【摘要】 目的利用16S rRNA测序技术,探讨早期经验性应用抗生素不同疗程对早产儿日龄28 d肠道微生物的影响。方法选取2017年12月～2018年5月在广东省妇幼保健院新生儿科住院治疗的27例早产儿作为研究对象,其中使用青霉素+三代头孢菌素≤3 d为短疗程组(G1组,9例),使用青霉素+三代头孢菌素≥7 d为长疗程组(G2组,18例)。收集28 d日龄的粪便标本,采用16S rRNA测序技术分析菌群组成的变化。结果菌群的结构组成中,主要的菌门包括放线菌门、拟杆菌门、厚壁菌门、变形菌门,其中厚壁菌门含量最为丰富。G1组中的拟杆菌门(0.03%)和变形菌门(34.11%)与G2组(0.04%、14.23%)比较,差异无统计学意义(P>0.05)。G1组和G2组的alpha多样性比较,差异无统计学意义(P>0.05)。G1组中的β-变形菌纲(LDA=6.43,P=0.017)、丛毛单菌科(LDA=6.24,P=0.017)、皮杆菌科(LDA=6.60,P=0.016)、黄体杆菌属(LDA=6.06,P=0.026)和韦荣球菌属(LDA=7.51,P=0.049)高于G2组,差异有统计学意义(P<0.05)。结论早期经验性、长期应用广谱抗生素可能会导致早产儿肠道正常菌群的定植和达优势化时间延迟。更多还原

【Abstract】 Objective To explore the influence of early empirical application of different treatment courses of antibiotic on the gut microbiota of 28-day-old preterm infants through 16 S rRNA sequencing technology. Methods From December 2017 to May 2018, a total of 27 cases of hospitalized preterm infants in Guangdong Women and Children Hospital were enrolled, among them, penicillin + the third generation cephalosporin ≤ 3 days were selected as the short course group(the G1 group, 9 cases), penicillin + the third generation cephalosporin ≥ 7 days were selected as the long course group(the G2 group, 18 cases). The fecal samples at postnatal 28 days were collected, and 16 S rRNA sequencing technology was used to analyze the changes of microbial community diversity. Results In the structural composition of the flora, the main phylum included Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria, among which pachytene was the most abundant, the thick-walled mycoplasma was the most abundant. There were no significant differences in the Bacteroidetes and Proteobacteria between the G1 group(0.03%, 34.11%) and the G2 group(0.04%, 14.23%)(P>0.05).There was no statistical difference in the alpha diversity between the G1 group and the G2 group(P >0.05).Betaproteobacteria(LDA =6.43, P =0.017), Comomamonadaceae(LDA =6.24, P =0.017), Dermabacteraceae(LDA =6.60,P=0.016), Luteibacter(LDA=6.06, P=0.026) and Veillonella(LDA=7.51, P=0.049) in the G1 group were higher than those in the G2 group, there were statistical differences(P <0.05). Conclusion Early empirical and long-term application of broad-spectrum antibiotic may lead to the colonization of normal intestinal flora and the delay of the advantage of time in preterm infants.更多还原