期刊
JOURNAL OF PEDIATRICS
卷 165, 期 1, 页码 23-29出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2014.01.010
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资金
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health [HD059140, HD13021, HD27853]
- National Institute of Environmental Health Sciences [T32 ES010957]
- National Center for Research Resources, National Institutes of Health [U01 RR026314]
- National Human Genome Research Institute, National Institutes of Health [HG005969]
- Danone Research [PLF-5972-GD]
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services [HHSN272200900018C]
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.
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