The Microbiome of Pregnant African American Women with Group B Streptococcus Colonization and the Influence of Prenatal Antibiotics

B 族链球菌定植的非裔美国孕妇的微生物组及产前抗生素的影响

• 批准号: 9794141
• 负责人: Michelle Lynn Wright
• 金额: $ 9.03万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-26 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9794141
• 关键词: 16S ribosomal RNA sequencing; Affect; African American; Antibiotic Therapy; Antibiotics; Atopobium vaginae; Award; Bacterial Vaginosis; Cessation of life; Child; Chlamydia; Clinical; Communicable Diseases; Communities; Data; Databases; Discipline of Nursing; Environment; Epigenetic Process; Exposure to; Foundations; Gestational Age; Goals; Health; Human; Incidence; Infant; Infection prevention; Interruption; Intervention; Longevity; Medical Care Costs; Medical Records; Mentors; Methods; Metronidazole; Microbe; Mothers; Neonatal; Neonatal Mortality; Nested Case-Control Study; Newborn Infant; Oral; Organism; Outcome; Pattern; Perinatal; Perinatal Exposure; Population; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Birth; Preventive; Prospective Studies; Research Training; Ribosomal RNA; Risk; Risk Factors; Sampling; Science; Screening procedure; Sepsis; Shapes; Site; Source; Spontaneous abortion; Streptococcal Infections; Streptococcus; Streptococcus Group B; Training; Training Support; United States; Vagina; Vertical Disease Transmission; Woman; age group; base; biobehavior; clinical practice; design; early onset; epidemiology study; gut microbiome; improved; intraamniotic infection; intrapartum; late onset sepsis; maternal microbiome; metagenomic sequencing; microbiome; microbiome composition; microbiome sequencing; multiple omics; neonatal morbidity; neonatal sepsis; neonate; oral microbial community; oral microbiome; pregnant; prenatal; prenatal influence; prenatal risk factor; prevent; protective factors; rectal; screening; stillbirth; translational research program; transmission process; vaginal infection; vaginal microbiome

Project Summary/Abstract Group B streptococcal (GBS) infection is the leading cause of infectious neonatal morbidity and mortality in the US. Maternal GBS colonization is the strongest predictor for neonatal GBS infection. African American (AA) mothers and infants are twice as likely to be affected by GBS than their white counterparts. There are currently no effective methods to prevent maternal GBS colonization. Current efforts to prevent maternal-infant GBS transmission during labor center around the administration of intrapartum antibiotics to mothers who screen positive for colonization, which has reduced the number of cases of early onset neonatal GBS sepsis; but this approach does not prevent GBS associated complications that occur prior to labor nor late onset sepsis. Furthermore, the disparity of GBS sepsis between AAs and their white counterparts remains unexplained, uncharacterized, and persistent despite the implementation of intrapartum antibiotics, underscoring the need to further understand factors that shape GBS colonization. Preliminary data suggests that exposure to antibiotics prenatally, which is more common among AA women, may increase the risk for GBS colonization. The advent of metagenomic sequencing of the microbiome offers promise for solving this important microbe-antibiotic clinical puzzle. To date, no studies have systematically examined perinatal antibiotic exposure and/or the dynamics of the microbiome related to maternal GBS colonization throughout pregnancy. In order to better understand the GBS disparity, identify risk and protective factors, this study will examine the oral, gut, and vaginal microbiome of AA pregnant women throughout pregnancy. This nested case-control study will serve to advance the understanding of prenatal risk factors associated with GBS colonization among AA pregnant women by evaluating 16S rRNA and medical record data to accomplish the following Aims: 1) Evaluate the vaginal, gut, and oral microbiome in early and later pregnancy among women with GBS positive vs. negative screening culture. 2) Determine whether prenatal antibiotic exposures predispose to, or protect against, GBS colonization and/or microbiome patterns associated with GBS colonization. Results from this study have the potential to change practice and improve antibiotic stewardship in pregnant populations. The K01 project and mentored training supported by this award were designed for Dr. Wright to establish expertise in quantifying perinatal exposures and microbiome analytic pipelines. Combined with her existing expertise in epigenetics and nursing, the additional training establishes multi-omic expertise as the foundation to sustain an independent, translational program of research focused on developing personalized and mechanistically-targeted interventions to improve health outcomes across the lifespan.

项目总结/摘要 B族链球菌（GBS）感染是新生儿感染性发病和死亡的主要原因， 我们母亲GBS定植是新生儿GBS感染的最强预测因子。非裔美国人（AA） 母亲和婴儿受GBS影响的可能性是白色母亲和婴儿的两倍。目前有 没有有效的方法来防止母体GBS定植。目前预防母婴GBS的努力 分娩期间的传播围绕着对筛查的母亲给予分娩期抗生素 阳性定植，这减少了早发性新生儿GBS败血症的病例数;但这 这种方法不能预防分娩前发生的GBS相关并发症，也不能预防迟发性败血症。 此外，AAs与其白色对应物之间GBS败血症的差异仍然无法解释， 尽管使用了产时抗生素，但仍持续存在，强调需要 进一步了解形成GBS定植的因素。初步数据表明，接触抗生素 产前，这是更常见的AA妇女，可能会增加GBS定植的风险。问世 微生物组的宏基因组测序为解决这一重要的微生物抗生素提供了希望 临床难题到目前为止，还没有研究系统地检查围产期抗生素暴露和/或 在整个妊娠期间与母体GBS定植相关的微生物组的动态。为了更好 了解GBS的差异，确定风险和保护因素，这项研究将检查口腔，肠道， AA孕妇在整个怀孕期间的阴道微生物组。这项巢式病例对照研究将有助于 提高对AA孕妇GBS定植相关产前危险因素的认识 通过评估16 S rRNA和病历数据，以实现以下目的：1）评估 GBS阳性与阴性女性妊娠早期和晚期的阴道、肠道和口腔微生物组 筛选培养2)确定产前抗生素暴露是否易患或预防GBS 定植和/或与GBS定植相关的微生物组模式。 这项研究的结果有可能改变实践，改善孕妇的抗生素管理。 人口。该奖项支持的K 01项目和指导培训旨在让Wright博士 建立量化围产期暴露和微生物组分析管道的专门知识。加上她 现有的表观遗传学和护理专业知识，额外的培训建立多组学专业知识， 基金会，以维持一个独立的，翻译的研究计划，重点是发展个性化 和有针对性的机械干预措施，以改善整个生命周期的健康结果。