School of Medicine, Ningbo University, Ningbo, China.
Ningbo Women and Children's Hospital, Ningbo, China.
J Clin Lab Anal. 2022 Mar;36(3):e24290. doi: 10.1002/jcla.24290. Epub 2022 Feb 11.
The intestine of newborns is colonized by bacteria immediately after birth. This study explored dominant bacteria and influencing factors of early intestinal colonization in the early life of very low birth weight infants (VLBWI).
We enrolled 81 VLBWI and collected anal swabs at 24 h, 7th, 14th and 21st day after birth. We conducted bacterial culture for anal swabs, then selected the colony with obvious growth advantages in the plate for further culture and identification. Afterward, we analyzed the distribution and influencing factors of intestinal dominant microbiota combined with clinical data.
A total of 300 specimens were collected, of which 62.67% (188/300) had obvious dominant bacteria, including 29.26% (55/188) Gram-positive bacteria and 70.74% (133/188) Gram-negative bacteria. The top five bacteria with the highest detection rates were Klebsiella pneumoniae, Escherichia coli, Enterococcus faecium, Enterococcus faecalis and Serratia marcescens. Meconium-stained amniotic fluid and chorioamnionitis were correlated with intestinal bacterial colonization within 24 h of birth. Mechanical ventilation and antibiotics were independent risk factors affecting colonization. Nosocomial infection of K. pneumoniae and S. marcescens were associated with intestinal colonization. The colonization rates of K. pneumoniae, E. coli, E. faecium, and E. faecalis increased with the birth time.
The colonization rate in the early life of VLBWI increased over time and the predominant bacteria were Gram-negative bacteria. Meconium-stained amniotic fluid and chorioamnionitis affect intestinal colonization in early life. Mechanical ventilation and antibiotics were independent risk factors for intestinal bacterial colonization. The nosocomial infection of some bacteria was significantly related to intestinal colonization.
新生儿的肠道在出生后立即被细菌定植。本研究旨在探讨极低出生体重儿（VLBWI）早期生活中肠道早期定植的优势菌及影响因素。
纳入 81 例 VLBWI，分别于生后 24 h、7 d、14 d 和 21 d 采集肛拭子，行细菌培养，挑取平板上生长优势明显的菌落进一步培养鉴定，结合临床资料分析肠道优势菌群的分布及其影响因素。
共采集标本 300 份，其中 62.67%（188/300）有明显优势菌定植，革兰阳性菌占 29.26%（55/188），革兰阴性菌占 70.74%（133/188）。检出率前五位的细菌分别为肺炎克雷伯菌、大肠埃希菌、屎肠球菌、粪肠球菌和黏质沙雷菌。生后 24 h 内胎粪污染羊水和绒毛膜羊膜炎与肠道细菌定植相关。机械通气和使用抗生素是影响定植的独立危险因素。医院获得性肺炎克雷伯菌和黏质沙雷菌感染与肠道定植相关。肺炎克雷伯菌、大肠埃希菌、屎肠球菌和粪肠球菌的定植率随出生时间增加而增加。
VLBWI 早期生活中的定植率随时间增加而增加，优势菌为革兰阴性菌。胎粪污染羊水和绒毛膜羊膜炎影响早期生活中的肠道定植。机械通气和抗生素是肠道细菌定植的独立危险因素。某些细菌的医院获得性感染与肠道定植显著相关。
