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南京医科大学学报(自然科学版) 第42卷第10期
·1432 · Journal of Nanjing Medical University(Natural Sciences) 2022年10月
·临床研究·
不同喂养方式对早期新生儿口咽微生态菌群的影响
王学娟 ,丁诗田 ,高胜男 ,迭馨娴 ,李冰洁 ,邵志英 ,朱敏蓉 ,游铭钰 ,张宇涵 ,陈筱青 1*
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南京医科大学第一附属医院儿科,江苏 南京 210029;上海市浦东新区妇幼保健院新生儿科,上海 201206;南京医科大
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学儿科学院,江苏 南京 211166
[摘 要] 目的:初步探讨足月健康早期新生儿口咽微生态中菌群分布的特点及不同喂养方式对早期新生儿口咽微生态菌群
定植的影响。 方法:选取 2021 年 9 月— 2022 年 2 月于上海市浦东新区妇幼保健院产科出生的 20 例足月健康新生儿为研
TM TM
究对象,纯母乳喂养 8 例、混合喂养 12 例。采集新生儿出生当天及生后第 5~7 天的咽拭子样本,利用 Illumina Miseq /Hiseq
平台对细菌 16S rRNA 的 V3~V4 可变区进行 DNA 测序,对测序结果进行生物信息学分析。结果:①40 个咽拭子样本中共发
现门 36 个,纲84个,目144个,科292个,属736个。②足月健康新生儿从出生到生后5~7天,新生儿口咽部菌群的相对丰富度
及多样性逐渐降低,个体间差异显著缩小;纯母乳喂养的早期新生儿口咽菌群α多样性低于混合喂养新生儿。③在门水平上,
不同喂养组的主要门均为变形菌门、厚壁菌门、放线菌门和拟杆菌门,4 个优势菌门的相对丰度组间比较差异均无统计学意
义(P 均 > 0.05)。与第 1 天相比,第 5~7 天纯母乳喂养组中厚壁菌门(P=0.008)、放线菌门(P=0.844)、拟杆菌门(P=0.250)的
相对丰度上升,变形菌门的相对丰度下降(P=0.055);而混合喂养组中厚壁菌门(P < 0.001)、放线菌门(P=0.733)的相对丰度上
升,变形菌门(P < 0.001)、拟杆菌门(P=0.027)的相对丰度下降。④在属水平上,出生当天以慢生根瘤菌属、葡萄球菌属、不动
杆菌属、伯克氏菌属、链球菌属为主要属,随着出生时间的推移,生后5~7天链球菌属、葡萄球菌属、拟杆菌属、罗氏菌属、双歧
杆菌属上升为主要属;不同喂养组均以链球菌属和葡萄球菌属为优势属,纯母乳喂养组中拟杆菌属、罗氏菌属、双歧杆菌属等
厌氧菌的丰度高于混合喂养组。结论:新生儿生后早期口咽微生态菌群的多样性逐渐降低,稳定性逐渐增加;且不同喂养方式
对早期新生儿口咽部菌群定植与分布存在一定的影响,纯母乳喂养有助于新生儿口咽部厌氧菌的早期定植。
[关键词] 口咽;微生态菌群;16S rRNA;新生儿;母乳喂养
[中图分类号] R722.1 [文献标志码] A [文章编号] 1007⁃4368(2022)10⁃1432⁃08
doi:10.7655/NYDXBNS20221013
Effects of different feeding methods on oropharyngeal microbiota in early⁃life of newborns
WANG Xuejuan ,DING Shitian ,GAO Shengnan ,DIE Xinxian ,LI Bingjie ,SHAO Zhiying ,ZHU Minrong ,
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YOU Mingyu ,ZHANG Yuhan ,CHEN Xiaoqing
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1 Department of Pediatric,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;Neonatal
Department,Shanghai Pudong New Area Health Care Hospital for Woman and Children,Shanghai 201206;School
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of Pediatrics,Nanjing Medical University,Nanjing 211166,China
[Abstract] Objective:To investigate the distribution characteristics of oropharyngeal microbiota and the effects of different feeding
methods on oropharyngeal microbiota colonization of healthy full term newborns in early⁃life. Methods:A total of 20 healthy term
infants delivered between September 2021 and February 2022 at Shanghai Pudong New Area Health Care Hospital for Women and
Children were recruited. According to feeding methods,infants were respectively divided into two groups,which were exclusively
breastfeeding(n=8)and mixed⁃feeding(n=12). Oropharyngeal swab samples of all subjects were collected on the first day and day 5⁃7
TM
TM
after birth. The V3~V4 region of 16S rRNA gene was sequenced on Illumina Miseq /Hiseq platform,and the results were analyzed
by bioinformatics. Results:①36 phylum,84 class,144 order,292 family and 736 genus were identified in the 40 oropharyngeal swab
samples. ②From day 1 to day 5~7 after birth,the relative abundance and diversity of oropharyngeal microbiota decreased gradually,
and the differences between individuals decreased significantly. The α diversity of oropharyngeal microbiota in the exclusive
breastfeeding group was lower than that in the mixed⁃feeding group. ③At the phylum level,Proteobacteria,Firmicutes,Actinobacteria
and Bacteroidetes were the main phyla in different feeding groups. However,there was no significant difference in the four dominant
phyla between two groups(P > 0.05). Compared with day 1,the relative abundance of Firmicutes(P=0.008),Actinobacteria(P=0.844)