三代头孢对老年心衰合并肺部感染患者肠道菌群的短期影响

Short-term effects of using the-third-generation cephalosporins on intestinal flora in elderly patients with heart failure complicated by pulmonary infection

目的:探究老年心衰合并肺部感染患者短期应用第三代头孢类抗菌药物肠道菌群的动态变化。方法:选取在某医院住院期间使用第三代头孢类抗菌药物治疗的7例老年心衰合并肺部感染患者,分别在使用前、使用后第3天、第5天收集粪便样本,通过16S rRNA测序分析患者肠道菌群结构改变。结果:应用第三代头孢类抗菌药物治疗的老年心衰合并肺部感染患者第5天后肠道菌群α多样性(Shannon指数、Faith's PD指数、Chao1指数)较使用前下降(P均<0.05),拟杆菌门丰度下降(P<0.05),拟杆菌纲丰度下降(P<0.05),酪酸梭状芽孢杆菌属、盲肠罗氏菌属、产粪甾醇真细菌属、瘤胃球菌002属、瘤胃球菌005属丰度下降(P均<0.05)。结论:老年心衰合并肺部感染患者短期应用第三代头孢类抗菌药物后肠道菌群多样性下降,产生短链脂肪酸的有益菌减少。

Objective:To explore the dynamic changes of intestinal flora in elderly patients having heart failure complicated with pulmonary infection after short-term application of the third-generation cephalosporins.Methods:A total of 7 elderly patients with heart failure complicated by pulmonary infection treated with the third-generation cephalosporins during hospitalization in hospital were selected.The stool specimens were then collected before using the-third-generation cephalosporins,3 days and 5 days after the use,respectively,and 16S rRNA sequencing was adopted to analyze the changes of the intestinal flora.Results:5 days after using the-thirdgeneration cephalosporins,the a-diversity of intestinal flora(Shannon index,Chao1 index,Faith’PD index)in the elderly patients with heart failure complicated by pulmonary infection was less than before cephalosporins(P<0.05).Meanwhile,the abundance of Bacteroidetes decreased(P<0.05).The abundance of Bacteroidetes decreased(P<0.05).The abundance of Clostridium butyricum,Rogeria cecal,Eubacteria coprosterol-producing,Ruminococcus 002 and Ruminococcus 005 decreased(all P<0.05).Conclusion:After short-term application of the third-generation cephalosporins,the diversity of intestinal flora decreased in the elderly patients with heart failure complicated by pulmonary infection and so did the beneficial bacteria producing short chain fatty acids.