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袋鼠式护理对极早产儿皮肤微生物组的影响——一项初步研究。

Impact of Kangaroo Mother Care on Skin Microbiome of Very Preterm Infants - A Pilot Study.

机构信息

Department of Pediatrics, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.

Undergraduate (MBBS), Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.

出版信息

Indian J Pediatr. 2024 Mar;91(3):229-234. doi: 10.1007/s12098-023-04562-4. Epub 2023 Apr 11.

DOI:10.1007/s12098-023-04562-4
PMID:37040016
Abstract

OBJECTIVES

To test whether Kangaroo mother care (KMC) aids in transfer of favourable skin microbiome from mother to infant by comparing the microbiome composition before and after KMC.

METHODS

A prospective cohort pilot study was conducted in a Level III neonatal intensive care unit (NICU) in South India, recruiting 30 preterm infants with gestation <32 wk from October 2020 through December 2020. Neonatal skin involving the area in contact with the mother during KMC i.e., axilla, chest and abdomen was swabbed at the end of first week of life, prior to initiation of KMC. The 2nd swab involving the same areas was taken following KMC for 7 d for at least 6 h a day. The swabs were analysed using Next Generation Sequencing (NGS) - 16sRNA and abundance of organisms isolated were mapped. Statistical analyses using t-test and PERMANOVA were performed to compare phyla and genera of bacterial abundance pre-KMC and post-KMC.

RESULTS

KMC at phyla level increased the relative abundance of Firmicutes (p=0.52) and significantly decreased Proteobacteria (p=0.02). At species level, KMC decreased pathogenic bacterial count of Escherichia (p=0.05), while counts of S. hemolyticus (p=0.01) and S. hominis (p=.002) significantly increased post KMC.

CONCLUSIONS

KMC has a potential role in altering the neonatal skin microbiota towards a more favourable microenvironment. The clinical significance of these novel findings needs to be validated with larger studies.

摘要

目的

通过比较袋鼠式护理(KMC)前后皮肤微生物组的组成,来检验 KMC 是否有助于将有利的皮肤微生物组从母亲转移到婴儿。

方法

这是一项在印度南部的三级新生儿重症监护病房(NICU)进行的前瞻性队列研究,招募了 2020 年 10 月至 12 月期间胎龄<32 周的 30 名早产儿。在开始 KMC 之前,在生命的第一周结束时,在 KMC 期间与母亲接触的区域(腋窝、胸部和腹部)采集新生儿皮肤拭子。在 KMC 进行至少 6 小时/天、持续 7 天后,采集第 2 个拭子,涉及相同的区域。使用下一代测序(NGS)-16sRNA 分析拭子,并对分离出的微生物丰度进行映射。使用 t 检验和 PERMANOVA 进行统计分析,以比较 KMC 前和 KMC 后的细菌丰度的门和属。

结果

KMC 在门水平上增加了厚壁菌门(Firmicutes)的相对丰度(p=0.52),并显著降低了变形菌门(Proteobacteria)的相对丰度(p=0.02)。在种水平上,KMC 降低了大肠杆菌(Escherichia)的致病性细菌计数(p=0.05),而溶血链球菌(S. hemolyticus)和人型链球菌(S. hominis)的计数显著增加(p=0.01 和 p=0.002)。

结论

KMC 可能在改变新生儿皮肤微生物组以形成更有利的微环境方面发挥作用。这些新发现的临床意义需要通过更大的研究来验证。

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