Early long-term antibiotic exposure in preterm infants appears to promote the development of multidrug-resistant gut microbiome bacteria, suggests a new study in Nature Microbiology.
Researchers used complementary metagenomic, culture-based, and machine learning techniques to study the gut microbiota and resistome of antibiotic-exposed preterm infants during and after hospitalisation.
Stool samples from 32 very preterm infants who received antibiotic treatment for 21 months, nine very preterm infants who received antibiotics for less than a week as newborns only, and 17 antibiotic-naïve healthy term and late preterm infants were analysed.
The researchers found persistently enriched gastrointestinal antibiotic resistome, prolonged carriage of multidrug-resistant Enterobacteriaceae and distinct antibiotic-driven patterns of microbiota and resistome assembly in extremely preterm infants who received long-term early-life antibiotics.
Moreover, the genomes of the high antibiotic-use preterm infant group contained genes for resistance to antibiotics typically not given to neonates, such as ciprofloxacin and chloramphenicol.
The findings emphasise the necessity for alternatives to broad spectrum antimicrobial therapy for managing infection in neonatal intensive care units (NICU) and follow-on research, the study authors said.
“This should not only entail therapeutic approaches, such as narrow spectrum antibiotics and probiotic therapies, but also improved accuracy and speed of diagnostics to reduce unnecessary courses of antibiotics,” the authors said.