Association between duration of intravenous antibiotic administration and early-life microbiota development in late-preterm infants

Abstract

Antibiotic treatment is common practice in the neonatal ward for the prevention and treatment of sepsis, which is one of the leading causes of mortality and morbidity in preterm infants. Although the effect of antibiotic treatment on microbiota development is well recognised, little attention has been paid to treatment duration. We studied the effect of short and long intravenous antibiotic administration on intestinal microbiota development in preterm infants. Faecal samples from 15 preterm infants (35 ± 1 weeks gestation and 2871 ± 260 g birth weight) exposed to no, short (≤ 3 days) or long (≥ 5 days) treatment with amoxicillin/ceftazidime were collected during the first six postnatal weeks. Microbiota composition was determined through 16S rRNA gene sequencing and by quantitative polymerase chain reaction (qPCR). Short and long antibiotic treat ment significantly lowered the abundance of Bifidobacterium right after treatment (p = 0.027) till postnatal week three (p = 0.028). Long treatment caused Bifidobacterium abundance to remain decreased till postnatal week six (p = 0.009). Antibiotic treatment was effective against members of the Enterobacteriaceae family, but allowed Enterococcus to thrive and remain dominant for up to two weeks after antibiotic treatment discontinuation. Community richness and diversity were not affected by antibiotic treatment, but were positively associated with postnatal age (p < 0.023) and with abundance of Bifidobacterium (p = 0.003). Intravenous antibiotic administration during the first postnatal week greatly affects the infant’s gastrointestinal microbiota. However, quick antibiotic treatment cessation allows for its recovery. Disturbances in microbiota development caused by short and, more extensively, by long antibiotic treatment could affect healthy development of the infant via interference with maturation of the immune system and gastrointestinal tract.Electronic supplementary materialThe online version of this article (10.1007/s10096-018-3193-y) contains supplementary material, which is available to authorized users.

Amoxicillin exposure significantly increases the population and virulence of antibiotic-resistant Klebsiella pathogen in the simulated human intestinal microbiota

“…A recent research revealed that AMX mediated opportunistic pathogen Escherichia/Shigella blooms persisted 42 days after the interruption of antibiotic therapy [22]. Similar phenomenon was also reported by Zwittink and colleagues, who also discovered that 5 days treatment with AMX and ceftazidime combinations allowed Enterococcus to thrive and remain dominant for up to two weeks and caused Bifidobacterium abundance to remain decreased till postnatal week six after antibiotic treatment discontinuation [51]. Therefore, our results demonstrated the serious negative side-effect of AMX could be persistent and colon region-different, which should be considered as an important aspect of the risk assessment for AMX prescription.…”

Persistent metagenomic signatures of early-life hospitalization and antibiotic treatment in the infant gut microbiota and resistome

“…Because microbiota perturbation during infancy may be disproportionately damaging 35,36 , it is imperative to study the lasting effects of antibiotics and hospitalization on the preterm IGM. Prior studies of preterm infants report IGM recovery concomitant with NICU discharge [37][38][39] . However, these studies rely on culture or amplicon sequencing (e.g.…”

Short‐term changes of intestinal microbiota composition in preterm infants after two prophylactic doses of vancomycin

“…Since bifidobacteria are considered beneficial early life colonisers of the gut, this is a point of concern. Bifidobacteria play an important role in milk digestion, limit pathogen colonisation and support development of the immune system . As shown previously, a lower abundance of bifidobacteria during early development of the gut microbiota may also be a result of postpartum antibiotic use rather than of two vancomycin doses .…”