Dynamic changes of the gut microbiota in a pair of newborn twins with cyanotic congenital heart disease and drug resistance of Enterobacter cloacae

Abstract:

[Objective] To observe the dynamic changes of gut microbiota in a pair of newborn twins with cyanotic congenital heart disease after surgery and antibiotic treatment and explore the variation of drug resistance of Enterobacter cloacae during treatment. [Methods] The fecal samples of the twins were collected at different stages of treatment and analyzed by culturomics and 16S rRNA gene sequencing.The susceptibility of ten Enterobacter cloacae strains isolated from the elder twin at different stages to antibiotics was determined.[Results] Culturomics results suggested that antibiotics decreased the flora richness of fecal samples before surgery and only Enterococcus,Acinetobacter and Enterobacter were isolated.Upon the long-time exposure to the hospital environment,opportunistic pathogens of several genera were isolated,including Enterobacter,Klebsiella,Acinetobacter and Pseudomonas.After 4 months of breast feeding,richness of fecal flora increased and the composition changed.To be specific,probiotics such as Lactobacillus and Bifidobacterium were isolated.16S rRNA gene sequencing results showed that α diversity indexes and the genus with highest relative abundance were different depending on treatment stages under the influence of various factors.The susceptibility tests indicated that E.cloacae strains gradually developed resistance to piperacillin during treatment.[Conclusion]Antibiotic treatment,exposure to hospital environment,and breast feeding all changed the gut microbiota structure of the twins during treatment and recovery.Even if only one antibiotic was used at different stages of treatment,the resistance of E.cloacae to different drugs might change.