Dierikx, T.H.

This thesis is divided into 3 parts. In the first part, the effect of perinatal antibiotic use on the microbiome and on necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) is described. Maternal antibiotic use during birth leads to microbiome disturbances in children born vaginally, as described in a systematic review. Maternal antibiotic use during caesarean section did not seem to have an effect on the child's microbiome in a randomized controlled trial. Postpartum antibiotic use did appear to influence the risk of NEC and LOS in a large observational cohort of very pretem infants.In the second part, it was investigated in an observational cohort whether a molecular test (IS-pro) and new biomarker (presepsin) could diagnose early-onset sepsis directly postpartum. In preterm infants, presepsin had a high accuracy. Implementation of presepsin may lead to a decrease in unnecessary antibiotic use in uninfected infants. Most IS-pro results were comparable to the conventional culture results, the current gold standard. Future research is needed to validate these tests. In the third part, the potential protective effects of probiotics on antibiotic-associated diarrhoea (AAD) and on antibiotic induced microbial aberrations was studied in a randomized trial. The use of probiotics resulted in a lower incidence of AAD. Probiotics also had a small effect on the microbiome. Future research is needed to validate whether probiotics have protective effects on the microbiome and whether their use should be incorporated in clinical guidelines

Antibiotics and microbiota colonization in infancy:What lessons can we learn?

Abstract

Similar works

Full text

Available Versions

UvA-DARE