The Effect of Probiotic Treatment on Patients Infected with the H7N9 Influenza Virus
Xinjun Hu1,2, Hua Zhang1, Haifeng Lu1
1State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, P.R. China.
Background:
A novel avian-origin influenza A (H7N9) virus emerged and spread among humans in Eastern China in 2013. Prophylactic treatment with antibiotics and probiotics for secondary infection is as important as antiviral treatment. This study aims to assess the ability of probiotic treatment to restore internal homeostasis under antibiotic pressure and to reduce/ameliorate the risk of secondary infections resulting from infection with the H7N9 virus.
Methods:
This is a retrospective study in archival samples. Between April 1 and May 10, 2013, 113 stool, sputum, and blood specimens were collected and analyzed by denaturing gradient gel electrophoresis (DGGE) to determine the composition of the patient microbiomes. Microbial diversity was calculated using Gel-Pro analyzer and Past software. Cluster analysis of DGGE pattern profiles was employed to create a phylogenetic tree for each patient, and multidimensional scaling (MDS) and principal component analysis (PCA) were performed to visualize relationships between individual lanes.
Results:
Five patients had secondary infections, including Klebsiella pneumonia, Acinetobacter baumanii and Candida albicans infection. The DGGE profiles of fecal samples obtained at different time points from the same individual were clearly different, particularly for patients with secondary infections. Shannon's diversity index and evenness index were lower in all infected groups compared to the control group. After B. subtilis and E. faecium or C. butyricum administration, the fecal bacterial profiles of patients who had not been treated with antibiotics displayed a trend of increasing diversity and evenness. C. butyricum failed to reduce/ameliorate secondary infection in H7N9-infected patients, but administration of B. subtilis and E. faecium appeared to reduce/ameliorate secondary infection in one patient.
Conclusion:
H7N9 infection might decrease intestinal microbial diversity and species richness in humans. C. butyricum failed to reduce/ameliorate secondary infection in H7N9-infected patients. B. subtilis and E. faecium may also play a role in reducing/ameliorating secondary infection in these patients.
Insights
Avian-origin influenza A (H7N9) virus infection may reduce gut microbial diversity. Certain probiotics, like B. subtilis and E. faecium, show potential in mitigating secondary infections in H7N9 patients.
Area of Science:
- Microbiology
- Infectious Diseases
- Gastroenterology
Background:
- Avian-origin influenza A (H7N9) virus emerged in China in 2013.
- Secondary infections are a significant concern in H7N9 patients.
- Prophylactic antibiotic and probiotic use is crucial alongside antiviral treatment.
Purpose of the Study:
- To assess probiotic efficacy in restoring homeostasis under antibiotic pressure.
- To evaluate probiotics' role in reducing secondary infections in H7N9 patients.
- To understand the impact of H7N9 on gut microbiome composition.
Main Methods:
- Retrospective analysis of archival stool, sputum, and blood specimens (n=113).
- Denaturing Gradient Gel Electrophoresis (DGGE) for microbiome composition analysis.
- Microbial diversity calculation and phylogenetic analysis using specialized software.
Main Results:
- H7N9 infection was associated with decreased microbial diversity and richness.
- Secondary infections (Klebsiella pneumoniae, Acinetobacter baumanii, Candida albicans) were observed.
- B. subtilis and E. faecium showed potential in reducing secondary infections in one patient, while C. butyricum did not.
Conclusions:
- H7N9 infection may disrupt human intestinal microbial diversity.
- B. subtilis and E. faecium show promise in managing secondary infections in H7N9 patients.
- C. butyricum was ineffective in ameliorating secondary infections in this cohort.
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