Intrapartum antibiotics for GBS prophylaxis alter colonization patterns in the early infant gut microbiome of low risk infants

Abstract

Early life microbial colonization and succession is critically important to healthy development with impacts on metabolic and immunologic processes throughout life. A longitudinal prospective cohort was recruited from midwifery practices to include infants born at full term gestation to women with uncomplicated pregnancies. Here we compare bacterial community succession in infants born vaginally, with no exposure to antibiotics (n = 53), with infants who were exposed to intrapartum antibiotic prophylaxis (IAP) for Group B Streptococcus (GBS; n = 14), and infants born by C-section (n = 7). Molecular profiles of the 16 S rRNA genes indicate that there is a delay in the expansion of Bifidobacterium, which was the dominate infant gut colonizer, over the first 12 weeks and a persistence of Escherichia when IAP for GBS exposure is present during vaginal labour. Longer duration of IAP exposure increased the magnitude of the effect on Bifidobacterium populations, suggesting a longer delay in microbial community maturation. As with prior studies, we found altered gut colonisation following C-section that included a notable lack of Bacteroidetes. This study found that exposure of infants to IAP for GBS during vaginal birth affected aspects of gut microbial ecology that, although dramatic at early time points, disappeared by 12 weeks of age in most infants.

Sanitization of Early Life and Microbial Dysbiosis

“…Similar evidence of infant gut dysbiosis post IAP was reported by Nogacka and colleagues, as well as the enrichment of beta-lactamase resistant genes [34]. In another study, differing succession of bacterial community was observed between IAP exposed and control full-term infants [35]. In fact, women who are to receive IAP are indicated to have at-risk pregnancies and more likely to undergo a series of interventions such as increased hospitalization [36].…”

Specific class of intrapartum antibiotics relates to maturation of the infant gut microbiota: a prospective cohort study

“…Our findings support other studies that suggested a particular microbiome signature, with low abundance of Bacteroides, with intrapartum antibiotic use. [39][40][41]45 In our study, Bacteroides and Bifidobacterium also differed in abundance over time when comparing infants exposed to penicillin-like antibiotics with infants who were not exposed to any type of antibiotic during labour and delivery. This finding is similar to those of previous studies focused on the use of maternal antibiotics in general, particularly with the decrease in Bacteroides and Bifidobacterium.…”

“…Despite their widespread use, there are few published data on the potential effects of antibiotics on the infant and maternal microbiome during the process of labour and delivery at term gestation. [37][38][39][40][41][42][43][44] To our knowledge, no large cohort study has examined the effect of specific classes of antibiotics on the developing infant intestinal microbiota of full-term infants. This is relevant in practice because different classes of antibiotics are Figure 3.…”

“…This finding is similar to those of previous studies focused on the use of maternal antibiotics in general, particularly with the decrease in Bacteroides and Bifidobacterium. [38][39][40][41][42][43]46,47 One study 40 observed significant effects of GBS prophylaxis on the infant gut microbiome at 6 months among 150 pregnancies for members of Clostridiaceae, Ruminococcoceae and Enterococcaceae whereas another 41 (n = 83) found lower levels of Bifidobacterium and Escherichia at 12 weeks of life in infants of mothers exposed to intrapartum antibiotics.…”

Dietary Factors in the Control of Gut Homeostasis, Intestinal Stem Cells, and Colorectal Cancer

“…By contrast, rupture of the chorioamniotic membrane as occurs during cesarean section allows an exposure of the baby to a different set of maternal microbes (which are subsequently found in the meconium) resulting in an early alteration of the newborn microbiota [105]. Accordingly, it has been observed that cesarean delivery as well as intrapartum antibiotics during vaginal delivery alter bacterial colonization in neonates [106], although it is not completely understood which maternal strains colonize the different parts of the newborn's body and their specific functions. Breastfeeding is the most relevant post-natal factor that supports adequate microbial colonization of the gut and drives immune system maturation [107][108][109].…”