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静脉注射阿莫西林/头孢他啶治疗后早产儿和足月儿肠道菌群的动态变化。

Dynamics of the bacterial gut microbiota in preterm and term infants after intravenous amoxicillin/ceftazidime treatment.

机构信息

Laboratory of Microbiology, Wageningen University, Stippeneng 4, 6708WE, Wageningen, The Netherlands.

Princess Amalia Dpt of Paediatrics, Dpt of Neonatology, Isala, Zwolle, The Netherlands.

出版信息

BMC Pediatr. 2020 May 7;20(1):195. doi: 10.1186/s12887-020-02067-z.

Abstract

BACKGROUND

It is important to understand the consequences of pre-emptive antibiotic treatment in neonates, as disturbances in microbiota development during this key developmental time window might affect early and later life health outcomes. Despite increasing knowledge regarding the detrimental effect of antibiotics on the gut microbiota, limited research focussed on antibiotic treatment duration. We determined the effect of short and long amoxicillin/ceftazidime administration on gut microbiota development during the immediate postnatal life of preterm and term infants.

METHODS

Faeces was collected from 63 (pre) term infants at postnatal weeks one, two, three, four and six. Infants received either no (control), short-term (ST) or long-term (LT) postpartum amoxicillin/ceftazidime treatment.

RESULTS

Compared to control infants, ST and LT infants' microbiota contained significantly higher abundance of Enterococcus during the first two postnatal weeks at the expense of Bifidobacterium and Streptococcus. Short and long antibiotic treatment both allowed for microbiota restoration within the first six postnatal weeks. However, Enterococcus and Bifidobacterium abundances were affected in fewer ST than LT infants.

CONCLUSIONS

Intravenous amoxicillin/ceftazidime administration affects intestinal microbiota composition by decreasing the relative abundance of Escherichia-Shigella and Streptococcus, while increasing the relative abundance of Enterococcus and Lactobacillus species during the first two postnatal weeks. Thriving of enterococci at the expense of bifidobacteria and streptococci should be considered as aspect of the cost-benefit determination for antibiotic prescription.

摘要

背景

了解新生儿预防性抗生素治疗的后果很重要,因为在此关键发育窗口期内,微生物群发育的干扰可能会影响早期和后期的健康结果。尽管人们越来越了解抗生素对肠道微生物群的有害影响,但针对抗生素治疗持续时间的研究有限。我们确定了短期和长期阿莫西林/头孢他啶给药对早产儿和足月儿出生后立即肠道微生物群发育的影响。

方法

从 63 名(早产)婴儿在产后第 1、2、3、4 和 6 周收集粪便。婴儿接受无(对照)、短期(ST)或长期(LT)产后阿莫西林/头孢他啶治疗。

结果

与对照婴儿相比,ST 和 LT 婴儿的微生物群在出生后的头两周内,由于双歧杆菌和链球菌的消耗,肠球菌的丰度显著增加。短期和长期抗生素治疗都允许在出生后的前 6 周内恢复微生物群。然而,与 LT 婴儿相比,ST 婴儿的肠球菌和双歧杆菌丰度受影响的情况较少。

结论

静脉内给予阿莫西林/头孢他啶会通过减少大肠杆菌-志贺氏菌和链球菌的相对丰度,同时增加肠球菌和乳杆菌属物种的相对丰度,从而影响肠道微生物群组成,在出生后的前两周。以双歧杆菌和链球菌为代价促进肠球菌的生长应被视为抗生素处方成本效益确定的一个方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a44/7204001/52479a70adcb/12887_2020_2067_Fig1_HTML.jpg

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