Abstract:
Antibiotics may alter the gut microbiome, and this is one of the mechanisms by which antimicrobial resistance may be promoted. Suboptimal antimicrobial stewardship in Asia has been linked to antimicrobial resistance. We aim to examine the relationship between oral antibiotic use and composition and antimicrobial resistance in the gut microbiome in 1093 Bangladeshi infants. We leverage a trial of 8-month-old infants in rural Bangladesh: 61% of children were cumulatively exposed to antibiotics (most commonly cephalosporins and macrolides) over the 12-month study period, including 47% in the first 3 months of the study, usually for fever or respiratory infection. 16S rRNA amplicon sequencing in 11-month-old infants reveals that alpha diversity of the intestinal microbiome is reduced in children who received antibiotics within the previous 7 days; these samples also exhibit enrichment for Enterococcus and Escherichia/Shigella genera. No effect is seen in children who received antibiotics earlier. Using shotgun metagenomics, overall abundance of antimicrobial resistance genes declines over time. Enrichment for an Enterococcus-related antimicrobial resistance gene is observed in children receiving antibiotics within the previous 7 days, but not earlier. Presence of antimicrobial resistance genes is correlated to microbiome composition. In Bangladeshi children, community use of antibiotics transiently reprofiles the gut microbiome.
摘要:
抗生素可能会改变肠道微生物组,这是可促进抗菌素耐药性的机制之一。亚洲的次优抗菌药物管理与抗菌素耐药性有关。我们旨在研究1093名孟加拉国婴儿的口服抗生素使用和成分与肠道微生物组耐药性之间的关系。我们利用孟加拉国农村地区8个月大婴儿的试验:在12个月的研究期间,61%的儿童累积暴露于抗生素(最常见的是头孢菌素和大环内酯类药物)。包括研究前3个月的47%,通常为发热或呼吸道感染。在11个月大的婴儿中进行16SrRNA扩增子测序表明,在过去7天内接受抗生素治疗的儿童中,肠道微生物组的α多样性降低;这些样品还表现出肠球菌和埃希氏菌/志贺氏菌属的富集。在较早接受抗生素治疗的儿童中没有效果。使用猎枪宏基因组学,抗菌素耐药基因的总体丰度随着时间的推移而下降.在过去7天内接受抗生素治疗的儿童中观察到肠球菌相关抗菌素耐药基因的富集,但不是更早。抗微生物抗性基因的存在与微生物组组成相关。在孟加拉儿童中,社区使用抗生素会暂时重新描述肠道微生物组。