梭状芽孢杆菌属致新生儿坏死性小肠结肠炎关联性分析

Analysis of the relationship between Clostridium genus and neonatal necrotizing enterocolitis

目的通过16S rRNA宏基因组测序技术和细菌培养法对肠道菌群变化与新生儿坏死性小肠结肠炎开展关联性分析。方法2018年9月至2019年3月在南京市妇幼保健院新生儿ICU病房内随机选取10例NEC病例及6例对照进行肠道菌群的16S rRNA宏基因组物种多样性分析,并对51例NEC患儿及其对照粪便样本和相应的环境样本开展梭菌属的分离与培养。结果病例组的组内样本离散程度小于对照组,样本物种多样性高于对照组;在梭菌属的分离培养中,病例组梭菌属总体检出率为43.14%(22/51),丁酸梭菌检出率最高(19.61%,10/51),且在两组间差异有统计学意义(χ^(2)=5.85,P=0.01558);全部的梭菌属菌株均未携带A,B和E型神经毒素基因。结论肠道菌群多样性升高、肠道菌群丰度与梭菌属的丰度变化可能与NEC患儿的肠道内环境状态密切相关;梭菌属特别是丁酸梭菌可能与NEC发生有关。

Objective To analyze the correlation between intestinal flora changes and neonatal necrotizing enterocolitis(NEC)through 16S rRNA metagenomic sequencing and bacterial culture.Methods From September 2018 to March 2019,10 NEC cases and 6 controls were randomly selected in the neonatal ICU ward of Nanjing maternal and child health care hospital to analyze the 16S rRNA metagenomic diversity of the for intestinal flora.The fecal samples and corresponding environmental samples were corrected from 51 cases of NEC children and their case controls to isolate and culture Clostridium.Results The dispersion of samples within the case group was smaller than that of the control group,and the sample diversity was higher than that of the control group.In the isolation and culture of Clostridium,the overall detection rate of Clostridium in the case group was 43.14%(22/51),and the detection rate of Clostridium butyricum was the highest(19.61%,10/51).There was a statistical difference between the two groups(χ^(2)=5.85,P=0.01558).All Clostridium strains did not carry the A,B and E type neurotoxin genes.Conclusion Increased intestinal flora diversity,intestinal flora abundance and changes in the abundance of Clostridium may be closely related to the intestinal environment of children with NEC;Clostridium,especially Clostridium butyricum,may be related to the occurrence of NEC.