Bashar S, Tun H M, Ting J Y, Hicks M, Mandhane P J, Moraes T J, Simons E, Turvey S E, Subbarao P, Scott J A, Kozyrskyj A L
Department of Pediatrics, University of Alberta, Edmonton, Canada.
The Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; Microbiota I-Center, Hong Kong, China.
J Hosp Infect. 2025 Feb;156:50-60. doi: 10.1016/j.jhin.2024.10.012. Epub 2024 Nov 5.
The primary concern with prolonged hospitalization following birth is the risk of acquiring hospital-acquired infections (HAIs) caused by opportunistic bacteria, which can alter the early establishment of gut microbiota.
To assess the association between postpartum hospital length of stay (LOS) and the composition of gut microbiota at 3 and 12 months of age according to birth mode.
In total, 1313 Canadian infants from the CHILD Cohort Study were involved in this study. Prolonged LOS was defined as ≥2 days following vaginal delivery (VD) and ≥3 days following caesarean section (CS). The gut microbiota of infants was characterized by Illumina 16S rRNA sequencing of faecal samples at 3-4 months and 12 months of age.
Following prolonged LOS, VD infants with no exposure to intrapartum antibiotics had a higher abundance of bacteria known to cause HAIs in their gut, including Enterococcus spp. at 3 and 12 months, Citrobacter spp. at 3 months, and Clostridioides difficile at 12 months. Abundance of Enterococcus spp. or Citrobacter spp. at 3 months significantly mediated the association between LOS and low abundance of Bacteroidaceae, or higher Enterococcaeae/Bacteriodaceae or Enterobacterales/Bacteroidaceae abundance ratios at 12 months of age in VD infants without intrapartum antibiotic exposure. HAI-causing Enterobacterales were also more abundant in later infancy in infants with prolonged LOS following CS. In the absence of exclusive breastfeeding at 3 months or any breastfeeding at 12 months, Porphyromonadaceae (of Bacteroidota) were depleted in CS infants with prolonged LOS.
Prolonged hospital stay after birth is associated with infant gut dysbiosis.
出生后长时间住院的主要担忧是获得由机会性细菌引起的医院获得性感染（HAIs）的风险，这可能会改变肠道微生物群的早期建立。
根据分娩方式评估产后住院时间（LOS）与3个月和12个月龄时肠道微生物群组成之间的关联。
共有来自儿童队列研究的1313名加拿大婴儿参与了本研究。延长住院时间定义为阴道分娩（VD）后≥2天和剖宫产（CS）后≥3天。通过对3 - 4个月和12个月龄粪便样本进行Illumina 16S rRNA测序来表征婴儿的肠道微生物群。
在延长住院时间后，未暴露于产时抗生素的VD婴儿肠道中已知会引起医院获得性感染的细菌丰度更高，包括3个月和12个月时的肠球菌属、3个月时的柠檬酸杆菌属以及12个月时的艰难梭菌。在未暴露于产时抗生素的VD婴儿中，3个月时肠球菌属或柠檬酸杆菌属的丰度显著介导了住院时间与12个月龄时拟杆菌科低丰度、或更高的肠球菌科/拟杆菌科或肠杆菌目/拟杆菌科丰度比之间的关联。在CS后延长住院时间的婴儿中，引起医院获得性感染的肠杆菌目在婴儿后期也更为丰富。在3个月时未进行纯母乳喂养或12个月时未进行任何母乳喂养的情况下，延长住院时间的CS婴儿中（属于拟杆菌门的）卟啉单胞菌科减少。
出生后长时间住院与婴儿肠道菌群失调有关。
