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Impact of intrapartum antimicrobial prophylaxis upon the intestinal microbiota and the prevalence of antibiotic resistance genes in vaginally delivered full-term neonates
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2017-08-08
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Nogacka, A., Salazar, N., Suárez, M. et al. Impact of intrapartum antimicrobial prophylaxis upon the intestinal microbiota and the prevalence of antibiotic resistance genes in vaginally delivered full-term neonates. Microbiome 5, 93 (2017). https://doi.org/10.1186/s40168-017-0313-3
Abstract
Background: Disturbances 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.
Results: Fecal 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.
Conclusions: Our 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.