Antibiotic Treatment in Breastfeeding Mothers: Effects on Milk, Microbiome, and Infant Outcomes

母乳喂养母亲的抗生素治疗：对乳汁、微生物组和婴儿结局的影响

• 批准号: 10309709
• 负责人: CHRISTINA CHAMBERS
• 金额: $ 22.83万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-10 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10309709
• 关键词: 1 year old; Adult; Age; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Analytical Chemistry; Antibiotic Therapy; Antibiotics; Azithromycin; Biological Assay; Biological Markers; Breast Feeding; Breastfed infant; California; Carbohydrates; Clinical; Collaborations; Collection; Data; Data Science; Development; Drug Kinetics; Drug Prescriptions; Enrollment; Fatty acid glycerol esters; Feces; Female; Growth; Growth and Development function; Health Personnel; Height; Home; Home environment; Human Milk; Immune response; Infant; Infant Development; Infection; Infrastructure; Interdisciplinary Study; Interview; Knowledge; Lactation; Life; Measures; Medical Records; Milk; Monitor; Mothers; Nitrofurantoin; Nutritional; Oligosaccharides; Participant; Population; Postpartum Period; Postpartum Women; Proteins; Public Health; Questionnaires; Research; Sampling; Skin; Swab; Testing; Time; Universities; Upper Respiratory Infections; Urinary tract; Weight; Woman; biobank; evidence base; follow-up; gut health; infant gut microbiome; infant outcome; male; mastitis; metabolomics; microbiome; microbiota; milk microbiome; pharmacometrics; prospective; recruit; reproductive; stool sample; transmission process; uptake

PROJECT SUMMARY Antibiotic use is common among women of reproductive potential, including lactating women. However, little is known about the transmission and pharmacokinetics of specific antibiotics in human milk, nor the effects of antibiotic treatment on milk composition and quality including nutritional components, oligosaccharide profile, and the microbiome. Establishment of the infant gut microbiome is dependent on a dynamic maternal–infant microbiota exchange during early life, which is largely facilitated via breastfeeding. It is thus critical to better understand the impact of specific antibiotics on milk composition. Furthermore, it is essential to determine how maternal antibiotic use may impact infant outcomes, including growth, development, and immune response. Building on the infrastructure of the University of California San Diego Human Milk Research Biorepository, a highly qualified, multidisciplinary research team will prospectively enroll and interview 480 maternal/infant pairs at baseline, collect milk, skin, and stool samples, and monitor ongoing breastfeeding practices and maternal use of one of four commonly used antibiotics over time. From these, we will subsequently identify 40 maternal/infant pairs with maternal uptake of target antibiotic treatment, 40 matched maternal/infant pairs without antibiotic exposure, and 20 non-lactating maternal/infant pairs with maternal uptake of a target antibiotic treatment. From these 100 pairs, we will collect additional home and maternal and infant biomarkers of exposure at 3 timepoints corresponding to antibiotic initiation, mid-course, and end-course, collect interview and medical record data, and obtain a questionnaire assessment of infant development at 12 months post-partum. Data will be used to determine the amount and pharmacokinetics of target antibiotics in breast milk samples and to test the central hypotheses that (1) milk composition, oligosaccharide, and microbiome profiles will differ between groups by antibiotic treatment status; (2) microbiome and metabolomic measures will differ in treated and untreated breastfeeding groups; and (3) antibiotics will be detectable in the stool, skin, and home environment swabs of mothers who are treated with antibiotics but are not breastfeeding. We will also explore the impact on maternal antibiotic use on infant growth and development. Findings of this study will fill a critical gap in knowledge regarding the presence of commonly used antibiotics in breast milk and the effects of antibiotic treatment on both breast milk composition and quality as well as short- and long-term infant outcomes, including growth, development, gut health, and immune response. This will inform evidence-based development of specific guidance on antibiotic use during lactation and help support advice provided by healthcare providers to breastfeeding women.

项目摘要 抗生素使用在具有生殖潜力的女性中很常见，包括哺乳期妇女。但是，几乎没有 关于人奶中特定抗生素的传播和药代动力学的了解 牛奶成分和质量的抗生素处理，包括营养成分，寡糖剖面， 和微生物组。婴儿肠道微生物组的建立取决于动态材料 - 吸引人 在早期生命中的微生物群交流，这在很大程度上是通过母乳喂养准备的。因此，至关重要 了解特定抗生素对牛奶成分的影响。此外，必须确定如何 母体抗生素的使用可能会影响婴儿预后，包括生长，发育和免疫反应。 建立在加利福尼亚大学圣地亚哥人类乳研究生物库的基础设施的基础上 高素质，多学科研究团队可能会注册和采访480对母亲/婴儿对 在基线时，收集牛奶，皮肤和凳子样品，并监视正在进行的母乳喂养习惯和母亲使用 随着时间的流逝，四种常用的抗生素之一。通过这些，我们将随后确定40个母亲/婴儿 对产妇摄取靶抗生素治疗的成对，有40个匹配的母乳/婴儿对，没有抗生素 暴露于靶抗生素治疗的孕妇摄取，有20种非乳腺母亲/婴儿对。从 这100对，我们将在3个时间点收集额外的家庭，母亲和婴儿生物标志物 对应于抗生素起始，中途课程和最终课程，收集访谈和病历数据，以及 在产后12个月的婴儿发育评估问卷评估。数据将用于 确定母乳样品中靶抗生素的数量和药代动力学并测试中心 假设（1）牛奶成分，寡糖和微生物组轮廓在组之间会有所不同 抗生素治疗状况； （2）微生物组和代谢组措施在处理和未经处理的情况下会有所不同 母乳喂养组； （3）在凳子，皮肤和家庭环境中可以检测到抗生素 接受抗生素治疗但没有母乳喂养的母亲。我们还将探索对母亲的影响 抗生素用于婴儿生长和发育。 这项研究的结果将填补有关常用抗生素存在的知识的关键空白 在母乳和抗生素治疗对母乳组成和质量的影响以及短暂的 以及长期婴儿的结局，包括增长，发育，肠道健康和免疫反应。这会 为基于循证的开发哺乳过程中有关抗生素使用的具体指南，并有助于支持 医疗保健提供者为母乳喂养妇女提供的建议。