Cited by 28Gut microbiota and healthInfant Nutrition and HealthMaternal and Perinatal Health Interventions

Timing of antimicrobial prophylaxis for cesarean section is critical for gut microbiome development in term born infants

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Bossung, Verena, Lupatsii, Mariia, Dashdorj, Lkhagvademberel, Tassiello, Oronzo, Jonassen, Sinje, Pagel, Julia, Demmert, Martin, Wolf, Ellinor Anna +5 more·2022·Gut Microbes

Abstract

Animal models imply that the perinatal exposure to antibiotics has a substantial impact on microbiome establishment of the offspring. We aimed to evaluate the effect of timing of antimicrobial prophylaxis for cesarean section before versus after cord clamping on gut microbiome composition of term born infants. We performed an exploratory, single center randomized controlled clinical trial. We included forty pregnant women with elective cesarean section at term. The intervention group received single dose intravenous cefuroxime after cord clamping (n = 19), the control group single dose intravenous cefuroxime 30 minutes before skin incision (n = 21). The primary endpoint was microbiome signature of infants and metabolic prediction in the first days of life as determined in meconium samples by 16S rRNA gene sequencing. Secondary endpoints were microbiome composition at one month and 1 year of life. In meconium samples of the intervention group, the genus Staphylococcus pre-dominated. In the control group, the placental cross-over of cefuroxime was confirmed in cord blood. A higher amino acid and nitrogen metabolism as well as increased abundance of the genera Cutibacterium, Corynebacterium and Streptophyta were noted (indicator families: Cytophagaceae, Lactobacilaceae, Oxalobacteraceae). Predictive models of metabolic function revealed higher 2'fucosyllactose utilization in control group samples. In the follow-up visits, a higher abundance of the genus Clostridium was evident in the intervention group. Our exploratory randomized controlled trial suggests that timing of antimicrobial prophylaxis is critical for early microbiome engraftment but not antimicrobial resistance emergence in term born infants.

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Crossref · 10.1080/19490976.2022.2038855

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  • In a randomized control trial of 40 mother/infant pairs, the timing of prophylactic antibiotics before versus after clamping of the cord was found to be critical for microbiota development.

    “In a RCT of 40 mother/infant pairs in which prophylactic antibiotics were administered before versus after clamping of the cord, the timing of the exposure was found to be critical for microbiota development (410).”

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  1. [11]Wacha H, Hoyme U, Isenmann R, Kujath P, Lebert C, Naber K, Salzberger B. Perioperative antibiotic prophylaxis. Evidence based guidelines by an expert panel of the Paul Ehrlich Gesellschaft. Chemother J. 2010; 19: 70– 84.

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Authors
Bossung, V., Lupatsii, M., Dashdorj, L., Tassiello, O., Jonassen, S., Pagel, J., Demmert, M., Wolf, E. A., Rody, A., Waschina, S., Graspeuntner, S., Rupp, J., & Härtel, C.
Affiliations
  • University Hospital Schleswig-Holstein (DE)
  • German Center for Infection Research (DE)
  • Christian-Albrechts-Universität zu Kiel (DE)
  • University of Lübeck (DE)
Corresponding author
Bossung, Verena
Venue
Gut Microbes
Published
2022-02-20
Volume
14
Issue
1
Pages
2038855-2038855
ISSN
  • 1949-0976 (ISSN-L)
  • 1949-0984
OpenAlex
W4212930045
Cited by
28
References
75
Citations by year
2026: 2 · 2025: 7 · 2024: 8 · 2023: 7 · 2022: 4
FWCI
2.12
Type
journal article
Language
en
Open access
Locations
  • Gut Microbes (publishedVersion)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
cesarean section, antibiotic prophylaxis, timing of prophylaxis, gut microbiota, term infants, cefuroxime, umbilical cord clamping, meconium, Staphylococcus, Clostridium, antimicrobial resistance
MeSH terms
Gastrointestinal Microbiome, Anti-Bacterial Agents, Cefuroxime, Cesarean Section, Feces, Female, Humans, Placenta, Pregnancy, RNA, Ribosomal, 16S

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