Gastrointestinal Microbiome Disruption and Antibiotic-Associated Diarrhea in Children Receiving Antibiotic Therapy for Community-Acquired Pneumonia

J Kwon, Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
Y Kong, Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
M Wade, Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
D J. Williams, Department of Pediatrics and the Vanderbilt Vaccine Research Program, Vanderbilt University School of Medicine and the Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
C B. Creech, Department of Pediatrics and the Vanderbilt Vaccine Research Program, Vanderbilt University School of Medicine and the Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
S Evans, Biostatistics Center, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
E B. Walter, Department of Pediatrics and Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC, USA.
J M. Martin, Department of Pediatrics, University of Pittsburgh School of Medicine and the UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
J S. Gerber, Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
J G. Newland, Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
M E. Hofto, Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
M A. Staat, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
H F. Chambers, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
V G. Fowler, Department of Medicine and Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
W C. Huskins, Mayo Clinic College of Medicine and Science and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.
M M. Pettigrew, Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.

Document Type

Journal Article

Publication Date

3-6-2022

Journal

The Journal of infectious diseases

DOI

10.1093/infdis/jiac082

Keywords

Antibiotic-associated diarrhea; children; community-acquired pneumonia; microbiota

Abstract

Antibiotic-associated diarrhea (AAD) is a common side effect of antibiotics. We examined the gastrointestinal microbiota in children treated with beta-lactams for community-acquired pneumonia. Data were from 66 children (n=198 samples), ages 6-71 months, enrolled in the SCOUT-CAP trial (NCT02891915). AAD was defined as ≥1 day of diarrhea. Stool samples were collected on study days 1, 6-10, and 19-25. Samples were analyzed using 16s-rRNA gene sequencing to identify associations between patient characteristics, microbiota characteristics, and AAD (yes/no). Nineteen (29%) children developed AAD. Microbiota compositional profiles differed between AAD groups (PERMANOVA, P < 0.03) and across visits (P < 0.001). Children with higher baseline relative abundances of two Bacteroides species were less likely to experience AAD. Higher baseline abundance of Lachnospiraceae and amino acid biosynthesis pathways were associated with AAD. Children in the AAD group experienced prolonged dysbiosis (P < 0.05). Specific gastrointestinal microbiota profiles are associated with AAD in children.

Department

Biostatistics and Bioinformatics

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