Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
College of Nursing, University of South Florida, Tampa, FL, USA.
Pediatr Res. 2019 Feb;85(3):361-368. doi: 10.1038/s41390-018-0254-y. Epub 2018 Dec 10.
Premature infants often develop enteric dysbiosis with a preponderance of Gammaproteobacteria, which has been related to adverse clinical outcomes. We investigated the relationship between increasing fecal Gammaproteobacteria and mucosal inflammation, measured by fecal calprotectin (FC).
Stool samples were collected from very-low-birth weight (VLBW) infants at ≤2, 3, and 4 weeks' postnatal age. Fecal microbiome was surveyed using polymerase chain reaction amplification of the V4 region of 16S ribosomal RNA, and FC was measured by enzyme immunoassay.
We enrolled 45 VLBW infants (gestation 27.9 ± 2.2 weeks, birth weight 1126 ± 208 g) and obtained stool samples at 9.9 ± 3, 20.7 ± 4.1, and 29.4 ± 4.9 days. FC was positively correlated with the genus Klebsiella (r = 0.207, p = 0.034) and its dominant amplicon sequence variant (r = 0.290, p = 0.003), but not with the relative abundance of total Gammaproteobacteria. Klebsiella colonized the gut in two distinct patterns: some infants started with low Klebsiella abundance and gained these bacteria over time, whereas others began with very high Klebsiella abundance.
In premature infants, FC correlated with relative abundance of a specific pathobiont, Klebsiella, and not with that of the class Gammaproteobacteria. These findings indicate a need to define dysbiosis at genera or higher levels of resolution.
早产儿常出现肠内菌群失调，以γ变形菌居多，这与不良临床结局相关。我们研究了粪便γ变形菌增多与粪便钙卫蛋白（FC）所测黏膜炎症之间的关系。
我们收集了≤2、3、4 周龄极低出生体重儿（VLBW）的粪便标本。采用 16S 核糖体 RNA V4 区聚合酶链反应扩增法检测粪便微生物群，用酶联免疫吸附法检测 FC。
我们纳入了 45 例 VLBW 婴儿（胎龄 27.9±2.2 周，出生体重 1126±208 g），并在 9.9±3、20.7±4.1 和 29.4±4.9 天获取粪便标本。FC 与克雷伯菌属（r=0.207，p=0.034）及其优势扩增子序列变异（r=0.290，p=0.003）呈正相关，但与总γ变形菌相对丰度无关。克雷伯菌在肠道中以两种不同的模式定植：一些婴儿开始时克雷伯菌丰度较低，随着时间的推移逐渐获得这些细菌，而另一些婴儿开始时克雷伯菌丰度非常高。
在早产儿中，FC 与特定条件致病菌，即克雷伯菌的相对丰度相关，而与γ变形菌纲无关。这些发现表明需要在属或更高分辨率水平上定义菌群失调。
