β-内酰胺类抗菌药物对社区获得性肺炎患儿肠道菌群多样性及肠道菌群代谢能力的影响

Effect of β-lactam antibiotics on intestinal flora diversity and intestinal flora metabolism in children with community acquired pneumonia

目的探讨β-内酰胺类抗菌药物对社区获得性肺炎(CAP)患儿肠道菌群多样性及肠道菌群代谢能力的影响。方法选择2018年1月至2019年12月在该院治疗的120例CAP患儿为研究对象,分别对治疗前及治疗后的菌群丰度、肠道菌群菌属以及肠道菌群代谢能力进行比较。结果与治疗前比较,治疗3 d后,患儿粪便中不动杆菌属、肠球菌属、颤螺菌属、埃格特菌属丰度均显著升高,奇异菌属、双歧杆菌属、Dorea、乳酸菌属、链球菌属、萨特菌属、韦荣球菌属的菌群丰度均显著下降,差异有统计学意义(P<0.05);治疗前后,不动杆菌属、肠球菌属、颤螺菌属、埃格特菌属、奇异菌属、双歧杆菌属、Dorea、乳酸菌属、链球菌属、萨特菌属、韦荣球菌属的优势条带相似度之间的差异无统计学意义(P>0.05);治疗后,患儿粪便中乙酸水平显著高于治疗前,异戊酸、戊酸、丙酸、异丁酸、丁酸水平显著低于治疗前(P<0.05)。结论CAP患儿长时间使用β-内酰胺类抗菌药物治疗后,患者的肠道菌群丰度显著下降,肠道代谢能力随之发生改变。

Objective To study the effect ofβ-lactam antibiotics on intestinal flora diversity and intestinal flora metabolism in children with community acquired pneumonia(CAP).Methods A total of 120 patients with CAP in our hospital from January 2018 to December 2019 were selected as the research objects,the bacterial abundance,intestinal microflora and intestinal microflora metabolic capacity before and after treatment were compared.Results After 3 days of treatment,the abundance of Acinetobacter,Enterococcus,Oscillospira and Eggerthella in feces was significantly higher than that before treatment,while that of Atopobium,Bifidobacterium,Dorea,Lactobacillus,Streptococcus,Sutterella and Veillonella were significantly lower than that before treatment(P<0.05).There was no significant differences among the dominant bands of Acinetobacter,Enterococcus,Oscillospira,Eggerthella,Atopobium,Bifidobacterium,Dorea,Lactobacillus,Streptococcus,Sutterella and Veillonella(P>0.05).After treatment,the acetic acid of the patients was significantly higher than that before treatment,and isovaleric acid,valeric acid,propionic acid,isobutyric acid and butyric acid were significantly lower than that before treatment(P<0.05).Conclusion After the long-time treatment ofβ-lactam antibiotics in patients with CAP,the abundance of intestinal flora has decreased significantly,and the intestinal metabolic capacity has changed accordingly.