Evidence map›Paper›PMID 37550487›Full record

ArticlePediatric research2024

Baseline azithromycin resistance in the gut microbiota of preterm born infants.

David J Gallacher, Lei Zhang, Ali F Aboklaish, Emma Mitchell, Richard Wach, Julian R Marchesi, Sailesh Kotecha

Open access · hybridAbstract read
In one paragraph

Article in Pediatric research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Macrolide Resistance in theAntibiotics (Basel, Switzerland) · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

David J Gallacher *Neonatal Unit, University Hospital of Wales, Cardiff, UK.
Lei Zhang *Department of Child Health, Cardiff University School of Medicine, Cardiff, UK.
Ali F AboklaishDepartment of Child Health, Cardiff University School of Medicine, Cardiff, UK.
Emma MitchellDepartment of Child Health, Cardiff University School of Medicine, Cardiff, UK.
Richard WachNeonatal Unit, Southmead Hospital, Bristol, UK.
Julian R MarchesiDivision of Digestive Diseases, Faculty of Medicine, Imperial College London, London, UK.
Sailesh KotechaDepartment of Child Health, Cardiff University School of Medicine, Cardiff, UK. KotechaS@cardiff.ac.uk.
Cardiff University · GBImperial College London · GBSouthmead Hospital · GBUniversity Hospital of Wales · GB

Funding

Health Technology Assessment programmeNIHR Imperial Biomedical Research Centre (BRC)The Division of Digestive Diseases at Imperial College LondonUK’s National Institute of Health Research (NIHR)
6 · The paper itself

Abstract

backgroundMacrolides, including azithromycin, are increasingly used in preterm-born infants to treat Ureaplasma infections. The baseline carriage of macrolide resistance genes in the preterm stool microbiota is unknown.

objectivesIdentify carriage of azithromycin resistant bacteria and the incidence of macrolide resistant genes.

methodsAzithromycin resistant bacteria were isolated from serial stool samples obtained from preterm infants (≤32 weeks' gestation) by culturing aerobically/anaerobically, in the presence/absence of azithromycin. Using quantitative PCR, we targeted 6 common macrolide resistance genes (erm(A), erm(B), erm(C), erm(F), mef(A/E), msr(A)) in DNA extracted from selected bacteria resistant to azithromycin.

resultsFrom 89 stool samples from 37 preterm-born infants, 93.3% showed bacterial growth in aerobic or anaerobic conditions. From the 280 azithromycin resistant isolates that were identified, Staphylococcus (75%) and Enterococcus (15%) species dominated. Macrolide resistance genes were identified in 91% of resistant isolates: commonest were erm(C) (46% of isolates) and msr(A) (40%). Multiple macrolide resistance genes were identified in 18% of isolates.

conclusionMacrolide resistance is common in the gut microbiota of preterm-born infants early in life, most likely acquired from exposure to the maternal microbiota. It will be important to assess modulation of macrolide resistance, if macrolide treatment becomes routine in the management of preterm infants. IMPACT STATEMENT: Azithromycin resistance is present in the stool microbiota in the first month of life in preterm infants 91% of azithromycin resistant bacteria carried at least one of 6 common macrolide resistant genes Increasing use of macrolides in the preterm population makes this an important area of study.

Indexed as

AzithromycinGastrointestinal MicrobiomeAnti-Bacterial AgentsDrug Resistance, BacterialHumansInfantInfant, NewbornInfant, PrematureMacrolidesMicrobial Sensitivity TestsAnti-Bacterial AgentsAzithromycinMacrolides

Identifiers

PMID37550487
PMCPMC10798878
OpenAlexW4385617071

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.