Nottingham Digestive Diseases Centre and NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, the University of Nottingham, Nottingham, UK.
Human Microbiome Research Program, University of Helsinki Faculty of Medicine, Helsinki, Finland.
Gut. 2023 Mar;72(3):451-459. doi: 10.1136/gutjnl-2021-326828. Epub 2022 Sep 28.
Persistent bowel dysfunction following gastroenteritis (postinfectious (PI)-BD) is well recognised, but the associated changes in microbiota remain unclear. Our aim was to define these changes after gastroenteritis caused by a single organism, , examining the dynamic changes in the microbiota and the impact of antibiotics.
A single-centre cohort study of 155 patients infected with . Features of the initial illness as well as current bowel symptoms and the intestinal microbiota composition were recorded soon after infection (visit 1, <40 days) as well as 40-60 days and >80 days later (visits 2 and 3). Microbiota were assessed using 16S rRNA sequencing.
PI-BD was found in 22 of the 99 patients who completed the trial. The cases reported significantly looser stools, with more somatic and gastrointestinal symptoms. Microbiota were assessed in 22 cases who had significantly lower diversity and altered microbiota composition compared with the 44 age-matched and sex-matched controls. Moreover 60 days after infection, cases showed a significantly lower abundance of 23 taxa including phylum Firmicutes, particularly in the order Clostridiales and the family increased Proteobacteria abundance and increased levels of Fusobacteria and Gammaproteobacteria. The microbiota changes were linked with diet; higher fibre consumption being associated with lower levels of Gammaproteobacteria.
The microbiota of PI-BD patients appeared more disturbed by the initial infection compared with the microbiota of those who recovered. The prebiotic effect of high fibre diets may inhibit some of the disturbances seen in PI-BD.
NCT02040922.
肠炎后持续性肠功能紊乱（感染后（PI）-BD）已得到广泛认识，但相关的微生物群变化仍不清楚。我们的目的是在由单一病原体引起的肠炎后定义这些变化，研究肠炎后微生物群的动态变化以及抗生素的影响。
对 155 名感染 的患者进行单中心队列研究。在感染后<40 天（就诊 1）、40-60 天和>80 天（就诊 2 和 3）时，记录患者初始疾病的特征、当前肠道症状和肠道微生物群组成。使用 16S rRNA 测序评估微生物群。
99 例完成试验的患者中发现 22 例存在 PI-BD。报告病例的粪便明显更稀，且有更多的躯体和胃肠道症状。与 44 名年龄和性别匹配的对照相比，22 例病例的微生物多样性明显较低，且微生物群组成发生改变。此外，感染后 60 天，病例组的 23 个菌属丰度明显降低，包括厚壁菌门，特别是梭菌目和乳杆菌科；变形菌门丰度增加，梭杆菌门和γ-变形菌门水平升高。微生物群变化与饮食有关；高纤维饮食与较低水平的γ-变形菌门有关。
与恢复患者的微生物群相比，PI-BD 患者的微生物群似乎受到初始感染的干扰更大。高纤维饮食的益生元作用可能抑制了 PI-BD 中观察到的一些紊乱。
NCT02040922。
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