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围生期母亲使用抗生素治疗给婴儿留下隐患。

Antibiotic treatments to mothers during the perinatal period leaving hidden trouble on infants.

机构信息

Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province, Interdisciplinary Research Academy, Zhejiang Shuren University, Hangzhou, 310015, China.

The Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310001, China.

出版信息

Eur J Pediatr. 2022 Sep;181(9):3459-3471. doi: 10.1007/s00431-022-04516-6. Epub 2022 Jun 10.

Abstract

UNLABELLED

Antibiotic application during the perinatal period is unavoidable in the clinic, but the potential effects on mothers and infants remain unknown. Herein, 25 breast milk samples from mothers who received cefuroxime (CXM) or CXM + cefoxitin (CFX) treatments and fecal samples from their infants were collected to investigate the undesirable effects of antibiotics on the microbiota of mothers and neonates. Furthermore, five fecal samples of infants, whose mothers had antibiotic treatments, were collected at a 6-month postpartum follow-up visit to evaluate the long-term effects on infants' gut microbiota. Moreover, the relative abundance of antibiotic resistance genes (ARGs) in fecal samples was compared to investigate the transfer of ARGs in the infant gut microbiota. The results indicated that the antibiotic treatments had no influence on the microbiota of breast milk. The dominant bacterial phyla in the fecal samples changed to Firmicutes and Proteobacteria after antibiotic treatments, while the bacterial community showed a recuperative trend at the follow-up visits. In addition, the abundance of ARGs in the infant gut microbiota demonstrated a declining trend in the CXM- and CXM + CFX-treated groups, while ARG abundance presented a significant increasing trend after a 6-month recovery period.

CONCLUSION

Antibiotic treatments for mothers during the perinatal period disturb the gut microbiota in neonates. The infants' gut microbiota would partly return to their initial state after rehabilitation, but the transfer of ARGs would leave the hidden trouble of antibiotic resistance. Overall, the data presented here can help to guide the scientific use of antibiotics during the perinatal period and provide potential approaches to mitigate the negative consequences.

WHAT IS KNOWN

• Antibiotic application during the perinatal period is unavoidable in the clinic. • Misuse of antibiotics can cause various unintended consequences, especially for antibiotic resistance.

WHAT IS NEW

• Antibiotic treatments had no influence on the microbiota of breast milk but greatly disturbed the gut microbiota composition in infants. • The gut microbiota in infants would partly return to its initial state after rehabilitation but the transfer of ARGs would leave the hidden trouble of antibiotic resistance.

摘要

未加标签

围产期抗生素的应用在临床上是不可避免的,但对母亲和婴儿的潜在影响尚不清楚。在此,收集了 25 例接受头孢呋辛(CXM)或头孢呋辛酯(CFX)治疗的母亲的母乳样本和她们婴儿的粪便样本,以研究抗生素对母亲和新生儿菌群的不良影响。此外,在产后 6 个月的随访中,还收集了 5 例接受抗生素治疗的母亲的婴儿的粪便样本,以评估对婴儿肠道菌群的长期影响。此外,比较了粪便样本中抗生素耐药基因(ARGs)的相对丰度,以研究 ARGs 在婴儿肠道菌群中的转移。结果表明,抗生素治疗对母乳菌群没有影响。抗生素治疗后,粪便样本中优势细菌门变为厚壁菌门和变形菌门,而在随访时细菌群落表现出恢复趋势。此外,在 CXM 和 CXM+CFX 治疗组中,婴儿肠道菌群中 ARG 的丰度呈下降趋势,而在 6 个月恢复期后,ARG 丰度呈显著增加趋势。

结论

围产期母亲的抗生素治疗会干扰新生儿的肠道菌群。婴儿的肠道菌群在康复后会部分恢复到初始状态,但 ARG 的转移会留下抗生素耐药的隐患。总的来说,这里提供的数据可以帮助指导围产期抗生素的科学使用,并提供减轻负面影响的潜在方法。

已知内容

• 围产期抗生素的应用在临床上是不可避免的。• 抗生素的滥用会导致各种意想不到的后果,尤其是抗生素耐药性。

新内容

• 抗生素治疗对母乳菌群没有影响,但极大地干扰了婴儿肠道菌群的组成。• 婴儿的肠道菌群在康复后会部分恢复到初始状态,但 ARG 的转移会留下抗生素耐药的隐患。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afac/9395442/5ea622af88ba/431_2022_4516_Fig1_HTML.jpg

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