Characteristics of Gut Microbiome and Prediction of Infection in Neutropenic Children with Acute Leukemia

Abstract Background: Neutropenia in children with acute leukemia have a high incidence of infection and mortality. To identify and classify the potentially infected pathogens, this study compared the structural characteristics of gut microbiome in neutropenic and non-neutropenic children with acute leukemia. Results: The results showed that 6033 OUTs were observed in total, and the sequence coverage index was more than 0.97. In the analysis of alpha diversity, the colony richness index (Chao1 index) of Group A1 was significantly lower than that of Group A0 (P = 0.035). The fecal bacterial communities were dominated by the phylum Firmicutes, Proteobacteria, and Bacteroidetes in both groups, with no significant difference. Higher relative abundance of genera Enterococcus (P = 0.0076), Streptococcus (P = 0.014) and species Bacteroides fragilis (P = 0.034) were observed in Group A1, but class Clostridia (P = 0.038), genera Blautia (P = 0.021) and Roseburia (P = 0.011) were more prevalent in Group A0. The relatively high abundance of Bacteroides fragilis in neutropenia with childhood acute leukemia was an independent risk factor for infection (P=0.028, 95% CI 1.024-1.241).Conclusions: The increase of Enterococcus, Streptococcus and Bacteroides fragilis, and the decrease of Clostridium, Blautia, and Roseburia may be the characteristics of intestinal flora in patients with acute leukemia. The relatively high abundance of Bacteroides fragilis in neutropenia with childhood acute leukemia may predict the occurrence of infection.