C. difficile-инфекция у новорожденных: решенные и нерешенные вопросы
https://doi.org/10.22627/2072-8107-2021-20-3-39-47
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Аннотация
В статье представлен аналитический обзор работ отечественных и зарубежных авторов по проблеме изучения особенностей формирования микробиоты кишечника и факторов риска развития микродисбиоза у новорожденных с активацией условно патогенных бактерий (УПБ), в том числе Clostridioides difficile. Особое внимание уделено влиянию антибиотиков на состояние микробиоты кишечника и активацию токсигенных штаммов C. difficile. Приведены разнонаправленные взгляды на роль токсигенных штаммов C. difficile в развитии инфекционной патологии новорожденных.
Об авторах
Л. Н. МазанковаРоссия
Мазанкова Людмила Николаевна – доктор медицинских наук, профессор, заведующая кафедры детских инфекционных болезней РМАНПО, главный внештатный специалист по инфекционным болезням у детей.
Москва.
С. Г. Перловская
Россия
Перловская Светлана Геннадьевна - врач-педиатр.
Москва.
О. В. Рыбальченко
Россия
Рыбальченко Оксана Владимировна – доктор биологических наук, профессор кафедры физиологии.
Санкт-Петербург.
Список литературы
1. Мазанкова Л.Н., Рыбальченко О.В., Николаева И.В. Микро-дисбиоз и эндогенные инфекции: руководство для врачей. М.: ГЭОТАР-Медиа, 2018:336.
2. Lawson P.A., Citron D.M., Tyrrell K.L., and Finegold S.M. Reclassification of Clostridium difficile as Clostridioides difficile (Hall and O'Toole 1935) Prevot 1938. Anaerobe, 2016; 40:95-99.
3. Yutin N., Galperin M.Y. A genomic update on clostridial phylogeny: Gram-negative spore formers and other misplaced clostridia. Environ. Microbiol. 2013; 15:2631-2641.
4. https://www.ncbi.nlm.nih.gov/Taxonomy
5. Lopetuso LR, Scaldaferri F, Petito V, Gasbarrini A. Commensal Clostridia: leading players in the maintenance of gut homeostasis. Gut Pathog, 5:23, 2013. https://doi.org/10.1186/1757-4749-5-23.
6. Salminen S, Gibson GR, McCartney AL, Isolauri E. Influence of mode of delivery on gut microbiota composition in seven year old children. Gut, 2004; 53:1388-1389.
7. Бондаренко В.М., Лиходед В.Г. Микробиологическая диагностика дисбактериоза кишечника: Методические рекомендации. М.: НИИЭМ им. Н.Ф. Гамалеи РАМН, 2007:86.
8. McFarland LV, Brandmarker SA, Guandalini S. Pediatric Clostridium difficile: a phantom menace or clinical reality. J. Pediatr. Gastroenterol Nutr, 2000; 31:220-31. [Accessed 14 September, 2015]. http://www.ncbi.nlm.nih.gov/pubmed/10997362.
9. McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, Dubberke ER, Garey KW, Gould CV, Kelly C, Loo V, Shaklee Sammons J, Sandora TJ, Wilcox MH. Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018 Mar 19; 66(7):987-994. https://doi.org/10.1093/cid/ciy149. PMID: 29562266
10. Enad D, Meislich D, Brodsky NL, Hurt H. Is Clostridium difficile a pathogen in the newborn intensive care unit? A prospective evaluation. J Perinatol. 2015;17:355-9 [Accessed 14 September, 2015]. http://www.ncbi.nlm.nih.gov/pubmed/9373839.
11. Schutze GE, Willoughby RE. Clostridium difficile infection in infants and children. Pediatrics. 2013;131:196-200. https://doi.org/10.1542/peds.2012-2992.
12. Adlerberth I, Huang H, Lindberg E, Aberg N, Hesselmar B, Saal-man R, et al. Toxin- producing Clostridium difficile strains as longterm gut colonizers in healthy infants. J Clin Microbiol. 2014; 52:173-9. https://doi.org/10.1128/JCM.01701-1713.
13. Jangi S, Lamont JT. Asymptomatic colonization by Clostridium difficile in infants: implications for disease in later life. J Pediatr Gastroenterol Nutr. 2010; 51:2-7. https://doi.org/10.1097/MPG.0b013e3181d29767.
14. Morelli L. Postnatal development of intestinal microflora as influenced by infant nutrition. J Nutr. 2008; 138(9):1791-1795.
15. Palmer C., Bik E. M., DiGiulio D. B., Relman D. A., and Brown P. O. Development of the human infant intestinal microbiota. PLoS Biology, vol. 5, no. 7, article e177, 2007.
16. Николаева И.В. Формирование кишечной микрофлоры ребенка и факторы, влияющие на этот процесс. Детские инфекции. 2011; 10(3).
17. Самсыгина Г.А. Особенности становления биоценоза кишечника и кишечный дисбактериоз. Педиатрия. Приложение к журналу Consilium Medicum. 2003; 2:30-33.
18. Урсова Н.И. Особенности формирования микробиоценоза у грудных детей и дисбактериоз кишечника. Педиатрия. Приложение к журналу Consilium medicum. 2005; 7(2): 56-59.
19. Буланов Р. Л., Г. Н. Чумакова, Т. А. Бажукова, О. В. Лебедева. Особенности формирования микроэкологии новорожденного при абдоминальном родоразрешении. Экология человека. 2008; 9:37- 41.
20. Penders J, Thijs C, Vink C, Stelma FF, Snijders B, Kummeling I, et al. Factors influencing the composition of the intestinal microbiota in early infancy. Pediatrics, 2006; 118(2):511-21.10.
21. Gronlund MM, Lehtonen OP, Eerola E, Kero P. Fecal microflora in healthy infants born by different methods of delivery: permanent changes in intestinal flora after cesarean delivery. J Pediatr Gastroenterol Nutr. 1999; 28(1):19-25. https://doi.org/10.1097/00005176-199901000-00007.
22. Kabeerdoss J, Ferdous S, Balamurugan R, Mechenro J, Vidya R, Santhanam S, Jana AK, Ramakrishna BS. Development of the gut microbiota in southern Indian infants from birth to 6 months: a molecular analysis. J Nutr Sci. 2013; 2:e18. https://doi.org/10.1017/jns.2013.6.
23. Adlerberth I, Strachan DP, Matricardi PM, Ahrne S, Orfei L, Aberg N, Perkin MR, Tripodi S, Hesselmar B, Saalman R, et al. Gut microbiota and development of atopic eczema in 3 European birth cohorts. J Allergy Clin Immunol. 2007; 120(2):343-350. https://doi.org/10.1016/j.jaci.2007.05.018.
24. Pandey PK, Verma P, Kumar H, Bavdekar A, Patole MS, Shouche YS. Comparative analysis of fecal microflora of healthy full-term Indian infants born with different methods of delivery (vaginal vs cesarean): Acinetobacter sp prevalence in vaginally born infants. J Biosci. 2012; 37(6):989-998. https://doi.org/10.1007/s12038-012-9268-5.
25. Кафарская Л.И., Шуникова М.Л., Ефимов Б.А. и др. Особенности формирования микрофлоры у детей раннего возраста и пути ее коррекции с помощью пробиотиков. Педиатрическая фармакология, 2011; 2(8): 94-8.
26. Favier CF, de Vos WM, Akkermans ADL. Development of bacterial and bifidobacterial communities in feces of newborn babies. Anaerobe. 2003; 9:219-22.
27. Johnson S, Gerding DN. Clostridium difficile-associated diarrhea. Clin Infect Dis, 1998; 26. [Accessed 21 October, 2015. http://www.ncbi.nlm.nih.gov/pubmed/95972211027-34-6.
28. Eglow R, Pothoulakis C, Itzkowitz S, Israel EJ, O'Keane CJ, Gong D, et al. Diminished Clostridium difficile toxin A sensitivity in newborn rabbit ileum is associated with decreased toxin A receptor. J Clin Invest, 1992; 90:822-9. https://doi.org/10.1172/JCI115957.
29. Lyerly DM, Krivan HC, Wilkins TD. Clostridium difficile: its disease and toxins. Clin Microbiol Rev, 1988; 1:1-18. [Accessed 18 September, 2015].
30. Pant C, Deshpande A, Altaf MA, Minocha A, Sferra TJ.Clostridium difficile infection in children: a comprehensive review. Curr Med Res Opin. 2013; 29(8):967-984. https://doi.org/10.1185/03007995.2013.803058.
31. Hammerschmidt S, Talay SR, Brandtzaeg P, Chhatwal GS. SpsA, a novel pneumococcal surface protein with specific binding to secretory immunoglobulin A and secretory component. Mol Microbiol. 1997; 25(6): 1113-24.
32. Dabard J, Bridonneau C, Phillipe C, Anglade P, Molle D, Nardi M, Ladire M, Girardin H, Marcille F, Gomez A, Fons M. Ruminococcin A, a new lantibiotic produced by a Ruminococcus gnavus strain isolated from human feces. Appl Environ Microbiol. 2001 Sep; 67(9):4111-8.
33. Lonnerdal, B. Nutritional and physiologic significance of human milk proteins. Am J Clin Nutr. 2003 Jun; 77(6):1537S-1543S. Review.
34. Macpherson, A.J.; Yilmaz, B.; Limenitakis, J.P.; Ganal-Vonarburg, S.C. IgA Function in Relation to the Intestinal Microbiota. Annu. Rev. Immunol. 2018, 36:359-381.
35. Wang, M.; Li, M.; Wu, S.; Lebrilla, C.B.; Chapkin, R.S.; Ivanov, I.; Donovan, S.M. Fecal Microbiota Composition of Breast-Fed Infants is Correlated With Human Milk Oligosaccharides Consumed. J. Pediatr. Gastroenterol. Nutr. 2015, 60, 825-833. [CrossRef] [PubMed]
36. Newburg D.S.; Walker W.A. Protection of the Neonate by the Innate Immune System of Developing Gut and of Human Milk. Pediatr. Res. 2007, 61:2-8.
37. Stefka AT. et al. Commensal bacteria protect against food-allergen sensitization. Proc Natl Acad Sci USA. 2014 Sep 9; 111(36): 13145-50. https://doi.org/10.1073/pnas.1412008111. Epub 2014 Aug 25.
38. Noverr MC, Falkowski NR, McDonald RA, McKenzie AN, Huffna-gle GB. Development of allergic airway disease in mice following antibiotic therapy and fungal microbiota increase: role of host genetics, antigen and interleukin-13. Infect Immun. 2005 Jan; 73(1):30-8.
39. Gonzalez-Perez G, Hicks AL, Tekieli TM,et al. Maternal antibiotic treatment impacts development of the neonatal intestinal microbiome and antiviral immunity. J Immunol. 2016 May 1; 196(9): 3768-79. https://doi.org/10.4049/jimmunol.1502322.
40. Beura LK, Hamilton SE, Bi K,et al. Normalizing the environment recapitulates adult human immune traits in laboratory mice. Nature. 2016 Apr 28; 532(7600):512-6. https://doi.org/10.1038/nature17655.
41. Chervonsky AV. Influence of microbial environment on autoimmunity. Nat Immunol. 2010 Jan; 11(1):28-35. https://doi.org/10.1038/ni.1801. Epub 2009 Dec 17. Review.
42. Hooper LV, Littman DR, Macpherson AJ. Interactions between the microbiota and the immune system. Science. 2012 Jun 8; 336(6086): 1268-73. https://doi.org/10.1126/science.1223490. Epub 2012 Jun 6. Review.
43. Favier CF, de Vos WM, Akkermans ADL. Development of bacterial and bifidobacterial communities in feces of newborn babies. Anaerobe. 2003; 9:219-22.
44. Barbara L, Lazzari R, Roda A, et al. Serum bile acids in newborns and children. Pediatr Res, 14: 222-1225, 1980. https://doi.org/10.1203/00006450-198011000-00014.
45. Suchy FJ, Balistreri WF, Heubi JE, Searcy JE, Levin RS. Physiologic cholestasis: elevation of the primary serum bile acid concentrations in normal infants. Gastroenterology, 80:1037-1041, 1981. https://doi.org/10.1016/0016-5085(81)90078-0.
46. Encrantz JC, Sjovall J. On the bile acids in duodenal contents of infants and children. Bile acids and steroids 72. Clin Chim Acta, 4:793-799, 1959. https://doi.org/10.1016/0009-8981(59)90030-0.
47. Huang CT, Rodriguez JT, Woodward WE, Nichols BL. Comparison of patterns of fecal bile acid and neutral sterol between children and adults. Am J Clin Nutr. 29:1196-1203, 1976. https://doi.org/10.1093/ajcn/29.11.1196.
48. Kitahara M, Takamine F, Imamura T, Benno Y. Clostridium hiranonis sp. nov., a human intestinal bacterium with bile acid 7alpha-dehy-droxylating activity. Int J Syst Evol Microbiol. 51:39-44, 2001. https://doi.org/10.1099/00207713-51-1-39.
49. Ridlon JM, Harris SC, Bhowmik S, Kang DJ, Hylemon PB. Consequences of bile salt biotransformations by intestinal bacteria. Gut Microbes. 7:22-39, 2016. https://doi.org/10.1080/19490976.2015.1127483.
50. Reed AD, Theriot CM. Contribution of Inhibitory Metabolites and Competition for Nutrients to Colonization Resistance against Clostridioides difficile by Commensal Clostridium. Microorganisms. 2021 Feb 12; 9(2):371. https://doi.org/10.3390/microorganisms9020371.
51. Studer N, Desharnais L, Beutler M, Brugiroux S, Terrazos MA, Menin L, Schurch CM, McCoy KD, Kuehne SA, Minton NP, Stecher B, Bernier-Latmani R, Hapfelmeier S. Functional intestinal bile acid 7-dehydroxylation by Clostridium scindens associated with protection from Clostridium difficile infection in a gnotobiotic mouse model. Front Cell Infect Microbiol. 6:191, 2016. https://doi.org/10.3389/fcimb.2016.00191.
52. Bartlett JG. Clostridium difficile infection: pathophysiology and diagnosis. Semin Gastrointest Dis. 8:12-21, 1997.
53. Cheng S, Zhu L, Faden HS. Interactions of bile acids and the gut microbiota: learning from the differences in Clostridium difficile infection between children and adults. Physiol Genomics. 2019 Jun 1; 51(6):218-223. https://doi.org/10.1152/physiolgenomics.00034.2019.
54. Martinez de Tejada B. Antibiotic use and misuse during pregnancy and delivery: benefits and risks. Int J Environ Res Public Health, 2014; 11(8): 7993-8009.
55. Ledger WJ, Blaser MJ. Are we using too many antibiotics during pregnancy. BJOG: an international journal of obstetrics and gynaecology, 2013; 120(12):1450-2.
56. Bookstaver PB, Bland CM, Griffin B, Stover KR, Eiland LS, McLaughlin M. A Review of Antibiotic Use in Pregnancy. Pharmacotherapy, 2015; 35(11): 1052-62.
57. Dierikx TH, Visser DH, Benninga MA, et al. The influence of prenatal and intrapartum antibiotics on intestinal microbiota colonisation in infants: A systematic review. J Infect. 2020 Aug; 81(2):190- 204. https://doi.org/10.1016/j.jinf.2020.05.002. Epub 2020 May 7.
58. Rizzatti G, Lopetuso LR, Gibiino G, Binda C, Gasbarrini A. Proteo-bacteria: A Common Factor in Human Diseases. Biomed Res Int 2017; 2017: 9351507.
59. Dubberke ER, Gerding DN, Classen D , et al. Strategies to prevent Clostridium difficile infections in acute care hospitals. Infect Control Hosp Epidemiol. 2008; 29(suppl 1): S81-S92 pmid: 18840091
60. Morinville V, McDonald J. Clostridium difficile-associated diarrhea in 200 Canadian children. Can J Gastroenterol, 2005;19:497- 501 [Accessed 15 September, 2015]. http://www.ncbi.nlm.nih.gov/pubmed/16107901.
61. Samady W, Bush R, Pong A, Andrews A, Fisher ES. Predictors of Clostridium difficile infections in hospitalized children. J Hosp Med. 2014; 9:94-8. https://doi.org/10.1002/jhm.2135.
62. Duleba K, Pawtowska M, Wietlicka-Piszcz M. Clostridium difficile infection in children hospitalized due to diarrhea. Eur J Clin Microbiol Infect Dis. 2014; 33:201-9. https://doi.org/10.1007/s10096-013-1946-1.
63. Vesikari T, Isolauri E, Maki M, Gronroos P. Clostridium difficile in young children. Association with antibiotic usage. Acta PaediatrScand, 1984; 73:86-91 [Accessed 15 September, 2015]. http://www.ncbi.nlm.nih.gov/pubmed/6702456.
64. Ferreira CEA, Nakano V, Durigon EL, Avila-Campos MJ. Prevalence of Clostridium spp. and Clostridium difficile in children with acute diarrhea in Sao Paulo city, Brazil. Mem Inst Oswaldo Cruz. 2003; 98:444-51. [Accessed 12 September, 2015]. http://www.ncbi.nlm.nih.gov/pubmed/12937752.
65. Pai S, Aliyu SH, Enoch DA, Karas JA. Five years experience of Clostridium difficile infection in children at a UK tertiary hospital: proposed criteria for diagnosis and management. PLoS One. 2012; 7:e51728. https://doi.org/10.1371/journal.pone.0051728.
66. Khanna S, Baddour LM, Huskins WC, Kammer PP, Faubion WA, Zinsmeister AR, et al. The epidemiology of Clostridium difficile infection in children: a populationbased study. Clin Infect Dis. 2013; 56:1401-6. https://doi.org/10.1093/cid/cit075.
67. Lees EA, Miyajima F, Pirmohamed M, Carrol ED , et al. The role of Clostridium difficile in the paediatric and neonatal gut - a narrative review. Review. Eur J Clin Microbiol Infect Dis. 2016 Jul; 35(7): 1047-57. https://doi.org/10.1007/s10096-016-2639-3
68. Lishman AH, Al Jumaili IJ, Elshibly E. Clostridium difficile isolation in neonates in a special care unit. Lack of correlation with necrotizing enterocolitis. Scand J Gastroenterol.1984; 19(3): 441-444.
69. Han VK, Sayed H., Chance GW. An outbreak of Clostridium difficile necrotizing enterocolitis: a case for oral vancomycin therapy. Pediatrics. 1983; 71(6): 935-941.
70. Mathew OP, Bhatia JS, Richardson CJ An outbreak of Clostridium difficile necrotizing enterocolitis. Pediatrics. 1984; 73(2):265- 266.
71. Peter CS, Feuerhahn M, Bohnhorst B, Schlaud M, Ziesing S, von der Hardt H, Poets CF. Necrotising enterocolitis: is there a relationship to specific pathogens?. Eur J Pediatr. 1999; 158: 67-70.
72. Alfa MJ, Robson D, Davi M, Bernard K, Van Caeseele P, Harding GK. An outbreak of necrotizing enterocolitis associated with a novel Clostridium species in a neonatal intensive care unit. Clin Infect Dis 2002; 35:S101-S105.
73. Gewolb IH, Schwalbe RS, Taciak VL, Harrison TS, Panigrahi P Stool microflora in extremely low birthweight infants. Arch Dis Child Fetal Neonatal Ed. 1999; 80:F167-F173.
74. Schwiertz A, Gruhl B, Lobnitz M, Michel P, Radke M, Blaut M. Development of the intestinal bacterial composition in hospitalized preterm infants in comparison with breast-fed, full-term infants. Pediatr Res. 2003; 54: 393-399.
75. Millar MR, Linton CJ, Cade A, Glancy D, Hall M, Jalal H. Application of 16S rRNA gene PCR to study bowel flora of preterm infants with and without necrotizing enterocolitis. J Clin Microbiol. 1996; 34:2506-2510.
76. Wilson KH, Sheagren JN. Antagonism of toxigenic Clostridium difficile by nontoxigenic C. difficile. J Infect Dis. 1983; 147: 733-6.
77. Shim JK, Johnson S, Samore MH, Bliss DZ, Gerding DN . Primary symptoms colonization by Clostridium difficile and decreased risk of subsequent diarrhea. Lancet. 1998; 351:633-6.
78. Fardou H. Heida, Anne G. J. F. van Zoonen, et al. A Necrotizing Enterocolitis-Associated Gut Microbiota Is Present in the Meconium: Results of a Prospective Study. Clinical Infectious Diseases, April 2016: 62(7), 1:863-870. https://doi.org/10.1093/cid/ciw016.
79. Мазанкова Л.Н., Юнес Б., Горбунов С.Г., Курохтина И.С. Эпидемиология и клинические варианты Clostridium difficile-инфекции у детей. Детские инфекции. 2012. 3:39-42.
80. Юнес Б. Роль Clostrdium difficile в формировании антибиотик-ас-социированной диареи у детей: автореферат. М., 2013:25.
81. Мазанкова Л.Н., С.Г. Перловская, И.С. Курохтина, С.В. Лебедева. Особенности течения dostridia difficile-инфекции у детей раннего возраста. Педиатрия. 2016; 95(6):122-130.
82. Xie X, Xiang B, Wu Y, Zhao Y, Wang Q, Jiang X. Infant progressive colonic stenosis caused by antibiotic-related Clostridium difficile colitis - a case report and literature review. BMC Pediatr. 2018 Oct 9; 18(1):320. https://doi.org/10.1186/s12887-018-1302-9.
83. Tibesar E. Clostridium difficile Infection in a Very Young Infant with Pseudomembranous Colitis Noted on Endoscopy. Case Rep Gastroenterol. 2020 Oct 27; 14(3):522-526. https://doi.org/10.1159/000508916. eCollection 2020 PMID: ec.PMID: 33250692
84. Wopereis H., Oozeer R., Knipping K., Belzer C., Knol, J. The first thousand days-Intestinal microbiology of early life: Establishing a symbiosis. Pediatr. Allergy Immunol. 2014, 25:428-438.
85. Kamada N., Chen G.Y., Inohara N., Nunez G. Control of pathogens and pathobionts by the gut microbiota. Nat. Immunol. 2013, 14: 685-690.
86. Khanna S., Baddour L.M., Huskins W.C., et al. The Epidemiology of Clostridium difficile Infection in Children: A Population-Based Study. Clin Infect Dis. 2013; 56(10):1401-6.
87. Wendt J.M., Cohen J.A., Mu Y., et al. Clostridium difficile Infection Among Children Across Diverse US Geographic Locations. Pediatrics. 2014; 133(4): 651-8.
88. Larry K. Kociolek, Robyn O. Espinosa, Dale N. Gerding et al. Natural Clostridioides difficile Toxin Immunization in Colonized Infants. Clinical Infectious Diseases, 15 May 2020, 70(10): 2095- 2102. https://doi.org/10.1093/cid/ciz582
89. Tamma P.D., Sandora T.J. Clostridium difficile Infection in Children: Current State and Unanswered Questions. J Pediatric Infect Dis Soc. 2012; 1(3): 230-43.
Рецензия
Для цитирования:
Мазанкова Л.Н., Перловская С.Г., Рыбальченко О.В. C. difficile-инфекция у новорожденных: решенные и нерешенные вопросы. ДЕТСКИЕ ИНФЕКЦИИ. 2021;20(3):39-47. https://doi.org/10.22627/2072-8107-2021-20-3-39-47
For citation:
Mazankova L.N., Perlovskaya S.G., Rubalchenko O.V. C. difficile-infection and microbyota in newborns: resolved and outstanding issues. CHILDREN INFECTIONS. 2021;20(3):39-47. (In Russ.) https://doi.org/10.22627/2072-8107-2021-20-3-39-47
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