产时阿奇霉素对儿童早期肠道微生物群发育的影响：一项双盲随机试验的事后分析

Effect of intrapartum azithromycin on gut microbiota development in early childhood: A post hoc analysis of a double-blind randomized trial.

作者信息

Sanyang Bakary, de Silva Thushan I, Camara Bully, Beloum Nathalie, Kanteh Abdoulie, Manneh Jarra, de Steenhuijsen Piters Wouter A A, Bogaert Debby, Sesay Abdul Karim, Roca Anna

机构信息

Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia.

The Florey Institute and Department of Infection, Immunity and Cardiovascular Disease, Medical School, University of Sheffield, Sheffield, UK.

出版信息

iScience. 2024 Aug 3;27(9):110626. doi: 10.1016/j.isci.2024.110626. eCollection 2024 Sep 20.

Intrapartum azithromycin prophylaxis has shown the potential to reduce maternal infections but showed no effect on neonatal sepsis and mortality. Antibiotic exposure early in life may affect gut microbiota development, leading to undesired consequences. Therefore, we here assessed the impact of 2 g oral intrapartum azithromycin on gut microbiota development from birth to the age of 3 years, by 16S-rRNA gene profiling of rectal samples from 127 healthy Gambian infants selected from a double-blind randomized placebo-controlled clinical trial (PregnAnZI-2). Microbiota trajectories showed, over the first month of life, a slower community transition and increase of ( = 0.001) and ( = 0.064) and a decrease of ( < 0.001) in the azithromycin compared to the placebo arm. Intrapartum azithromycin alters gut microbiota development and increases proinflammatory bacteria in the first month of life, which may have undesirable effects on the child.

产时阿奇霉素预防用药已显示出降低产妇感染的潜力，但对新生儿败血症和死亡率并无影响。生命早期接触抗生素可能会影响肠道微生物群的发育，从而导致不良后果。因此，我们通过对127名从双盲随机安慰剂对照临床试验（PregnAnZI - 2）中选取的健康冈比亚婴儿的直肠样本进行16S - rRNA基因分析，评估了2克口服产时阿奇霉素对从出生到3岁儿童肠道微生物群发育的影响。微生物群轨迹显示，在生命的第一个月，与安慰剂组相比，阿奇霉素组的群落过渡较慢，（ = 0.001）和（ = 0.064）增加，（ < 0.001）减少。产时阿奇霉素会改变肠道微生物群的发育，并在生命的第一个月增加促炎细菌，这可能会对儿童产生不良影响。