Liu Jing, Wang Mingbang, Chen Weiming, Ma Jian, Peng Yi, Zhang Mingzhi, Wang Chuanqing, Yan Gangfeng, Lu Guoping
Pediatric Intensive Care Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
Shanghai Key Laboratory of Birth Defects, Division of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
Front Pediatr. 2021 Apr 7;9:645060. doi: 10.3389/fped.2021.645060. eCollection 2021.
The gut is thought to play an important role in the pathogenesis of sepsis. Changes in the gut microbiota are closely related to the occurrence and development of human diseases, but few studies have focused on taxonomic composition of gut microbiota in septic patients. Knowledge of changes in the gut microbiota is a key issue in intensive care. Clinicians must understand how an altered gut microbiota affects the susceptibility and prognosis of septic patients. In the single-center case control study, 20 septic patients and 20 healthy children were recruited. The taxonomic composition of gut microbiota was determined 16S rRNA gene sequencing. Gut microbiota diversity in children with sepsis was significantly reduced compared with that in healthy children. The taxonomic composition of gut microbiota can effectively distinguish children with sepsis from healthy children. Thirteen taxa of gut microbiota were significantly increased in the guts of children with sepsis compared with those of healthy children. The increased abundances of Enterococcaceae, , and in gut of septic patients were significantly positively correlated with blood inflammation indicators CRP and WBC. The abundances of seven bacteria were significantly decreased in the guts of septic children compared with those of healthy children. The decreased abundance of Bifidobacteriales in gut of septic patients is significantly negatively correlated with blood inflammation index WBC. A machine-learning classifier was built for distinguishing sepsis and achieved the AUC value of 81.25%. It shows that the composition of gut microbiota has certain potential for diagnosis of sepsis. Gut microbiota alterations in septic patients exhibit proliferation of opportunistic pathogenic bacteria, the massive reduction of the commensal flora, and the significant decrease in the diversity of the gut microbiota. Dysbiosis may also account for some changes in the inflammation indexes.
肠道被认为在脓毒症发病机制中起重要作用。肠道微生物群的变化与人类疾病的发生和发展密切相关，但很少有研究关注脓毒症患者肠道微生物群的分类组成。了解肠道微生物群的变化是重症监护中的一个关键问题。临床医生必须了解肠道微生物群的改变如何影响脓毒症患者的易感性和预后。在这项单中心病例对照研究中，招募了20名脓毒症患者和20名健康儿童。通过16S rRNA基因测序确定肠道微生物群的分类组成。脓毒症患儿的肠道微生物群多样性与健康儿童相比显著降低。肠道微生物群的分类组成可以有效区分脓毒症患儿和健康儿童。与健康儿童相比，脓毒症患儿肠道中13种肠道微生物分类群显著增加。脓毒症患者肠道中肠球菌科等的丰度增加与血液炎症指标CRP和WBC显著正相关。与健康儿童相比，脓毒症患儿肠道中7种细菌的丰度显著降低。脓毒症患者肠道中双歧杆菌目的丰度降低与血液炎症指标WBC显著负相关。构建了一个用于区分脓毒症的机器学习分类器，其AUC值为81.25%。这表明肠道微生物群的组成在脓毒症诊断方面具有一定潜力。脓毒症患者的肠道微生物群改变表现为机会致病菌增殖、共生菌群大量减少以及肠道微生物群多样性显著降低。生态失调也可能导致炎症指标的一些变化。
