Quantitative Analysis Of Intestinal Flora Imbalance In Patients With Hematological Caused By Broad-spectrum Antibiotics

Objective:1 Quantitative analysis was conducted on the flora before and after antibiotic-related diarrhea,and the flora that might cause antibiotic-related diarrhea was comprehensively and concretely analyzed.2 To investigate the changes in colonization rate and risk factors of CD in patients with antibiotic-related diarrhea.Methods:1 The sample sourceFresh feces of patients with a clear diagnosis of hematological disease were collected from the Department of Hematology,Affiliated Hospital of Chengde Medical College from November 2018 to October 2019.Through the electronic case system of Chengde Medical College Affiliated Hospital to query the relevant clinical data of the patient,including the hospital number,age,gender,length of hospital stay,antibiotic use,etc.By comparing and analyzing the intestinal flora of the same patient without antibiotics and the occurrence of antibiotic associated diarrhea,the changes of intestinal flora when different antibiotics caused diarrhea were identified.2 The experimental method2.1 The 16 S amplicon sequencing method of Illumina sequencing technology was used to conduct a comprehensive analysis on the flora structure of the feces samples of the prolactam group,prolactam with other antibiotics(other antibiotics include antifungal and glycopeptide antibiotics.2.2 Tcd B was detected by real-time quantitative polymerase chain reaction(RT-q PCR)in feces from enrolled patients with diarrhea and without antibiotics.Results:? In patients with hematological diseases without antibiotics,the intestinal flora after chemotherapy was dominated by Firmicutes and Proteobacteria,followed by Bacteroidetes and actinobacteria.At the genus level,Escherichia-Shigella,Enterococcus,Bacteroides,Bifidobacterium,Lactobacillus,Streptococcus,Subdoligranulum,and Faecalibacterium were selected.Bacteroidetes significantly decreased in the beta-lactam antibiotic group compared with the non-antibiotic group,while Bacteroidetes decreased in the beta-lactam with other antibiotic groups,but no significant difference was found.No significant difference was found in Firmicutes,which the enterococcaceae and enterococcus were significantly decreased in beta-lactam group and beta-lactam with other antibiotic group,beta-lactam with other antibiotic group as the main group.Proteobacteria were the second dominant bacteria in the two groups,and no significant difference was found in the use of antibiotics.The number of Bifidobacterium was significantly increased in the beta-lactam group and beta-lactam with other antibiotic groups.Alpha diversity suggested that the abundance and diversity of intestinal flora in diarrhea patients treated with beta-lactam antibiotics and beta-lactam with other antibiotics were lower than those without antibiotics.PCA analysis showed that the overall structure of intestinal flora was significantly different in patients with antibiotic-related diarrhea in the beta-lactam group and the beta-lactam combined with other antibiotic groups compared with those without antibiotics.? The colonization rate of clostridium difficile increased in patients with antibiotic-associated diarrhea in hematology.Agranulocytosis was a risk factor for CDAD(Clostridium difficile associated diarrhea,CDAD)(p=0.018).Gender,age,length of hospitalization,recent 2-month hospitalization,diabetes,hypertension,chemotherapy,and antibiotic type were not associated with CDAD(p= > 0.05).Conclusion:1 Antibiotic-associated diarrhea is related to the diversity and abundance of intestinal bacterial flora,which can reduce the diversity and abundance of bacterial flora;the application of broad-spectrum antibiotics can induce the increase in the abundance of Proteobacteria.2 The colonization rate of clostridium difficile increased in hematology patients with antibiotic-associated diarrhea,and agranulocytosis was a risk factor for CDAD.