喂养方式对住院早产儿肠道微生物群发育的影响。
Influence of Feeding Type on Gut Microbiome Development in Hospitalized Preterm Infants.
作者信息
Cong Xiaomei, Judge Michelle, Xu Wanli, Diallo Ana, Janton Susan, Brownell Elizabeth A, Maas Kendra, Graf Joerg
机构信息
Xiaomei Cong, PhD, RN, is Associate Professor, School of Nursing, University of Connecticut, Storrs; Affiliated Faculty, Institute for Systems Genomics, University of Connecticut, Farmington; and Faculty, Department of Pediatrics, School of Medicine, University of Connecticut, Farmington. Michelle Judge, PhD, RD, CD-N, is Assistant Professor; Wanli Xu, BSN, MS, RN, is PhD student; and Ana Diallo, MSN, RN, is PhD student, School of Nursing, University of Connecticut, Storrs. Susan Janton, MS, is Technician, Department of Molecular and Cell Biology, University of Connecticut, Storrs. Elizabeth A. Brownell, PhD, is Assistant Professor, Department of Pediatrics, School of Medicine, University of Connecticut, Farmington, and Perinatal Epidemiologist, Division of Neonatology, Connecticut Children's Medical Center, Hartford. Kendra Maas, PhD, is Facility Scientist, Microbial Analysis, Resources, and Services, University of Connecticut, Storrs. Joerg Graf, PhD, is Professor, Department of Molecular and Cell Biology, University of Connecticut, Storrs and Institute for Systems Genomics, University of Connecticut, Farmington.
出版信息
Nurs Res. 2017 Mar/Apr;66(2):123-133. doi: 10.1097/NNR.0000000000000208.
BACKGROUND
Premature infants have a high risk for dysbiosis of the gut microbiome. Mother's own milk (MOM) has been found to favorably alter gut microbiome composition in infants born at term. Evidence about the influence of feeding type on gut microbial colonization of preterm infants is limited.
OBJECTIVE
The purpose of this study was to explore the effect of feeding types on gut microbial colonization of preterm infants in the neonatal intensive care unit.
METHODS
Thirty-three stable preterm infants were recruited at birth and followed up for the first 30 days of life. Daily feeding information was used to classify infants into six groups (MOM, human donor milk [HDM], Formula, MOM + HDM, MOM + Formula, and HDM + Formula) during postnatal days 0-10, 11-20, and 21-30. Stool samples were collected daily. DNA extracted from stool was used to sequence the 16S rRNA gene. Exploratory data analysis was conducted with a focus on temporal changes of microbial patterns and diversities among infants from different feeding cohorts. Prediction of gut microbial diversity from feeding type was estimated using linear mixed models.
RESULTS
Preterm infants fed MOM (at least 70% of the total diet) had highest abundance of Clostridiales, Lactobacillales, and Bacillales compared to infants in other feeding groups, whereas infants fed primarily HDM or formula had a high abundance of Enterobacteriales compared to infants fed MOM. After controlling for gender, postnatal age, weight, and birth gestational age, the diversity of gut microbiome increased over time and was constantly higher in infants fed MOM relative to infants with other feeding types (p < .01).
DISCUSSION
MOM benefits gut microbiome development of preterm infants, including balanced microbial community pattern and increased microbial diversity in early life.
背景
早产儿肠道微生物群失调风险高。已发现母乳对足月儿肠道微生物群组成有有益影响。关于喂养方式对早产儿肠道微生物定植影响的证据有限。
目的
本研究旨在探讨喂养方式对新生儿重症监护病房早产儿肠道微生物定植的影响。
方法
33名病情稳定的早产儿在出生时被招募，并在出生后的前30天进行随访。根据每日喂养信息，在出生后第0 - 10天、11 - 20天和21 - 30天期间，将婴儿分为六组（母乳、人乳库捐赠母乳[HDM]、配方奶、母乳+ HDM、母乳+配方奶和HDM +配方奶）。每天收集粪便样本。从粪便中提取的DNA用于对16S rRNA基因进行测序。进行探索性数据分析，重点关注不同喂养队列婴儿的微生物模式和多样性的时间变化。使用线性混合模型估计从喂养方式预测肠道微生物多样性。
结果
与其他喂养组的婴儿相比，喂养母乳（至少占总饮食的70%）的早产儿梭菌目、乳杆菌目和芽孢杆菌目的丰度最高，而主要喂养HDM或配方奶的婴儿与喂养母乳的婴儿相比，肠杆菌目的丰度较高。在控制了性别、出生后年龄、体重和出生胎龄后，肠道微生物群的多样性随时间增加，并且与其他喂养方式的婴儿相比，喂养母乳的婴儿的多样性持续更高（p <.01）。
讨论
母乳有益于早产儿肠道微生物群的发育，包括在生命早期平衡微生物群落模式和增加微生物多样性。
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