Avaliação da microbiota intestinal de crianças com doença falciforme em uso crônico de antibioticoprofilaxia

Abstract

Sickle cell disease (SCD) causes a malfunction of the spleen increasing the susceptibility of children under the age of five to recurrent and severe infections, mainly by Streptococcus pneumoniae. Thus, until the fifth year of life, the period with the highest occurrence of deaths and serious complications, prophylactic care represents the essence of treatment, such as the use of penicillin and folic acid. This work aimed to evaluate the intestinal microbiota of patients with sickle cell disease in chronic use of antibiotic prophylaxis. The stool bacterial microbiome of 30 children with SCD and 28 controls was analyzed using the 16S rRNA gene, using New Generation Sequencing-NGS (Next Generation Sequencing) on Illumina's MiSeq platform. Data from the main alpha diversity indices (Chao1, ACE, Shannon and Simpson) show that the group with SCD has less diversity in the intestinal microbiota. When beta diversity was assessed, through Principal Coordinate Analysis - PCoA, the group with SCD presented greater dissimilarity within the group and among the controls. In the taxonomic evaluation, the four most abundant phyla in both groups were Firmicutes, Bacteroidetes, Actinobacteria and Proteobacteria. Among the Archeaes, 98% of the OTUs obtained, belonged to Metanobrevibacter, with less frequency and AR in the SCD. At the family level, Lachnospiraceae and Ruminococcaceae appear with more than 50% of AR. The group with SCD showed a statistical difference in the families of gram-negative bacteria, with greater abundance of Bacteroidaceae and Enterobacteriaceae, which increases the availability of the LPS endotoxin in the intestine lumen. Of the 40 divergent genera, only ten were more abundant in the SCD when compared to CTL: Bacteroide, Blautia, Eggerthella, Erysipelatoclostridium, Klebsiella, Lactobacillus, Hungatella, Megamonas, Rikenellaceae_RC9_gut_group and Rothia.