Zarnu mikrobiotas izmaiņas un kuņģa - zarnu trakta sipmtomu attīstība bērniem pēc antibakteriālas terapijas
Loading...
Date
Authors
Advisor
Journal Title
Journal ISSN
Volume Title
Publisher
Latvijas Universitāte
Language
lav
Abstract
Ievads: Zarnu trakta mikrobiotas attīstību bērniem var ietekmēt dažādi faktori (kā dzimšanas veids un uzturs pirmajā dzīves gadā), tomēr būtiska ietekme ir saņemtai antibakteriālai terapijai. Tā kā antibiotikas bieži izmanto pediatrijas praksē, tās var ietekmēt zarnu trakta mikrobiotas sastāvu, veicinot bakteriālu disbiozi. Darba mērķis: Pētījuma mērķis ir analizēt bērnu zarnu mikrobiotas sastāva izmaiņas un dažādu kuņģa-zarnu trakta simptomu attīstību pēc antibiotiku terapijas.Metodes: Pētījumā tika iesaistīti bērni vecumā no 0 līdz 60 mēnešiem, kuri saņem antibakteriālu ārstēšanu. Bērnu vecākiem lūdzām aizpildīt anketu un atnest bērna fekāliju paraugu. Zarnu mikrobiotas sastāvu analizēja ar 16S sekvencēšanas metodi Latvijas Biomedicīnas centrā, nosakot dažādu baktēriju sugu (taksonu) relatīvo sastopamību un izvērtējot to dinamiskās izmaiņas antibiotiku terapijas ietekmē. Rezultāti: Kopā pētījumā tika iekļauti 46 pacienti (V/S: 23/23), vidējais vecums – 25,22 mēneši (SD±10,36), kuri tika ārstēti ar amoksicilīnu, sulfametoksazolu-trimetoprimu un klaritromicīnu. Visbiežāk ziņotais simptoms, kas tika saistīts ar antibiotiku terapiju, bija šķidra un/vai biežāka vēdera izeja (9 bērniem (19.6%)). Fēču paraugi bija pieejami 25 bērniem. Bifidobacteriaceae relatīvais daudzums pirms antibakteriālās terapijas bija 40.15% pirms terapijas, pēc nedēļas tas samazinājās līdz 26.10 %, bet pēc mēneša daļēji atjaunojās līdz 31.95% pēc (p=0.368). Pēc nedēļas Clostridiaceae relatīvais daudzums samazinājās no 0,00013 līdz 0,00000 (p = 0,033), savukārt Coriobacteriaceae samazinājās no 0,01 līdz 0,000 (p = 0,022). Pēc menēša Acidaminococcaceae relatīvais daudzums palielinājās no 0,00026 līdz 0,01438 (p = 0,043), bet Veillonellaceae palielinājās no 0,00000 līdz 0,00178 (p = 0,013). Pēc mēneša pacientiem, kuriem bija šķidra vēdera izeja, Enterobacteriaceae daudzums bija statistiski nozīmīgi zemāks nekā tiem, kuriem nebija vēdera izejas izmaiņu (vidējais rangs 6.67 vs 12.73; p = 0.037). Enterococcaceae relatīvais daudzums pirms antibakteriālās terapijas bija augsrtāks pacientiem bez šķidras vēdera izejas izmaiņām (vidējais rangs 16.75 vs 11.82; p = 0.041). Prevotellaceae daudzuma salīdzinājums starp pacientiem ar un bez vēdera izejas izmaiņām uzrādīja statistiski nozīmīgu atšķirību pēc nedēļas (vidējais rangs 16.80 vs 11.37; p = 0.045). Secinājumi: Pētītajā pacientu kopā gandrīz piektdaļai bērnu pēc antibakteriālās terapijas attīstījās šķidra un/vai bieža vēdera izeja. Bifidobacteriaceae dzimtas relatīvais daudzums pēc terapijas nedaudz samazinājās (p=0,160), taču mēneša laikā tika novērota atjaunošanās tendence. Antibakteriālā terapija izraisīja noturīgas izmaiņas (mēnesi pēc terapijas) tādās dzimtās kā Acidaminococcaceae un Veillonellaceae , bet visizteiktākās atšķirības tika konstatētas pacientiem ar izmainītu vēdera izeju, īpaši Enterobacteriaceae un Prevotellaceae dzimtās.
Introduction: The development of the intestinal microbiota in children can be influenced by various factors, however, a significant influence is antibacterial therapy. Since antibiotics are often used in pediatric practice, they can affect the composition of the intestinal microbiota, promoting bacterial dysbiosis. Aim: The aim of the study is to analyze changes in the composition of the intestinal microbiota of children and the development of various gastrointestinal symptoms after antibiotic therapy. Methods: Children from 0 to 60 months who received antibacterial treatment were included in the study. Parents were asked to complete a questionnaire and bring a fecal sample of their child. The composition of the intestinal microbiota was analyzed using the 16S sequencing method at the Latvian Biomedical Center, determining the relative abundance of different bacterial species (taxa) and evaluating their dynamic changes under the influence of antibiotic therapy. Results: A total of 46 patients (M/F: 23/23), mean age 25.22 months(SD±10.36), were included in the study and were treated with amoxicillin, sulfamethoxazole/trimethoprim and clarithromycin. The most commonly reported symptom associated with antibiotic therapy was loose and/or frequent bowel movements (9 children (19.6%)). Stool samples were available for 25 children. The relative abundance of Bifidobacteriaceae before antibacterial therapy was 40.15%, after a week it decreased to 26.10%, but after a month it partially recovered to 31.95% (p=0.368). After one week, the relative abundance of Clostridiaceae decreased from 0.00013 to 0.00000 (p = 0.033), while Coriobacteriaceae decreased from 0.01 to 0.000 (p = 0.022). After one month, the relative abundance of Acidaminococcaceae increased from 0,00026 to 0,01438 (p = 0.043),while Veillonellaceae increased from 0.00000 to 0.00178 (p = 0.013).After one month, patients with loose stools had a statistically significantly lower Enterobacteriaceae count than those with no change in stool (mean rank 6.67 vs 12.73; p = 0.037). The relative abundance of Enterococcaceae before antibacterial therapy was higher in patients without changes in stool(mean rank 16.75 vs 11.82; p = 0.041). Comparison of the abundance of Prevotellaceae between patients with and without changes in stool showed a statistically significant difference after one week (mean rank 16.80 vs 11.37; p = 0.045).Conclusions:In the studied patient population, almost one fifth of children developed loose and/or frequent bowel movements after antibacterial therapy.The relative abundance of the Bifidobacteriaceae family decreased slightly after therapy (p=0.160), but a recovery trend was observed within a month. Antibacterial therapy caused persistent changes (one month after therapy) in such families as Acidaminococcaceae and Veillonellaceae, but the most pronounced differences were found in patients with altered bowel movement especially in the Enterobacteriaceae and Prevotellaceae family.
Introduction: The development of the intestinal microbiota in children can be influenced by various factors, however, a significant influence is antibacterial therapy. Since antibiotics are often used in pediatric practice, they can affect the composition of the intestinal microbiota, promoting bacterial dysbiosis. Aim: The aim of the study is to analyze changes in the composition of the intestinal microbiota of children and the development of various gastrointestinal symptoms after antibiotic therapy. Methods: Children from 0 to 60 months who received antibacterial treatment were included in the study. Parents were asked to complete a questionnaire and bring a fecal sample of their child. The composition of the intestinal microbiota was analyzed using the 16S sequencing method at the Latvian Biomedical Center, determining the relative abundance of different bacterial species (taxa) and evaluating their dynamic changes under the influence of antibiotic therapy. Results: A total of 46 patients (M/F: 23/23), mean age 25.22 months(SD±10.36), were included in the study and were treated with amoxicillin, sulfamethoxazole/trimethoprim and clarithromycin. The most commonly reported symptom associated with antibiotic therapy was loose and/or frequent bowel movements (9 children (19.6%)). Stool samples were available for 25 children. The relative abundance of Bifidobacteriaceae before antibacterial therapy was 40.15%, after a week it decreased to 26.10%, but after a month it partially recovered to 31.95% (p=0.368). After one week, the relative abundance of Clostridiaceae decreased from 0.00013 to 0.00000 (p = 0.033), while Coriobacteriaceae decreased from 0.01 to 0.000 (p = 0.022). After one month, the relative abundance of Acidaminococcaceae increased from 0,00026 to 0,01438 (p = 0.043),while Veillonellaceae increased from 0.00000 to 0.00178 (p = 0.013).After one month, patients with loose stools had a statistically significantly lower Enterobacteriaceae count than those with no change in stool (mean rank 6.67 vs 12.73; p = 0.037). The relative abundance of Enterococcaceae before antibacterial therapy was higher in patients without changes in stool(mean rank 16.75 vs 11.82; p = 0.041). Comparison of the abundance of Prevotellaceae between patients with and without changes in stool showed a statistically significant difference after one week (mean rank 16.80 vs 11.37; p = 0.045).Conclusions:In the studied patient population, almost one fifth of children developed loose and/or frequent bowel movements after antibacterial therapy.The relative abundance of the Bifidobacteriaceae family decreased slightly after therapy (p=0.160), but a recovery trend was observed within a month. Antibacterial therapy caused persistent changes (one month after therapy) in such families as Acidaminococcaceae and Veillonellaceae, but the most pronounced differences were found in patients with altered bowel movement especially in the Enterobacteriaceae and Prevotellaceae family.