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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

基本信息

批准号：
10004727
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
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-26 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10004727
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

项目摘要

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.

项目概要/摘要 B 族链球菌 (GBS) 感染是新生儿传染性发病和死亡的主要原因我们。母体 GBS 定植是新生儿 GBS 感染的最强预测因素。非裔美国人 (AA) 母亲和婴儿感染 GBS 的可能性是白人的两倍。目前有没有有效的方法来预防母体 GBS 定植。当前预防母婴 GBS 的努力分娩期间的传播中心围绕对产时抗生素的使用进行筛查的母亲定植呈阳性，减少了早发新生儿 GBS 败血症的病例数；但是这个该方法不能预防临产前发生的 GBS 相关并发症，也不能预防迟发性败血症。此外，AA 和白人之间 GBS 败血症的差异仍然无法解释，尽管使用了产时抗生素，但仍没有特征且持续存在，这强调了需要进一步了解影响 GBS 定植的因素。初步数据表明，接触抗生素产前感染（在 AA 女性中更为常见）可能会增加 GBS 定植的风险。来临微生物组宏基因组测序为解决这一重要的微生物抗生素问题提供了希望临床难题。迄今为止，还没有研究系统地检查围产期抗生素暴露和/或整个怀孕期间与母体 GBS 定植相关的微生物组动态。为了更好为了了解 GBS 差异，识别风险和保护因素，本研究将检查口腔、肠道和 AA 孕妇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促进对 AA 孕妇中与 GBS 定植相关的产前危险因素的了解通过评估 16S rRNA 和医疗记录数据来实现以下目标： 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文化。 2) 确定产前接触抗生素是否会诱发或预防 GBS 与 GBS 定植相关的定植和/或微生物组模式。这项研究的结果有可能改变实践并改善孕妇的抗生素管理人口。该奖项支持的 K01 项目和指导培训旨在帮助 Wright 博士建立量化围产期暴露和微生物组分析管道的专业知识。与她结合现有的表观遗传学和护理专业知识，额外的培训建立了多组学专业知识作为基金会维持一个独立的、转化性的研究计划，重点是开发个性化的以及有针对性的干预措施，以改善整个生命周期的健康结果。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Exploring the vaginal bacteriophage frontier.

探索阴道噬菌体前沿。

DOI：
10.1111/1471-0528.16539
发表时间：
2021
期刊：
BJOG : an international journal of obstetrics and gynaecology
影响因子：
0
作者：
Wright,ML
通讯作者：
Wright,ML

The Impact of Language Discordance on Patients' Perception of a Clinical Encounter and Trust in Provider.

语言不一致对患者对临床遭遇的感知和对医疗服务提供者的信任的影响。

DOI：
10.1097/spv.0000000000001283
发表时间：
2023
期刊：
Urogynecology (Philadelphia, Pa.)
影响因子：
0
作者：
Caldwell,Lauren;Halder,GabrielaE;White,AmandaB;High,RachelA;Wright,MichelleL;Rogers,RebeccaG
通讯作者：
Rogers,RebeccaG

Doula Support Challenges and Coping Strategies during the COVID-19 Pandemic: Implications for Maternal Health Inequities.

DOI：
10.1080/10410236.2021.2012898
发表时间：
2022-11
期刊：
HEALTH COMMUNICATION
影响因子：
3.9
作者：
Nguyen, Tien C.;Donovan, Erin E.;Wright, Michelle L.
通讯作者：
Wright, Michelle L.

Comparison of commercial DNA extraction kits for whole metagenome sequencing of human oral, vaginal, and rectal microbiome samples.

用于人类口腔、阴道和直肠微生物样本全宏基因组测序的商业 DNA 提取试剂盒的比较。

DOI：
10.1101/2023.02.01.526597
发表时间：
2023
期刊：
bioRxiv : the preprint server for biology
影响因子：
0
作者：
Wright,MichelleL;Podnar,Jessica;Longoria,KaylaD;Nguyen,TienC;Lim,Sungju;Garcia,Sarina;Wylie,Dennis
通讯作者：
Wylie,Dennis

Dysbiosis Disconnect Between Research and Clinical Practice.

研究与临床实践之间的生态失调脱节。