Deciphering effect of maternal postpartum antibiotic prophylaxis on infant gut microbiome: a whole metagenomic analysis

• Published in: Future microbiology 2023-05, Vol.18 (7), p.427-441
• Main Authors: Shankar, Aparna, Das, Devika J, Nayar, Seema, Thomas, Sabu
• Format: Article
• Language: English
• Subjects: Antibiotic Prophylaxis; antimicrobial resistance; bacterial diversity; breast milk microbiome; Feces; Female; Gastrointestinal Microbiome; Humans; Infant; infant gut microbiome; Milk, Human; Mothers; postpartum antibiotic prophylaxis; Postpartum Period; resistome
• ISSN: 1746-0913; 1746-0921
• DOI: 10.2217/fmb-2022-0200

To analyze the impact of postpartum antibiotic (Ab) prophylaxis on the infant gut microbiome. Whole metagenomic analysis was performed on breast milk and infant fecal samples collected from mother–infant pairs who belonged to two groups: an Ab group comprising mothers who had received a single course of Abs in the immediate postpartum period and a non-Ab group comprising mothers who had not received Abs. The characteristic presence of , an emerging multidrug-resistant uropathogen, and a higher relative abundance of genes encoding resistance to specific Abs were noted in samples from the Ab group compared with those from the non-Ab group. Policies regarding prophylactic Ab prescription across government and private health sectors in the postpartum period need to be strengthened. We studied the impact of antibiotics (Abs) that were taken by mothers as a preventive measure in the immediate postdelivery period on the bacterial diversity of the infant gut. All mother–infant pairs who participated in the study had undergone ‘low-risk’, normal delivery and practiced exclusive breastfeeding. Stool samples of the infants and breast milk samples of the corresponding mothers were collected for analysis of the pattern of microbial composition. On analysis, it was found that stool samples of the infants in the Ab group comprised opportunistic pathogens and harbored genes encoding resistance to specific Abs. There was a relatively higher abundance of beneficial bacteria in infant stool samples of the non-Ab group. This study highlights the need to reconsider the existing practice of taking Abs as a preventive measure after normal delivery to maintain health and reduce the spread of antimicrobial resistance in this particular region. We investigated the impact of maternal postpartum antibiotic prophylaxis on the infant gut microbiome subsequent to vaginal delivery. Based on the results gathered, we suggest the need to reframe the existing antimicrobial resistance strategy in the postpartum period.