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. 2023 Sep 15;18(9):e0290633.
doi: 10.1371/journal.pone.0290633. eCollection 2023.

Childhood infection burden, recent antibiotic exposure and vascular phenotypes in preschool children

Angela Yu  1 , Maria A C Jansen  2 , Geertje W Dalmeijer  2 , Patricia Bruijning-Verhagen  2 , Cornelis K van der Ent  3 , Diederick E Grobbee  2 , David P Burgner  1   4   5 , Cuno S P M Uiterwaal  2
Affiliations

Childhood infection burden, recent antibiotic exposure and vascular phenotypes in preschool children

Angela Yu et al. PLoS One. .

Erratum in

Abstract

Background: Severe childhood infection has a dose-dependent association with adult cardiovascular events and with adverse cardiometabolic phenotypes. The relationship between cardiovascular outcomes and less severe childhood infections is unclear.

Aim: To investigate the relationship between common, non-hospitalised infections, antibiotic exposure, and preclinical vascular phenotypes in young children.

Design: A Dutch prospective population-derived birth cohort study.

Methods: Participants were from the Wheezing-Illnesses-Study-Leidsche-Rijn (WHISTLER) birth cohort. We collected data from birth to 5 years on antibiotic prescriptions, general practitioner (GP)-diagnosed infections, and monthly parent-reported febrile illnesses (0-1 years). At 5 years, carotid intima-media thickness (CIMT), carotid artery distensibility, and blood pressure (BP) were measured. General linear regression models were adjusted for age, sex, smoke exposure, birth weight z-score, body mass index, and socioeconomic status.

Results: Recent antibiotic exposure was associated with adverse cardiovascular phenotypes; each antibiotic prescription in the 3 and 6 months prior to vascular assessment was associated with an 18.1 μm (95% confidence interval, 4.5-31.6, p = 0.01) and 10.7 μm (0.8-20.5, p = 0.03) increase in CIMT, respectively. Each additional antibiotic prescription in the preceding 6 months was associated with an 8.3 mPa-1 decrease in carotid distensibility (-15.6- -1.1, p = 0.02). Any parent-reported febrile episode (compared to none) showed weak evidence of association with diastolic BP (1.6 mmHg increase, 0.04-3.1, p = 0.04). GP-diagnosed infections were not associated with vascular phenotypes.

Conclusions: Recent antibiotics are associated with adverse vascular phenotypes in early childhood. Mechanistic studies may differentiate antibiotic-related from infection-related effects and inform preventative strategies.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Overview of the study population.
See this image and copyright information in PMC

References

    1. Kassebaum NJ, Arora M, Barber RM, Bhutta ZA, Brown J, Carter A, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388: 1603–1658. doi: 10.1016/S0140-6736(16)31460-X - DOI - PMC - PubMed
    1. GBD 2015 Mortality and Causes of Death Collaborators H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet (London, England). 2016;388: 1459–1544. doi: 10.1016/S0140-6736(16)31012-1 - DOI - PMC - PubMed
    1. Vernon ST, Coffey S, Bhindi R, Soo Hoo SY, Nelson GI, Ward MR, et al. Increasing proportion of ST elevation myocardial infarction patients with coronary atherosclerosis poorly explained by standard modifiable risk factors. Eur J Prev Cardiol. 2017;24: 1824–1830. doi: 10.1177/2047487317720287 - DOI - PubMed
    1. Strong JP, Malcom GT, Mcmahan CA, Tracy RE, Iii WPN, Herderick EE, et al. Prevalence and Extent of Atherosclerosis in Adolescents and Young Adults. JAMA. 1999;281: 727–35. doi: 10.1001/jama.281.8.727 - DOI - PubMed
    1. Prasad A, Zhu J, Halcox JPJ, Waclawiw MA, Epstein SE, Quyyumi AA. Predisposition to atherosclerosis by infections: Role of endothelial dysfunction. Circulation. 2002;106: 184–190. doi: 10.1161/01.cir.0000021125.83697.21 - DOI - PubMed

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