婴幼儿社区获得性肺炎使用抗生素后肠道菌群代谢改变的探讨

Study on Metabolic Changes of Intestinal Microflora in Infant with Community-Acquired Pneumonia after Antibiotics Treatment

摘要: 目的：采用肠道微生态体外发酵模型对使用抗生素后的婴儿肠道菌群代谢进行探讨。方法：收集2017年5月至2017年9月期间于苏州大学附属儿童医院呼吸科住院的23例明确诊断社区获得性肺炎并同时有静脉使用抗生素治疗的婴幼儿为观察组。同时收集同期于儿童保健科例行体检的16例正常婴幼儿为对照组。采集并处理其粪便标本后置于低聚糖培养基中恒温发酵，24 h后采用气相色谱法(GC)检测各培养基中的短链脂肪酸(SCFA)含量，最后应用SPASS 19.0对数据进行统计学分析。结果：1) 观察组婴幼儿粪便中总短链脂肪酸(SCFA)、丙酸、丁酸的含量明显低于正常对照组(P < 0.05)，乙酸值无差异(P = 0.65)。2) 对照组粪便中乙酸:丙酸:丁酸的百分比为59.1:20.9:15.6，观察组三者比值为84.5:6.3:6.1，其中丙酸、丁酸含量明显低于正常对照组(P < 0.05)。3) 观察组24 h发酵后，各低聚糖培养基总SCFA、丙酸、丁酸含量明显低于对照组(P < 0.05)，乙酸含量除YCFA、MAI、XYI无差异，其余培养基乙酸含量亦低于对照组(P < 0.05)。4) 两组24 h产气量相比，除LAU、RAF、XOS无差异(P > 0.05)，其余各低聚糖培养基(包括FOS、GOS、IMO、MOS、INU、STA、MAI、XYI)观察组明显低于对照组(P < 0.05)。结论：社区获得性肺炎婴儿使用抗生素后，肠道菌群的代谢被抑制，表现为SCFA总含量、丙酸和丁酸含量，部分产乙酸菌群也被抑制。

Abstract: Objective: The aim of this study was to explore the metabolites produced by intestinal microflora after antibiotic treated infants using an in vitro colonic fermentation model with infant faecal mi-crobiota. Method: The experimental group consisted of 23 children who were hospitalized in the Department of Respiratory, Affiliated Children’s Hospital of Suzhou University from May to Sep-tember 2017, and these children all were diagnosed with community-acquired pneumonia and treated with antibiotics at the same time. The control group was 16 children with normal physical examination in children’s health section. The concentration of short chain fatty acid (SCFA) in feces was detected by GC. And then the fresh fecal samples were inoculated into the in vitro fermentation systems, which contained Basal (YCFA) and oligosaccharides medium. The SCFA concentration at 24 h was detected. SPASS 19.0 was used to analyze the data. Results: 1) The contents of the total SCFA, propionic acid and butyric acid in the feces of infants in antibiotic group were significantly lower than those in control group (P < 0.05); but there is no difference in acetic acid value (P = 0.65). 2) The ratio of the percentage of acetic acid, propionic acid and butyric acid in normal control group was 59.1:20.9:15.6, and the ratio of the three acids in antibiotic group was 84.5:6.3:6.1. The contents of propionic acid and butyric acid in antibiotic group were significantly lower than that in normal control group (P < 0.05). 3) After fermentation for 24 h, the contents of total SCFA, propionic acid and butyric acid in each oligosaccharide medium were significantly lower than those in the control group (P < 0.05). There was no difference in acetic acid contents in the media including YCFA, MAI, and XYI; and the acetic acid content in the other mediums was lower than that in the control group (P < 0.05). 4) The production of gas in these mediums (including FOS, GOS, IMO, MOS, INU, STA, MAI, XYI) in antibiotic group was significantly lower than that in the control group (P < 0.05). But there was no significant difference between the two groups in 24 h gas production (P > 0.05) in these mediums including LAU, RAU, and XOS. Conclusion: After treatment of antibiotics in infants with community-acquired pneumonia, the metabolites produced by intestinal microflora were significantly inhibited, which was showed as the total content of SCFA, propionic acid and butyric acid, and some acetic acid-producing bacteria were also inhibited.