Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
J Infect Chemother. 2020 Aug;26(8):795-801. doi: 10.1016/j.jiac.2020.03.008. Epub 2020 Apr 10.
Surgical antibiotic prophylaxis (SAP) is recommended for the prevention of surgical site infections. However, there is a concern about adverse effects of SAP, such as antibiotic-associated diarrhea (AAD). To prevent AAD, administration of probiotics has been investigated. Although recent advances in next-generation sequencing makes it possible to analyze the gut microbiome, the effect of probiotics on the gut microbiome in the patients with SAP remains unknown. To test a hypothesis that SAP influences the gut microbiome and probiotics prevent the influence, a randomized controlled study was conducted with patients who underwent spinal surgery at Nagasaki University Hospital. After obtaining informed consent, the patients were automatically classified into the non-probiotics group and the probiotics group. In the probiotics group, the patients took 1 g of Enterococcus faecium 129 BIO 3B-R, 3 times a day on postoperative days (PODs) 1-5. The feces of all patients were sampled before administration of SAP and on PODs 5 and 10. We compared alpha and beta diversity and differential abundance analysis of the gut microbiome before and after SAP. During the study period, a total of 33 patients were evaluated, comprising 17 patients in the non-probiotics group and 16 in the probiotics group. There was no significant difference between the groups regarding patient characteristics. In alpha and beta diversity, there were no significant differences among all combinations. In differential abundance analysis at operational taxonomic unit level, Streptococcus gallolyticus and Roseburia were significantly increased in the non-probiotics group and significantly decreased in the probiotics group.
手术抗生素预防（Surgical Antibiotic Prophylaxis，SAP）被推荐用于预防手术部位感染。然而，人们对 SAP 的不良反应（如抗生素相关性腹泻（Antibiotic-Associated Diarrhea，AAD））表示担忧。为了预防 AAD，人们研究了益生菌的应用。尽管新一代测序技术的进步使得分析肠道微生物组成为可能，但 SAP 患者中益生菌对肠道微生物组的影响仍不清楚。为了验证 SAP 会影响肠道微生物组，而益生菌可以预防这种影响的假设，在长崎大学医院进行了一项针对接受脊柱手术患者的随机对照研究。在获得知情同意后，患者被自动分为非益生菌组和益生菌组。在益生菌组中，患者在术后第 1-5 天每天服用 1g 屎肠球菌 129 BIO 3B-R，每天 3 次。所有患者在 SAP 给药前和术后第 5 天和第 10 天采集粪便样本。我们比较了 SAP 前后肠道微生物组的 alpha 和 beta 多样性和差异丰度分析。在研究期间，共评估了 33 名患者，其中非益生菌组 17 名，益生菌组 16 名。两组患者的特征无显著差异。在 alpha 和 beta 多样性方面，所有组合之间均无显著差异。在操作分类单元水平的差异丰度分析中，非益生菌组中的屎肠球菌和罗斯伯里氏菌显著增加，而益生菌组中的屎肠球菌和罗斯伯里氏菌显著减少。
