immaturity with a striking depletion in oxygen-sensitive prokaryotes. Amoxicillin and therapeutic diet cure most of the children with severe acute malnutrition but an irreversible disruption of the gut microbiota is suspected in the refractory and most severe cases. In these cases, therapeutic diet may be unable to reverse the microbiota alteration leading to persistent impaired development or death. In addition, as enteric sepsis is a major cause of death in this context, identification of missing gut microbes to be tested as probiotics (live bacteria that confer a benefit to the host) to restore rapidly the healthy gut microbiota and prevent the gut pathogenic invasion is of foremost importance. In this study, stool samples of malnourished patients with kwashiorkor and healthy children were collected from Niger and Senegal and analyzed by culturomics and metagenomics. We found a globally decreased diversity, a decrease in the hitherto unknown diversity (new species isolation), a depletion in oxygen-sensitive prokaryotes including and an enrichment in potentially pathogenic and . A complex of 12 species identified only in healthy children using culturomics and metagenomics were identified as probiotics candidates, providing a possible, defined, reproducible, safe, and convenient alternative to fecal transplantation to restore a healthy gut microbiota in malnourished children. Microbiotherapy based on selected strains has the potential to improve the current treatment of severe acute malnutrition and prevent relapse and death by reestablishing a healthy gut microbiota.
重度急性营养不良是全球五岁以下儿童死亡的首要原因。近期的宏基因组学研究已证实肠道微生物群与重度急性营养不良之间存在关联，描述了一种不成熟状态，其中对氧敏感的原核生物显著减少。阿莫西林和治疗性饮食可治愈大多数重度急性营养不良儿童，但在难治性和最严重的病例中，怀疑肠道微生物群存在不可逆的破坏。在这些病例中，治疗性饮食可能无法逆转微生物群的改变，从而导致发育持续受损或死亡。此外，由于肠道败血症是这种情况下的主要死亡原因，因此识别有待作为益生菌（对宿主有益的活细菌）进行测试的缺失肠道微生物，以迅速恢复健康的肠道微生物群并防止肠道病原体入侵至关重要。在本研究中，从尼日尔和塞内加尔收集了夸希奥科病营养不良患者和健康儿童的粪便样本，并通过培养组学和宏基因组学进行分析。我们发现整体多样性下降，迄今未知的多样性（新物种分离）减少，对氧敏感的原核生物减少，包括[具体内容缺失]，以及潜在致病性[具体内容缺失]和[具体内容缺失]增加。通过培养组学和宏基因组学仅在健康儿童中鉴定出的12种物种的复合体被确定为益生菌候选物，为粪便移植提供了一种可能、明确、可重复、安全且方便的替代方法，以恢复营养不良儿童的健康肠道微生物群。基于选定菌株的微生物疗法有可能改善当前重度急性营养不良的治疗，并通过重建健康的肠道微生物群预防复发和死亡。
