Title: Early empiric antibiotic use in preterm infants is associated with lower bacterial diversity and higher relative abundance of Enterobacter.
Authors: Greenwood, Corryn; Morrow, Ardythe L; Lagomarcino, Anne J; Altaye, Mekibib; Taft, Diana H; Yu, Zhuoteng; Newburg, David S; Ward, Doyle V; Schibler, Kurt R
Published In J Pediatr, (2014 Jul)
Abstract: To determine the impact of empiric ampicillin and gentamicin use in the first week of life on microbial colonization and diversity in preterm infants.The 16s ribosomal DNA community profiling was used to compare the microbiota of 74 infants born ≤32 weeks gestational age by degree of antibiotic use in the first week of life. The degree of antibiotic use was classified as 0 days, 1-4 days, and 5-7 days of antibiotic administration. All of the antibiotic use was empiric, defined as treatment based solely on clinical suspicion of infection without a positive culture result.Infants who received 5-7 days of empiric antimicrobial agents in the first week had increased relative abundance of Enterobacter (P = .016) and lower bacterial diversity in the second and third weeks of life. Infants receiving early antibiotics also experienced more cases of necrotizing enterocolitis, sepsis, or death than those not exposed to antibiotics.Early empiric antibiotics have sustained effects on the intestinal microbiota of preterm infants. Intestinal dysbiosis in this population has been found to be associated with elevated risk of necrotizing enterocolitis, sepsis, or death.
PubMed ID: 24529620
MeSH Terms: Ampicillin/adverse effects; Ampicillin/therapeutic use; Anti-Bacterial Agents/adverse effects; Anti-Bacterial Agents/therapeutic use*; Biodiversity; Cohort Studies; DNA Fingerprinting; DNA, Ribosomal/genetics; Enterobacter/drug effects*; Female; Gentamicins/adverse effects; Gentamicins/therapeutic use; Gestational Age; Humans; Infant, Newborn; Infant, Premature*; Intestines/microbiology*; Longitudinal Studies; Male; Microbiota/drug effects*; Ohio; RNA, Ribosomal, 16S/genetics