Antibiotic Resistance Acquisition in the First Week of Life

Abstract

Objectives: The fetus is considered sterile but recent studies have suggested that gut colonization could start before birth. Scarce data are available for the acquisition of resistant Gram-negative bacteria (GNB) during the first days of life. Several studies have shown that integrons play a major role in antibiotic resistance acquisition. In this work, we studied the dynamics of human intestinal acquisition of GNB and integrons during the first days of life.Methods: Meconium was collected at birth and a stool sample before hospital discharge (days 2 or 3) on 185 term neonates. GNB were searched by culture on each sample and class 1, 2, and 3 integrons from each GNB or directly from samples. Eight risk factors for integron and GNB acquisition were studied.Results: We isolated 228 GNB, 46 from meconium and the remainder from stools. No link was found between GNB isolation and antibiotic exposure during delivery, but antibiotic exposure during labor significantly selected blaTEM-positive amoxicillin-resistant Enterobacteria. Two-thirds of GNB were antibiotic-susceptible and most of the resistant isolates were acquired after birth. Integrons were detected in 18 of the 228 GNB isolates from 3 meconium and 20 stools. Antibiotic administration during delivery and vaginal carriage of Streptococcus agalactiae appeared as risk factors for integron acquisition.Conclusion: Gram-negative bacteria and integrons are mostly acquired after birth during the first days of life even if for some term neonates, meconium was not sterile. Antibiotic administration during delivery is a major risk for integron acquisition and for selection of amoxicillin-resistant Enterobacteria.

Human gut microbiota evaluation and comparation after the separate or combined antibiotics exposure using the simulator of human intestinal microbial ecosystem (SHIME)

“…{Yu, 2016 #1;Li, 2015 #3} These predominant phyla had also been observed in the fecal samples of humans and animals [34,35]. As mentioned above, a large body of data showed that stabilized microbiota might be disturbed by antibiotics exposure, resulting in chronic and relapsing infections [9][10][11]. The effects of AMX or POL on the human intestinal microbiota have been extensively studied [18][19][20][21][22][23][24].…”

“…As mentioned earlier, exposure to antibiotics may promote the spread of ARB and ARGs in the human gut, which may limit the treatment e ciency and resulting in chronic and relapsing infections [9][10][11]. For instance, ARGs from such classes, including aminoglycosides, beta-lactams, and tetracycline have been con rmed to enrich in human gut microbiota following administration of AMX-clavulanic acid for one week [36], while patients who have taken AMX lower the relative abundance of ARGs from 0.81% to 0.14% [37].…”

“…The minor effect of AMX on ARGs found in our study was not totally in agreement with the results. Barraud and associates discovered that AMX exposure to women during labor signi cantly selected bla (TEM)-positive Enterobacteria in their gut microbiota as well as their children's, indicating ARB would cumulate across generation [38]. Similarly, POL was suggested to cause the selection of antimicrobial-resistant bacteria and the exchange of ARGs through horizontal gene transfer (HGT) between bacterial species [23].…”

“…The stable intestinal microbial ecosystem has been demonstrated not only to provide essential nutrients for human health but also to modulate the immune function by protecting infectious pathogens [7,8]. However, exposure to antibiotics cocktail may lead to the disrupt of the stable ecosystem and promote the spread of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in the human gut, which may limit the treatment e ciency and resulting from the chronic and relapsing infectious diseases [9][10][11]. And loop forever, host-associated fecal with antibiotic residues as well as ARB and ARGs would contaminate the environment [12][13][14].…”

Amoxicillin exposure significantly increases the population and virulence of antibiotic-resistant Klebsiella pathogen in the simulated human intestinal microbiota

“…In recent years, the adverse influence of antibiotics on human health has become a public concern since it could cause the dysbiosis of human intestinal microbiota, resulting multiple human diseases [6,7]. Otherwise, antibiotics may also promote the evolution, proliferation, and maintenance of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in the human gut [8,9]. In general, both in vivo and in vitro experiments were widely used in examination of antibiotic influence on gut microbiota [10][11][12][13][14][15].…”