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: 10681292
• 负责人: CHRISTINA CHAMBERS
• 金额: $ 22.29万
• 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/10681292
• 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; Clavulanic Acids; 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; Qualifying; Questionnaires; Research; Sampling; Skin; Swab; Testing; Time; Universities; Upper Respiratory Infections; Urinary tract; Weight; Woman; Writing; biobank; evidence base; follow-up; gut health; infant gut microbiome; infant outcome; male; mastitis; metabolomics; microbiome; microbiota; 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.

项目概要 抗生素的使用在有生育潜力的女性（包括哺乳期女性）中很常见，但很少。 已知特定抗生素在母乳中的传播和药代动力学，也不知道其影响 抗生素处理对牛奶成分和质量的影响，包括营养成分、寡糖概况、 婴儿肠道微生物组的建立取决于动态的母婴关系。 生命早期的微生物群交换在很大程度上是通过母乳喂养促进的，因此对于更好地进行微生物群交换至关重要。 了解特定抗生素对牛奶成分的影响此外，确定如何影响也很重要。 母亲使用抗生素可能会影响婴儿的结局，包括生长、发育和免疫反应。 以加州大学圣地亚哥分校母乳研究生物储存库的基础设施为基础， 高素质的多学科研究团队将前瞻性地招募和采访 480 对母婴 在基线时，收集牛奶、皮肤和粪便样本，并监测持续的母乳喂养实践和母亲使用情况 随着时间的推移，我们将从中识别出 40 种常用抗生素中的一种。 母体接受目标抗生素治疗的配对，40 对不使用抗生素的匹配母体/婴儿 接触，以及 20 对非哺乳期母体/婴儿，母体接受了目标抗生素治疗。 这 100 对，我们将在 3 个时间点收集额外的家庭和母婴暴露生物标志物 对应于抗生素开始、中期和结束阶段，收集访谈和医疗记录数据，以及 获得产后 12 个月婴儿发育的问卷评估，数据将用于。 确定母乳样本中目标抗生素的含量和药代动力学，并测试中心抗生素 假设 (1) 乳成分、寡糖和微生物组特征在各组之间存在差异 抗生素治疗状态；（2）治疗和未治疗的微生物组和代谢组学指标会有所不同 母乳喂养组；(3) 在粪便、皮肤和家庭环境拭子中可检测到抗生素。 接受抗生素治疗但未进行母乳喂养的母亲我们还将探讨对母亲的影响。 抗生素的使用对婴儿生长发育的影响。 这项研究的结果将填补有关常用抗生素存在的知识空白 母乳中的抗生素治疗对母乳成分和质量以及短期的影响 以及婴儿的长期结局，包括生长、发育、肠道健康和免疫反应。 为哺乳期间抗生素使用的具体指南的循证发展提供信息并帮助支持 医疗保健提供者向母乳喂养妇女提供的建议。