Effect of early life antibiotic use on serologic responses to oral rotavirus vaccine in the MAL-ED birth cohort study.
Effect of early life antibiotic use on serologic responses to oral rotavirus vaccine in the MAL-ED birth cohort study.
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在MAL-ED出生队列研究中，生命早期使用抗生素对口服轮状病毒疫苗血清学反应的影响
DOI：
10.1016/j.vaccine.2022.03.023
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发表时间：
2022-04-20
期刊：
影响因子：
5.5
通讯作者：
Becker-Dreps, Sylvia
中科院分区：
文献类型：
--
作者：
St Jean, Denise T.;McQuade, Elizabeth T. Rogawski;Edwards, Jessie K.;Thompson, Peyton;Thomas, James;Becker-Dreps, Sylvia
口服轮状病毒疫苗在低收入和中等收入国家（LMIC）的效力低于高收入国家。抗生素的使用在多大程度上影响轮状病毒疫苗在LMIC中的免疫原性尚不清楚。利用来自营养不良和肠道疾病的多地点前瞻性出生队列研究（MAL-ED）的数据，我们研究了早期使用抗生素对轮状病毒疫苗免疫应答的影响。我们采用改良Poisson回归法评估了在巴西、秘鲁和南非，从出生到轮状病毒疫苗系列完成后7天内使用抗生素是否与7月龄时轮状病毒血清阳性相关。然后，我们使用参数g计算来估计假设干预措施的影响，这些干预措施治疗了所有儿童，并防止了不适当的抗生素治疗对血清阳性的影响。在537名儿童中，178名（33%）在暴露窗口期间接受了至少一个抗生素疗程。与未暴露于抗生素的儿童相比，至少使用一个疗程抗生素的儿童血清阳性概率高40%（PR：1.40，95% CI：1.04，1.89）。接受抗生素疗程的数量或抗生素的总持续时间无显著差异。用抗生素治疗所有儿童与7个月时血清阳性绝对增加19%（95%CI：18%，21%）相关。相反，去除不适当的抗生素将导致血清阳性率绝对下降4%（95% CI：-5%，-2%）。早期抗生素使用与血清阳性率增加相关。然而，一个假设的干预措施，以消除不适当的抗生素将对整体血清阳性的影响不大。需要进一步研究抗生素使用对婴儿肠道微生物组和免疫反应的潜在机制。
Oral rotavirus vaccine efficacy is lower in low- and middle-income countries (LMICs) than in high-income countries. The degree to which antibiotic use impacts rotavirus vaccine immunogenicity in LMICs is unknown. Using data from a multisite prospective birth cohort study of malnutrition and enteric disease, MAL-ED, we examined the effect of early life antibiotic use on the immune response to rotavirus vaccine. We assessed whether antibiotic use from birth to 7 days following rotavirus vaccine series completion was associated with rotavirus seropositivity at 7 months of age in Brazil, Peru, and South Africa using a modified Poisson regression. We then used parametric g-computation to estimate the impact of hypothetical interventions that treated all children and alternatively prevented inappropriate antibiotic treatments on seropositivity. Of 537 children, 178 (33%) received at least one antibiotic course during the exposure window. Probability of seropositivity was 40% higher among children who had at least one course of antibiotics compared with those with no antibiotic exposure (PR: 1.40, 95% CI: 1.04, 1.89). There was no significant difference by the number of antibiotic courses received or total duration of antibiotics. Treating all children with antibiotics would be associated with a 19% (95% CI: 18%, 21%) absolute increase in seropositivity at 7 months. In contrast, removing inappropriate antibiotics would result in a 4% absolute reduction (95% CI: −5%, −2%) in seropositivity. Early life antibiotic use was associated with increased seropositivity. However, a hypothetical intervention to remove inappropriate antibiotics would have little effect on overall seropositivity. Further investigation into the underlying mechanisms of antibiotic use on the infant gut microbiome and immune response are needed.
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影响因子：
3.3
作者：
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