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Perfil do microbiota intestinal de recém-nascidos sujeitos a enterostomia
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A composição do microbiota intestinal é considerado um importante determinante de
saúde nos recém-nascidos (RNs). Este é modulado por diversos fatores entre os quais a
presença de patologia gastrointestinal e o seu respetivo tratamento cirúrgico, como a
enterostomia. O objetivo da enterostomia é reconstituir e recuperar a zona do intestino
onde existe lesão e permitir a excreção de resíduos intestinais. Apesar da sua
importância, é ainda escasso o conhecimento acerca do seu impacto na composição do
microbiota intestinal de RNs. Como tal, o objetivo deste trabalho consistiu em
caracterizar o microbiota intestinal bacteriano e fúngico de RNs sujeitos a enterostomia,
e determinar a influência de parâmetros clínicos perinatais e cirúrgicos (relacionados
com a enterostomia) no microbiota intestinal desses RNs. Para tal, foram recrutados 32
RNs de termo ou pré-termo da Unidade de Cuidados Intensivos Neonatais do Hospital
Dona Estefânia com indicação clínica para colocação de enterostomia, tendo-se
avaliado a composição do seu microbiota intestinal no 1.° e 21.° dias após a colocação
da enterostomia. Os resultados do presente estudo mostraram que apesar da diversidade
bacteriana não se ter alterado, a abundância bacteriana total aumentou 20 % vinte dias
após a colocação da enterostomia. Além disso, observou-se pela primeira vez que a
abundância intestinal de Candida diminuiu cerca de 20 % após a colocação da
enterostomia. O aumento da abundância bacteriana total e a redução da de Candida
estavam associados a maior ganho de peso corporal, um importante biomarcador
precoce de crescimento e critério de alta hospitalar em RNs. Apesar de ser necessária
uma caracterização mais detalhada do microbiota intestinal, os resultados do presente
estudo sugerem que a composição do microbiota intestinal é uma variável fundamental
de monitorização e prognóstico a considerar nos cuidados de saúde de RNs.
Intestinal microbiota composition is considered an important determinant of health in newborns (NBs). It is modulated by several factors, including the presence of gastrointestinal pathology and its respective surgical treatment, such as enterostomy. The purpose of the enterostomy is to repair and restore the area of the intestine where there is an injury and allow the excretion of intestinal waste products. Despite its importance, knowledge about its impact on the composition of newborns’ intestinal microbiota is still scarce. As such, the aim of this study was to characterize the bacterial and fungal intestinal microbiota of NBs undergoing enterostomy, and to determine the influence of perinatal and surgical (enterostomy-related) clinical parameters on the intestinal microbiota of these NBs. To this end, 32 term or pre-term NBs were recruited from the Neonatal Intensive Care Unit of the Dona Estefânia Hospital with clinical indication for enterostomy, and the composition of their intestinal microbiota was assessed on the 1st and 21st days after enterostomy. The results of the present study showed that although bacterial diversity remained unchanged, total bacterial abundance increased by 20% twenty days after enterostomy. In addition, it was observed for the first time that intestinal abundance of Candida decreased by about 20% after enterostomy. Increased total bacterial abundance and decreased Candida abundance were associated with greater body weight gain, an important early biomarker of growth and a criterion for hospital discharge in NBs. Although a more detailed characterization of the gut microbiota is needed, the results of the present study suggest that gut microbiota composition maybe a fundamental variable in the monitorization and prognosis of NBs’ health.
Intestinal microbiota composition is considered an important determinant of health in newborns (NBs). It is modulated by several factors, including the presence of gastrointestinal pathology and its respective surgical treatment, such as enterostomy. The purpose of the enterostomy is to repair and restore the area of the intestine where there is an injury and allow the excretion of intestinal waste products. Despite its importance, knowledge about its impact on the composition of newborns’ intestinal microbiota is still scarce. As such, the aim of this study was to characterize the bacterial and fungal intestinal microbiota of NBs undergoing enterostomy, and to determine the influence of perinatal and surgical (enterostomy-related) clinical parameters on the intestinal microbiota of these NBs. To this end, 32 term or pre-term NBs were recruited from the Neonatal Intensive Care Unit of the Dona Estefânia Hospital with clinical indication for enterostomy, and the composition of their intestinal microbiota was assessed on the 1st and 21st days after enterostomy. The results of the present study showed that although bacterial diversity remained unchanged, total bacterial abundance increased by 20% twenty days after enterostomy. In addition, it was observed for the first time that intestinal abundance of Candida decreased by about 20% after enterostomy. Increased total bacterial abundance and decreased Candida abundance were associated with greater body weight gain, an important early biomarker of growth and a criterion for hospital discharge in NBs. Although a more detailed characterization of the gut microbiota is needed, the results of the present study suggest that gut microbiota composition maybe a fundamental variable in the monitorization and prognosis of NBs’ health.
Descrição
Palavras-chave
abundância Candida enterostomia microbiota intestinal parâmetros clínicos perinatais e cirúrgicos recém-nascidos