Early empiric antibiotic use in preterm infants is associated with lower bacterial diversity and higher relative abundance of Enterobacter.

J Pediatr
Authors
Keywords
Abstract

OBJECTIVES: To determine the impact of empiric ampicillin and gentamicin use in the first week of life on microbial colonization and diversity in preterm infants.

STUDY DESIGN: 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.

RESULTS: 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.

CONCLUSIONS: 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.

Year of Publication
2014
Journal
J Pediatr
Volume
165
Issue
1
Pages
23-9
Date Published
2014 Jul
ISSN
1097-6833
URL
DOI
10.1016/j.jpeds.2014.01.010
PubMed ID
24529620
PubMed Central ID
PMC4074569
Links
Grant list
U01 RR026314 / RR / NCRR NIH HHS / United States
HHSN272200900018C / AI / NIAID NIH HHS / United States
HD27853 / HD / NICHD NIH HHS / United States
P01 HD013021 / HD / NICHD NIH HHS / United States
UG1 HD027853 / HD / NICHD NIH HHS / United States
HG005969 / HG / NHGRI NIH HHS / United States
HD13021 / HD / NICHD NIH HHS / United States
U10 HD040689 / HD / NICHD NIH HHS / United States
U10 HD027853 / HD / NICHD NIH HHS / United States
HD059140 / HD / NICHD NIH HHS / United States
HHSN272200900018C / PHS HHS / United States
R01 HG005969 / HG / NHGRI NIH HHS / United States
R01 HD059140 / HD / NICHD NIH HHS / United States
T32 ES010957 / ES / NIEHS NIH HHS / United States
U19 AI110818 / AI / NIAID NIH HHS / United States
UL1 RR026314 / RR / NCRR NIH HHS / United States