Intestinal flora diversity in neonates with sepsis and its association with antibiotic adverse events
Objective To observe the diversity of gut microbiota in neonates with sepsis and its correlation with adverse events related to antibiotic use in neonates.Methods From July 2022 to June 2023,102 neonates with sepsis treated in our NICU were enrolled.Based on the occurrence of adverse events related to antibiotics,the subjects were divided into the adverse event group and the non-adverse event group.Basic information of the neonates was collected,and their gut micro-biota were detected by using 16S rDNA sequencing.Logistic regression analysis was used to analyze the relationship between the diversity of gut microbiota and adverse events related to antibiotics in neonates with sepsis.Results By the 28th day after birth,29 infants(28.4％)experienced adverse events related to antibiotics were included in the adverse event group,while 73(71.6％)who did not experience adverse events were included in the non-adverse event group.There were statistically significant differences in birth weight and antibiotic exposure time between the two groups(P＜0.05).The Chaol index,ACE index,and Shannon index in the adverse event group were lower,while the Simpson index was higher than those in the non-adverse event group respectively(P＜0.05).PCA results showed that there was a significant differ-ence in the distribution of gut microbiota between the two groups.The gut microbiota in the adverse event group was mainly dominated by Enterococcus,Klebsiella and Streptococcus,while in the non-adverse event group,it was mainly dominated by Bacteroidetes,Escherichia-Shigella,Staphylococcus,Parabacteroides and Bifidobacterium.Logistic regres-sion analysis showed that antibiotic exposure time(OR=2.975,P=0.045)was an independent risk factor affecting adverse events related to antibiotics in neonates with sepsis,while the Chaol index(OR=0.955,P=0.038)and Shannon index(OR=0.020,P=0.007)were protective factors.Conclusion There is a correlation between antibiotic exposure time and the diversity of gut microbiota in neonates with sepsis and adverse events related to antibiotics.
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