Low-Dose Antibiotic Prophylaxis Induces Rapid Modifications of the Gut Microbiota in Infants With Vesicoureteral Reflux

Frontiers in Pediatrics

article

William Morello¹  Marco Pennesi²  Aleksandra Zurowska³  Francesca Becherucci⁴  Dorota Drozdz⁵  Djalila Mekahli⁶  Grazyna Krzemien⁸  Claudio La Scola⁹  Katarzyna Taranta-Janusz^1,10  Otto Mehls^1,11  Franz Schaefer^1,11  Federica D'Amico^1,12  Marco Candela^1,12  Giovanni Montini¹  Jessica Serafinelli¹  Silvia Turroni^1,12  Isabella Abati¹  Jessica Fiori^1,14  Esra Baskin^1,15  Fatos Yalcinkaya^1,16  Augustina Jankauskiene^1,17 

[1] Dialysis and Transplant Unit, Ospedale Maggiore Policlinico;Department of Pediatrics, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo;Pediatric Nephrology Department, Medical University of Gdansk;Nephrology and Dialysis Unit, Meyer Children's Hospital;Department of Pediatric Nephrology, Jagiellonian University Medical College;Department of Development and Regeneration, Laboratory of Pediatrics, PKD Group, KU Leuven—University of Leuven;Department of Pediatric Nephrology, University Hospitals Leuven;Department of Pediatric Nephrology, The Medical University of Warsaw;Nephrology and Dialysis Unit, Department of Pediatrics, Azienda Ospedaliero Universitaria Sant'Orsola-Malpighi;Department of Pediatrics and Nephrology, Medical University of Bialystok;Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital;Unit of Microbiome Science and Biotechnology, Department of Pharmacy and Biotechnology, University of Bologna;Department of Clinical Sciences and Community Health, University of Milan;Department of Chemistry “Giacomo Ciamician, ” University of Bologna;Department of Pediatric Nephrology, Baskent University Hospital;Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Ankara University;Clinic of Children Diseases, Institute of Clinical Medicine, Vilnius University

关键词: gut microbiota;    antibiotic prophylaxis;    vesicoureteral reflux;    urinary tract infection;    children;   

DOI  :  10.3389/fped.2021.674716

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background and Objectives: Maturation of the gut microbiota (GM) in infants is critically affected by environmental factors, with potential long-lasting clinical consequences. Continuous low-dose antibiotic prophylaxis (CAP) is the standard of care for children with vesicoureteral reflux (VUR), in order to prevent recurrent urinary tract infections. We aimed to assess short-term GM modifications induced by CAP in infants. Methods: We analyzed the GM structure in 87 infants (aged 1-5 months) with high-grade VUR, previously exposed or naïve to CAP. Microbial DNA was extracted from stool samples. GM profiling was achieved by 16S rRNA gene-based next-generation sequencing. Fecal levels of short- and branched-chain fatty acids were also assessed. Results: 36/87 patients had been taking daily CAP for a median time of 47 days, while 51/87 had not. In all patients, the GM was predominantly composed by Bifidobacteriaceae and Enterobacteriaceae . Subgroup comparative analysis revealed alterations in the GM composition of CAP-exposed infants at phylum, family and genus level. CAP-exposed GM was enriched in members of Enterobacteriaceae and Bacteroidetes, especially in the genera Bacteroides and Parabacteroides , and showed a trend toward increased Klebsiella , often associated with antibiotic resistance. In contrast, the GM of non-CAP children was mostly enriched in Bifidobacterium . No differences were found in fatty acid levels. Conclusions: In infants with VUR, even a short exposure to CAP definitely alters the GM composition, with increased relative abundance of opportunistic pathogens and decreased proportions of health-promoting taxa. Early low-dose antibiotic exposure might bear potential long-term clinical risks.

【 授权许可】

CC BY