Nature子刊：真菌血液感染期间的肠道真菌动态变化
- ①在进行异体造血干细胞移植期间，收集8名念珠菌血症患者和7名对照的粪便样品；
- ②在移植后，念珠菌血症患者粪便中的真菌负荷增加，主要为念珠菌属富集所驱动；
- ③对照组患者的真菌负荷未显著增加，多样性高于念珠菌血症患者，组成与健康人类似；
- ④血液感染发生期间，胃肠道中的特定致病性念珠菌属物种（C. parapsilosis与白色念珠菌等）扩增并易位进入血液；
- ⑤肠道中致病性念珠菌属的扩增与细菌（特别是厌氧菌）负荷及多样性的降低相关。
主编推荐语
Nature Medicine上发表的一项病例-对照研究结果，对接受造血干细胞移植的15名患者移植前后的粪便及血液样本进行分析，发现移植后的念珠菌血症与肠道真菌的失调及易位相关，并伴随着肠道细菌的变化，提示可通过监测肠道细菌及真菌的变化预测患者的真菌血液感染风险。
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High-resolution mycobiota analysis reveals dynamic intestinal translocation preceding invasive candidiasis
高分辨率真菌组分析揭示侵袭性念珠菌感染前的动态肠道易位
10.1038/s41591-019-0709-7
2020-01-06, Letter
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The intestinal microbiota is a complex community of bacteria, archaea, viruses, protists and fungi1,2. Although the composition of bacterial constituents has been linked to immune homeostasis and infectious susceptibility3,4,5,6,7, the role of non-bacterial constituents and cross-kingdom microbial interactions in these processes is poorly understood2,8. Fungi represent a major cause of infectious morbidity and mortality in immunocompromised individuals, although the relationship of intestinal fungi (that is, the mycobiota) with fungal bloodstream infections remains undefined9. We integrated an optimized bioinformatics pipeline with high-resolution mycobiota sequencing and comparative genomic analyses of fecal and blood specimens from recipients of allogeneic hematopoietic cell transplant. Patients with Candida bloodstream infection experienced a prior marked intestinal expansion of pathogenic Candida species; this expansion consisted of a complex dynamic between multiple species and subspecies with a stochastic translocation pattern into the bloodstream. The intestinal expansion of pathogenic Candida spp. was associated with a substantial loss in bacterial burden and diversity, particularly in the anaerobes. Thus, simultaneous analysis of intestinal fungi and bacteria identifies dysbiosis states across kingdoms that may promote fungal translocation and facilitate invasive disease. These findings support microbiota-driven approaches to identify patients at risk of fungal bloodstream infections for pre-emptive therapeutic intervention.
First Authors:
Bing Zhai
Correspondence Authors:
Ying Taur,Tobias M Hohl
All Authors:
Bing Zhai,Mihaela Ola,Thierry Rolling,Nicholas L Tosini,Sari Joshowitz,Eric R Littmann,Luigi A Amoretti,Emily Fontana,Roberta J Wright,Edwin Miranda,Charlotte A Veelken,Sejal M Morjaria,Jonathan U Peled,Marcel R M van den Brink,N Esther Babady,Geraldine Butler,Ying Taur,Tobias M Hohl
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