Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 May 11;30(5):675-683.
doi: 10.1016/j.chom.2022.03.013.

The resistance within: Antibiotic disruption of the gut microbiome and resistome dynamics in infancy

Robert Thänert  1 , Sanjam S Sawhney  2 , Drew J Schwartz  3 , Gautam Dantas  4
Affiliations
Review

The resistance within: Antibiotic disruption of the gut microbiome and resistome dynamics in infancy

Robert Thänert et al. Cell Host Microbe. .

Abstract

Intestinal host-microbiota interactions during the first year of life are critical for infant development. Early-life antibiotic exposures disrupt stereotypical gut microbiota maturation and adversely affect childhood health. Furthermore, antibiotics increase the abundance of resistant bacteria and enrich the resistome-the compendium of antibiotic resistance genes-within the gut microbiota. Here, we discuss acute and persistent impacts of antibiotic exposure during infancy on pediatric health, the gut microbiome, and, particularly, the resistome. Reviewing our current understanding of antibiotic resistance acquisition and dissemination within and between microbiomes, we highlight open questions, which are imperative to resolve in the face of rising bacterial resistance.

Keywords: antibiotic resistance; antibiotics; gut microbiome; infancy; resistome.

PubMed Disclaimer

Conflict of interest statement

Declaration of interests The authors declare no competing interests.

Figures

Figure 1 |
Figure 1 |. Indications, acute and long-term effects of early-life antibiotic exposure on gut microbiome trajectory and health outcomes in term and preterm neonates.
40–70% of all term infants in high-income countries receive an antibiotic course in the first year of life, typically following community-acquired infection. Exposure results in a temporary decrease in gut microbiome diversity compared to antibiotic-naive infants. Most preterm infants receive empiric antibiotic therapy in the NICU, resulting in persistent low diversity microbiomes in the first year of life and sustained colonization with MDR pathobionts capable of causing infection. For all infants, antibiotic exposure in infancy is associated with adverse childhood health outcomes. Created with BioRender.com
Figure 2 |
Figure 2 |. Resistome dynamics in infancy.
The infant gut resistome, the collection of antibiotic resistance genes (ARGs) encoded by the gut microbiota, is seeded from maternal and environmental sources. Resistome burden is elevated in early life and compositionally different to infant mothers. Early-life antibiotics open niches for the colonization by pathobionts that are often multi-drug resistant (MDR) and associated with childhood infections, as well as increase resistome burden and abundance of gut endemic MDR bacteria. Further, antibiotic resistance is mobilized on plasmids, bacteriophages, or via transposons, integrons, and insertion sequences. These contribute to the spread of ARGs within gut communities, potentially triggered by antibiotic exposure. Created with BioRender.com
See this image and copyright information in PMC

References

    1. Abuali M, Zivot A, Guerguis S, Valladares E, Aleem S, Gonzalez-Salazar F, Rouchou B, Mottola N, Braitman L, and Paoletti A (2019). Outpatient antibiotic prescribing patterns in pediatric academic and community practices. Am. J. Infect. Control 47, 1151–1153. - PubMed
    1. Araujo da Silva AR, Jaszkowski E, Schober T, von Both U, Meyer-Buehn M, Marques AF, Farkas B, de Abreu BS, di Biase CB, Takahashi JM, et al. (2019). Patterns of antimicrobial consumption in neonatal and pediatric intensive care units in Germany and Brazil. Eur. J. Clin. Microbiol. Infect. Dis 2019 392 39, 249–255. - PubMed
    1. Aris IM, Lin P-ID, Rifas-Shiman SL, Bailey LC, Boone-Heinonen J, Eneli IU, Solomonides AE, Janicke DM, Toh S, Forrest CB, et al. (2021). Association of Early Antibiotic Exposure With Childhood Body Mass Index Trajectory Milestones. JAMA Netw. Open 4, e2116581–e2116581. - PMC - PubMed
    1. Bäckhed F, Roswall J, Peng Y, Feng Q, Jia H, Kovatcheva-Datchary P, Li Y, Xia Y, Xie H, Zhong H, et al. (2015). Dynamics and stabilization of the human gut microbiome during the first year of life. Cell Host Microbe 17, 690–703. - PubMed
    1. Beller L, Deboutte W, Falony G, Vieira-Silva S, Tito RY, Valles-Colomer M, Rymenans L, Jansen D, Van Espen L, Papadaki MI, et al. (2021). Successional Stages in Infant Gut Microbiota Maturation. MBio 12. - PMC - PubMed

Substances

LinkOut - more resources