University of Oulu

Tapiainen, T., Koivusaari, P., Brinkac, L. et al. Impact of intrapartum and postnatal antibiotics on the gut microbiome and emergence of antimicrobial resistance in infants. Sci Rep 9, 10635 (2019).

Impact of intrapartum and postnatal antibiotics on the gut microbiome and emergence of antimicrobial resistance in infants

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Author: Tapiainen, Terhi1,2; Koivusaari, Pirjo3; Brinkac, Lauren4;
Organizations: 1Department of Pediatrics and Adolescence, Oulu University Hospital, 90029, Oulu, Finland
2PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, 90014, Finland
3Ecology and Genetics, Faculty of Science, University of Oulu, Oulu, 90014, Finland
4J. Craig Venter Institute, Rockville, MD, 28050, USA
5University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
6J. Craig Venter Institute, La Jolla, CA, 92037, USA
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.8 MB)
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Language: English
Published: Springer Nature, 2019
Publish Date: 2020-04-20


Altogether, 20–30% of women receive intrapartum antibiotic prophylaxis (IAP) to prevent sepsis in infants and 2–5% of newborn infants receive antibiotics due to suspected sepsis. Caesarean section has a long-term impact on the intestinal microbiome but the effects of perinatal antibiotics on gut microbiome in vaginally delivered infants are not well known. We compared the impact of IAP, postnatal antibiotics, or their combination on the gut microbiome and emergence of antimicrobial resistance in a controlled study of 149 newborn infants recruited within 24 hours after birth. We collected 659 fecal samples, including 426 daily samples from infants before discharge from the hospital and 111 follow-up samples at six months. Penicillin was mostly used for IAP and the combination of penicillin and aminoglycoside for postnatal treatment. Postnatal antibiotic groups received Lactobacillus reuteri probiotic. Newborn gut colonization differed in both IAP and postnatal antibiotics groups as compared to that in control group. The effect size of IAP was comparable to that caused by postnatal antibiotics. The observed differences were still present at six months and not prevented by lactobacilli consumption. Given the present clinical results, the impact of perinatal antibiotics on the subsequent health of newborn infants should be further evaluated.

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Series: Scientific reports
ISSN: 2045-2322
ISSN-E: 2045-2322
ISSN-L: 2045-2322
Volume: 9
Article number: 10635
DOI: 10.1038/s41598-019-46964-5
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: The work performed in Finland was supported by the Pediatric Research Foundation, Finland, Juho Vainio Foundation, Finland, Emil Aaltonen Foundation, Finland, and Alma och K.A.: Snellman Foundation, Finland. The work performed at the J. Craig Venter Institute, USA, was supported in whole or in part by federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services under Award Number [U19AI110819 to L.B., H.A.L., W.L., K.N.].
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