Impact of Long-Term Low Dose Antibiotic Prophylaxis on Gut Microbiota in Children
Impact of Long-Term Low Dose Antibiotic Prophylaxis on Gut Microbiota in Children
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DOI：
10.1097/ju.0000000000001227
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发表时间：
2020-12-01
影响因子：
6.6
通讯作者：
Kaneko, Kazunari
中科院分区：
文献类型：
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作者：
Akagawa, Yuko;Kimata, Takahisa;Kaneko, Kazunari
目的：我们评估了长期低剂量抗生素预防对儿童肠道microbiots.Materials和方法的影响：我们进行了16 S核糖体RNA基因测序，使用粪便样本35例年龄小于3岁（中位年龄5.2个月;男性与女性的比例17：18）谁接受抗生素治疗的急性期发热性尿路感染。在5个时间点采集样本，即发热性尿路感染发作和抗生素治疗前、期间和后1至2个月、3至4个月和5至6个月。在23例III级或更高膀胱输尿管反流患者中开始使用甲氧苄啶-磺胺甲恶唑进行连续抗生素预防，12例无反流患者未使用。开始治疗发热性尿路感染后2周内，几乎所有肠道细菌都属于乳杆菌目，与处理前水平相比，肠道微生物群多样性降低（处理前平均Shannon指数为2.9，处理期间为1.4）。两组的差异在发热性尿路感染发作后1 ~ 2个月内恢复。研究期间，两组均保持多样性（p[0.43]）。一个较小比例的肠道菌群组成部分属于肠杆菌目（p[0.002]）在抗生素预防group.Conclusions：我们的研究结果显示，接受连续抗生素预防的患者有正常的肠道菌群多样性，表明甲氧苄啶-磺胺甲恶唑对肠道菌群的影响是微不足道的。此外，甲氧苄啶-磺胺甲恶唑预防可能选择性抑制属于肠杆菌目的细菌的生长，例如大肠杆菌和克雷伯氏菌属，它们是发热性尿路感染的主要致病菌。
Purpose: We evaluated the effect of long-term low dose antibiotic prophylaxis on children's gut microbiota.Materials and Methods: We conducted 16S ribosomal RNA gene sequencing using stool samples from 35 patients younger than 3 years old (median age 5.2 months; male-to-female ratio 17:18) who underwent antibiotic treatment during the acute phase of febrile urinary tract infection. Samples were collected at 5 time points, ie before, during and at 1 to 2, 3 to 4, and 5 to 6 months after febrile urinary tract infection onset and antibiotic treatment. Continuous antibiotic prophylaxis using trimethoprim-sulfamethoxazole was initiated in 23 patients with grade III or higher vesicoureteral reflux and was not administered in 12 patients without reflux.Results: Within 2 weeks after initiation of treatment for febrile urinary tract infection almost all enteric bacteria belonged to the order Lactobacillales, and gut microbiota diversity decreased compared to the pretreatment level (average Shannon index 2.9 before treatment, 1.4 during treatment). The diversity recovered within 1 to 2 months after febrile urinary tract infection onset in both groups. Diversity was maintained during the study period in both groups (p[0.43). A smaller proportion of gut microbiota component belonged to the order Enterobacteriales (p[0.002) in the antibiotic prophylaxis group.Conclusions: Our results revealed that patients receiving continuous antibiotic prophylaxis had normal gut microbiota diversity, indicating that the effect of trimethoprim-sulfamethoxazole on gut microbiota was insignificant. Furthermore, prophylaxis with trimethoprim-sulfamethoxazole might selectively suppress the growth of bacteria belonging to the order Enterobacteriales, such as Escherichia coli and Klebsiella species, which are the main causative bacteria of febrile urinary tract infections.