Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China.
Zigong City Center for Disease Control and Prevention, Zigong City, Sichuan, China.
Int J Infect Dis. 2021 Oct;111:313-321. doi: 10.1016/j.ijid.2021.08.064. Epub 2021 Sep 3.
The aim of this study was to identify the differences in diversity, composition, and function of the gut microbiota between tuberculosis (TB) patients and healthy controls (HCs).
A cross-sectional study was conducted in three cities of China. Stool samples from 94 treatment-naive TB patients and 62 HCs were analyzed by 16S rRNA gene sequencing. TB patients were further divided into antibiotic-free and antibiotic-exposure according to their use of non-specific antibiotics before the TB diagnosis.
Compared with HCs, antibiotic-free TB patients presented a different gut microbial community (P < 0.005) and decreased Shannon diversity (P < 0.005). Among TB patients, the relative abundances of short-chain fatty acid (SCFA)-producing genera such as Lachnospiraceae ND3007 group (log2(FC) = -2.74) were lower, while several conditional pathogen-related genera such as Enterococcus (log2(FC) = 12.05) and Rothia (log2(FC) = 6.322) were at higher levels. In addition, 41% of patients received antibiotics before TB diagnosis. Antibiotic exposure was correlated with an additional reduction in α diversity and depletion of SCFA-producing bacteria. Microbial functional analysis revealed that the biosynthesis capacity of amino acids and fatty acids was lower among TB patients compared to HCs.
Significant alterations in gut microbiota composition and metabolic pathways of TB patients were observed. Antibiotic exposure could alter the gut microbiota of TB patients, which should be considered in anti-TB treatment.
本研究旨在鉴定结核病（TB）患者和健康对照（HC）之间肠道微生物菌群的多样性、组成和功能差异。
在中国三个城市进行了一项横断面研究。通过 16S rRNA 基因测序分析了 94 例未经治疗的初治 TB 患者和 62 例 HCs 的粪便样本。根据 TB 诊断前是否使用非特异性抗生素，将 TB 患者进一步分为抗生素未暴露组和抗生素暴露组。
与 HCs 相比，抗生素未暴露的 TB 患者表现出不同的肠道微生物群落（P < 0.005）和 Shannon 多样性降低（P < 0.005）。在 TB 患者中，产生短链脂肪酸（SCFA）的属，如 Lachnospiraceae ND3007 组（log2(FC) = -2.74）的相对丰度较低，而一些条件致病菌相关的属，如肠球菌（log2(FC) = 12.05）和罗特氏菌（log2(FC) = 6.322）的相对丰度较高。此外，41%的患者在 TB 诊断前接受了抗生素治疗。抗生素暴露与 α 多样性的进一步降低和 SCFA 产生菌的耗竭有关。微生物功能分析显示，与 HCs 相比，TB 患者的氨基酸和脂肪酸生物合成能力较低。
观察到 TB 患者肠道微生物菌群组成和代谢途径的显著改变。抗生素暴露可能改变 TB 患者的肠道微生物菌群，这在抗 TB 治疗中应予以考虑。
