Pretreatment with Antibiotics Impairs Th17-Mediated Antifungal Immunity in Newborn Rats

Clinical studies have confirmed that the use of antibiotics, especially carbapenems, is a high-risk factor for fungal infection in preterm infants. However, it is not entirely clear whether the increased risk for fungal infection is due to the immune differences in preterm infants or antibiotic usage. We found that after newborn rats received antibiotics, they exhibited significantly impaired anti-Candida albicansimmunity in comparison with those without treatment, as shown by significantly increased levels of fungal glucan in the peripheral blood, multiple caseous fungal infections in the abdominal cavity, intestinal congestion, ischemia, and a decrease in the number of intestinal villi. Mechanistically, pretreatment with antibiotics diminished antifungal innate immunity by TLR2 and inhibited IL-17A release and neutrophil recruitment, leading to increased susceptibility to fungi. In summary, we demonstrate that antibiotic usage impairs antifungal immunity in neonates and suggest that antifungal prophylaxis may be required after antibiotic treatment in high-risk preterm babies.