Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA, USA.
Gut Microbes. 2021 Jan-Dec;13(1):1-15. doi: 10.1080/19490976.2021.1897209.
disproportionally affects the elderly living in nursing homes (NHs). Our objective was to explore the prevalence of in NH elders, over time and to determine whether the microbiome or other clinical factors are associated with colonization.We collected serial stool samples from NH residents. prevalence was determined by quantitative polymerase-chain reaction detection of Toxin genes and ; microbiome composition was determined by shotgun metagenomic sequencing. We used mixed-effect random forest modeling machine to determine bacterial taxa whose abundance is associated with prevalence while controlling for clinical covariates including demographics, medications, and past medical history.We enrolled 167 NH elders who contributed 506 stool samples. Of the 123 elders providing multiple samples, 30 (24.4%) elders yielded multiple samples in which was detected and 78 (46.7%) had at least one positive sample. Elders with positive samples were characterized by increased abundances of pathogenic or inflammatory-associated bacterial taxa and by lower abundances of taxa with anti-inflammatory or symbiotic properties. Proton pump inhibitor (PPI) use is associated with lower prevalence of (Odds Ratio 0.46; 95%CI, 0.22-0.99) and the abundance of bacterial species with known beneficial effects was higher in PPI users and markedly lower in elders with high prevalence. is prevalent among NH elders and a dysbiotic gut microbiome associates with colonization status. Manipulating the gut microbiome may prove to be a key strategy in the reduction of in the NH.
在养老院（NH）中生活的老年人中不成比例地受到影响。我们的目的是探讨 NH 老年人中 的流行情况随时间的变化，并确定微生物组或其他临床因素是否与 定植有关。
我们从 NH 居民中收集了一系列粪便样本。通过定量聚合酶链反应检测毒素基因 和 来确定 的流行情况；通过 shotgun 宏基因组测序来确定微生物组组成。我们使用混合效应随机森林建模机器来确定与 流行率相关的细菌分类群的丰度，同时控制包括人口统计学、药物和既往病史在内的临床协变量。
我们招募了 167 名 NH 老年人，他们提供了 506 份粪便样本。在提供多个样本的 123 名老年人中，有 30 名（24.4%）老年人的多个样本中检测到 ，78 名（46.7%）老年人至少有一个 阳性样本。 阳性样本的老年人的特征是致病性或炎症相关细菌分类群的丰度增加，而具有抗炎或共生特性的分类群的丰度降低。质子泵抑制剂（PPI）的使用与 的低流行率相关（优势比 0.46；95%置信区间，0.22-0.99），并且 PPI 使用者中具有已知有益效果的细菌种类的丰度较高，而在 流行率高的老年人中则明显较低。 在 NH 老年人中很普遍，肠道微生物组的失调与 定植状态有关。 操纵肠道微生物组可能被证明是减少 NH 中 的关键策略。
