肠道病原体定植:新生儿重症监护室早产新生儿血流感染的风险因素--一项前瞻性队列研究。

Neonatology Pub Date : 2024-12-13 DOI:10.1159/000542335
Faiza Iqbal, N Siva, Padmaja A Shenoy, Leslie Edward S Lewis, Jayashree Purkayastha, Vandana Kalwaje Eshwara
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引用次数: 0

摘要

导言:肠道病原体定植,即病原体破坏正常的肠道微生物群,已被认为与血流感染(BSI)的发生有关。本研究调查了肠道病原体定植与 BSI 之间的关联,假设导致 BSI 的病原体主要来自肠道:一项前瞻性队列研究于 2021 年 1 月至 2023 年 9 月在印度卡纳塔克邦三级医院的新生儿重症监护室(NICU)进行。研究对象为先天性早产儿。研究对象分为两组:A 组(无败血症的新生儿)和 B 组(有败血症的新生儿)。收集了详细的人口统计学资料和血液培养结果。A 组在第 4 天和第 14 天采集粪便样本,B 组在第 4 天和败血症确诊当天采集粪便样本:结果:与 A 组(1,757 ± 656 克)相比,B 组的平均出生体重(1,649.6 ± 652.1 克)较低。肺炎克雷伯菌是导致 BSI 的最常见病原体(44.1%)。分析表明,B 组新生儿肠道微生物组中潜在病原体的数量较多,同时有益肠道菌群减少:本研究为新生儿重症监护室早产新生儿肠道病原体定植与 BSI 发生之间的关联提供了有力证据。肠道微生物群调节可作为预防 BSIs 的策略,因此有必要在这一领域开展进一步研究,以改善易感人群的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Gut Pathogen Colonization: A Risk Factor to Bloodstream Infections in Preterm Neonates Admitted in the Neonatal Intensive Care Unit - A Prospective Cohort Study.

Introduction: Gut pathogen colonization, where pathogens disrupt the normal gut microbiota, has been implicated in the development of bloodstream infections (BSIs). This study investigates the association between gut pathogen colonization and BSI, hypothesizing that species causing BSI primarily originated from gut.

Methods: A prospective cohort study was conducted in the neonatal intensive care unit (NICU) of tertiary care hospital in Karnataka, India, from January 2021 to September 2023. Inborn preterm infants were enrolled. The study population was divided into two groups: group A (neonates without sepsis) and group B (neonates with sepsis). Demographic details and blood culture results were collected. Stool samples were taken on day 4 and day 14 for group A, and on day 4 and the day of sepsis diagnosis for group B.

Results: Group B had a lower mean birthweight (1,649.6 ± 652.1 g) compared to group A (1,757 ± 656 g). Klebsiella pneumoniae was the most common pathogen causing BSIs (44.1%). The analysis revealed a high abundance of potential pathogens in the gut microbiome of group B neonates, with a concurrent decrease in beneficial gut flora.

Conclusion: This study provides strong evidence for the association between gut pathogen colonization and BSI development in preterm neonates in NICUs. Gut microbiota modulation may serve as preventive strategy against BSIs, emphasizing the need for further research in this area to improve outcomes in vulnerable population.

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