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对口腔白色念珠菌分离株的多位点序列分型揭示了生命早期母婴对子的高度遗传相关性。

Multilocus sequence typing of Candida albicans oral isolates reveals high genetic relatedness of mother-child dyads in early life.

机构信息

Department of General Dental Practice, College of Dentistry, Health Science Center, Kuwait University, Safat, Kuwait.

Translational Biomedical Science Program, Clinical and Translational Science Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America.

出版信息

PLoS One. 2024 Jan 17;19(1):e0290938. doi: 10.1371/journal.pone.0290938. eCollection 2024.

Abstract

Candida albicans is a pathogenic fungus recently recognized for its role in severe early childhood caries development (S-ECC). C. albicans oral colonization begins at birth, but the extent of the mother's involvement in yeast transmission to their children is unclear, therefore, this study used a prospective mother-infant cohort to investigate the maternal contribution of C. albicans oral colonization in early life. Oral samples were collected from 160 mother-child dyads during pregnancy and from birth to two years of life. We used whole-genome sequencing to obtain the genetic information of C. albicans isolates and examined the genetic relatedness of C. albicans between mothers and their children using Multilocus Sequence Typing. Multivariate statistical methods were used to identify factors associated with C. albicans' acquisition (horizontal and vertical transmissions). Overall, 227 C. albicans oral isolates were obtained from 93 (58.1%) of mother-child pairs. eBURST analysis revealed 16 clonal complexes, and UPGMA analysis identified 6 clades, with clade 1 being the most populated 124 isolates (54.6%). Significantly, 94% of mothers and children with oral C. albicans had highly genetically related strains, highlighting a strong maternal influence on children's C. albicans acquisition. Although factors such as race, ethnicity, delivery method, and feeding behaviors did not show a significant association with C. albicans vertical transmission, the mother's oral hygiene status reflected by plaque index (PI) emerged as a significant factor; Mothers with higher dental plaque accumulation (PI >=2) had a significantly increased risk of vertically transmitting C. albicans to their infants [odds ratio (95% confidence interval) of 8.02 (1.21, 53.24), p=0.03]. Furthermore, Black infants and those who attended daycare had an elevated risk of acquiring C. albicans through horizontal transmission (p <0.01). These findings highlight the substantial role of maternal transmission in the oral acquisition of C. albicans during early life. Incorporating screening for maternal fungal oral carriage and implementing oral health education programs during the perinatal stage may prove valuable in preventing fungal transmission in early infancy.

摘要

白色念珠菌是一种致病性真菌,最近被认为在严重婴幼儿早期龋病(S-ECC)的发展中起作用。白色念珠菌口腔定植始于出生,但母亲在将酵母菌传播给子女方面的作用程度尚不清楚,因此,本研究使用前瞻性母婴队列来研究母亲在生命早期对白色念珠菌口腔定植的贡献。在妊娠期间以及从出生到两岁期间,从 160 对母婴对中采集了口腔样本。我们使用全基因组测序获取白色念珠菌分离株的遗传信息,并使用多位点序列分型(MLST)检查母亲与其子女之间白色念珠菌的遗传相关性。使用多变量统计方法来确定与白色念珠菌获得(水平和垂直传播)相关的因素。总体而言,从 93 对母婴对中的 58.1%(93 对)获得了 227 株白色念珠菌口腔分离株。eBURST 分析显示有 16 个克隆复合体,UPGMA 分析鉴定出 6 个分支,其中分支 1 是最流行的 124 株(54.6%)。重要的是,94%的携带白色念珠菌的母亲和儿童具有高度遗传相关的菌株,这突出表明母亲对儿童白色念珠菌获得具有很强的影响。尽管种族、民族、分娩方式和喂养行为等因素与白色念珠菌垂直传播没有显著关联,但通过菌斑指数(PI)反映的母亲口腔卫生状况成为一个显著因素;菌斑积累(PI>=2)较高的母亲垂直传播白色念珠菌给婴儿的风险显著增加[比值比(95%置信区间)8.02(1.21,53.24),p=0.03]。此外,黑人婴儿和入托的婴儿通过水平传播获得白色念珠菌的风险增加(p<0.01)。这些发现强调了母亲传播在生命早期白色念珠菌口腔获得中的重要作用。在围产期筛查母体真菌口腔携带并实施口腔健康教育计划可能有助于预防婴儿期真菌传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4002/10793898/ac1722dd474b/pone.0290938.g001.jpg

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