近日，美国纪念斯隆-凯特琳癌症中心Tobias M. Hohl、Ying Taur等研究人员利用高分辨率真菌群体分析揭示，侵袭性念珠菌病发生前的肠道动态转移。相关论文于2020年1月6日在线发表于国际学术期刊《自然—医学》。

研究人员将优化的生物信息学流程与高分辨率的真菌菌群测序以及来自同种异体造血细胞移植受者的粪便和血液样本的比较基因组分析相集成。念珠菌血液感染的患者先前经历了病原性念珠菌物种的明显肠道扩张；这种扩展包括多个物种和亚种之间的复杂动态，并具有随机转移到血液中的模式。致病性念珠菌属的肠道扩张与细菌负担和多样性的大量丧失有关，尤其是厌氧菌。因此，对肠道真菌和细菌的同时分析可确定不同界的稳态失调，这可能会促进真菌转移并促进侵袭性疾病。这些发现表明，基于微生物群的方法可用来识别有真菌血液感染风险的患者，以进行先发性治疗干预。

据介绍，肠道菌群是细菌、古细菌、病毒、原生生物和真菌组成的复杂群落。尽管细菌成分的组成已与免疫稳态和传染性易感性存在关联，但人们对这些过程中非细菌成分和不同界微生物相互作用的功能知之甚少。真菌是免疫功能低下个体中传染病发病率和死亡率的主要原因，尽管肠道真菌（即真菌菌群）与真菌血液感染之间的关系仍然不确定。

附：英文原文

Title: High-resolution mycobiota analysis reveals dynamic intestinal translocation preceding invasive candidiasis

Author: 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

Issue&Volume: 2020-01-06

Abstract: 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.

DOI: 10.1038/s41591-019-0709-7

Source: https://www.nature.com/articles/s41591-019-0709-7