Impact of intrapartum antimicrobial prophylaxis upon the intestinal microbiota and the prevalence of antibiotic resistance genes in vaginally delivered full-term neonates

Abstract

BackgroundDisturbances in the early establishment of the intestinal microbiota may produce important implications for the infant’s health and for the risk of disease later on. Different perinatal conditions may be affecting the development of the gut microbiota. Some of them, such as delivery mode or feeding habits, have been extensively assessed whereas others remain to be studied, being critical to identify their impact on the microbiota and, if any, to minimize it. Antibiotics are among the drugs most frequently used in early life, the use of intrapartum antimicrobial prophylaxis (IAP), present in over 30% of deliveries, being the most frequent source of exposure. However, our knowledge on the effects of IAP on the microbiota establishment is still limited. The aim of the present work was to evaluate the impact of IAP investigating a cohort of 40 full-term vaginally delivered infants born after an uncomplicated pregnancy, 18 of which were born from mothers receiving IAP.ResultsFecal samples were collected at 2, 10, 30, and 90 days of age. We analyzed the composition of the fecal microbiota during the first 3 months of life by 16S rRNA gene sequencing and quantified fecal short chain fatty acids by gas chromatography. The presence of genes for resistance to antibiotics was determined by PCR in the samples from 1-month-old infants. Our results showed an altered pattern of intestinal microbiota establishment in IAP infants during the first weeks of life, with lower relative proportions of Actinobacteria and Bacteroidetes and increased of Preoteobacteria and Firmicutes. A delay in the increase on the levels of acetate was observed in IAP infants. The analyses of specific antibiotic resistance genes showed a higher occurrence of some β-lactamase coding genes in infants whose mothers received IAP.ConclusionsOur results indicate an effect of IAP on the establishing early microbiota during the first months of life, which represent a key moment for the development of the microbiota-induced host homeostasis. Understanding the impact of IAP in the gut microbiota development is essential for developing treatments to minimize it, favoring a proper gut microbiota development in IAP-exposed neonates.Electronic supplementary materialThe online version of this article (doi:10.1186/s40168-017-0313-3) contains supplementary material, which is available to authorized users.

Fetal and early life antibiotics exposure and very early onset inflammatory bowel disease: a population-based study

“…Furthermore, it has been suggested in studies of repeated faecal samples from term infants that the use of intrapartum PcV prophylaxis, to prevent early onset group B streptococcal infection in newborns, alters the offspring microbiome,48 49 although others have found very few differences between antibiotic-exposed and non-antibiotic-exposed infants 50. Meanwhile, maternal intake of probiotics influences the expression of toll-like receptors in infant meconium,51 indicating that fetal exposure of antibiotics may play an important role for the development of microbiota and the immune system of the child 48. While a causative association between antibiotics during pregnancy and VEO-IBD thus seems plausible, we cannot exclude possible confounding from an intrauterine infection with fever of the mother and a raised inflammatory reaction, causing epigenetic imprinting in the fetus and subsequent VEO-IBD.…”

Household composition and the infant fecal microbiome: The INSPIRE study

“…In addition to vertical modes of transmission, the infant GIM may be continuously modified by environmental exposures; for example, maternal and/or infant antibiotic exposure is associated with a reduction in overall taxonomic richness and diversity of the infant GIM (Nogacka et al, ; Yasmin et al, ). Additionally, GIM composition may be influenced by pet ownership and proximity to animals (Azad et al, ; Tun et al, ), parental sanitation practices (pacifier cleaning method: Hesselmar et al, ; use of specific household products: Ribado et al, ) and other environmental factors varying by geographic location (Grześkowiak et al, ; Lin et al, ; Stearns et al, ).…”

C-section and the Neonatal Gut Microbiome Acquisition: Consequences for Future Health

“…Previous studies have demonstrated that breast-milk or formula-milk provides a different recovery of the beneficial gut microbiota profile after its alteration by antibiotic exposure of babies or their mothers [35]. It is then necessary to elucidate the effect that the feeding type could play in the gut microbiota restoration of newborns after caesarean delivery.…”