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

Frontiers in Pediatrics

卷:9

Dorota Drozdz¹  Djalila Mekahli³  Grazyna Krzemien⁴  Claudio La Scola⁵  Katarzyna Taranta-Janusz⁶  Otto Mehls⁷  Franz Schaefer⁷  Giovanni Montini⁸  Augustina Jankauskiene⁹  Jessica Fiori¹⁰  Esra Baskin¹¹  Marco Pennesi¹²  Fatos Yalcinkaya¹³  Francesca Becherucci¹⁴  Aleksandra Zurowska¹⁵  Jessica Serafinelli¹⁶  William Morello¹⁶  Isabella Abati¹⁶  Marco Candela¹⁷  Silvia Turroni¹⁷  Federica D'Amico¹⁷ 

[1] 0Department of Pediatric Nephrology, Jagiellonian University Medical College, Krakow, Poland;

[2] 1Department of Development and Regeneration, Laboratory of Pediatrics, PKD Group, KU Leuven—University of Leuven, Leuven, Belgium;

[3] 2Department of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium;

[4] 3Department of Pediatric Nephrology, The Medical University of Warsaw, Warsaw, Poland;

[5] 4Nephrology and Dialysis Unit, Department of Pediatrics, Azienda Ospedaliero Universitaria Sant'Orsola-Malpighi, Bologna, Italy;

[6] 5Department of Pediatrics and Nephrology, Medical University of Bialystok, Bialystok, Poland;

[7] 6Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany;

[8] 7Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy;

[9] Clinic of Children Diseases, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania;

[10] Department of Chemistry “Giacomo Ciamician,” University of Bologna, Bologna, Italy;

[11] Department of Pediatric Nephrology, Baskent University Hospital, Ankara, Turkey;

[12] Department of Pediatrics, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo,”Trieste, Italy;

[13] Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Ankara University, Ankara, Turkey;

[14] Nephrology and Dialysis Unit, Meyer Children's Hospital, Florence, Italy;

[15] Pediatric Nephrology Department, Medical University of Gdansk, Gdansk, Poland;

[16] Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy;

[17] Unit of Microbiome Science and Biotechnology, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy;

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

DOI  :  10.3389/fped.2021.674716

来源: DOAJ

【 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】

Unknown