Early Use of Antibiotics Is Associated with a Lower Incidence of Necrotizing Enterocolitis in Preterm, Very Low Birth Weight Infants: The NEOMUNE-NeoNutriNet Cohort Study

Yanqi Li; René Liang Shen; Adejumoke I. Ayede; Janet Berrington; Frank H. Bloomfield; Olubunmi O. Busari; Barbara E. Cormack; Nicholas D. Embleton; Johannes B. van Goudoever; Gorm Greisen; Zhongqian He; Yan Huang; Xiaodong Li; Hung Chih Lin; Jiaping Mei; Paula P. Meier; Chuan Nie; Aloka L. Patel; Per T. Sangild; Thomas Skeath; Karen Simmer; Signe Uhlenfeldt; Marita de Waard; Sufen Ye; Xuqiang Ye; Chunyi Zhang; Yanna Zhu; Ping Zhou

doi:10.1016/j.jpeds.2020.06.032

Early Use of Antibiotics Is Associated with a Lower Incidence of Necrotizing Enterocolitis in Preterm, Very Low Birth Weight Infants: The NEOMUNE-NeoNutriNet Cohort Study

Yanqi Li
, René Liang Shen
, Adejumoke I. Ayede
, Janet Berrington
, Frank H. Bloomfield
, Olubunmi O. Busari
, Barbara E. Cormack
, Nicholas D. Embleton
, Johannes B. van Goudoever
, Gorm Greisen^*
, Zhongqian He
, Yan Huang
, Xiaodong Li
, Hung Chih Lin
, Jiaping Mei
, Paula P. Meier
, Chuan Nie
, Aloka L. Patel
, Per T. Sangild
, Thomas Skeath

Karen Simmer, Signe Uhlenfeldt, Marita de Waard, Sufen Ye, Xuqiang Ye, Chunyi Zhang, Yanna Zhu, Ping Zhou

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Abstract

Objective: To determine whether commencement of antibiotics within 3 postnatal days in preterm, very low birth weight (VLBW; ≤1500 g) infants is associated with the development of necrotizing enterocolitis (NEC). Study design: Preplanned statistical analyses were done to study the association between early antibiotic treatment and later NEC development, using the NEOMUNE-NeoNutriNet cohort of VLBW infants from 13 neonatal intensive care units (NICUs) in 5 continents (n = 2831). NEC incidence was compared between infants who received early antibiotics and those who did not, with statistical adjustments for NICU, gestational age, birth weight, sex, delivery mode, antenatal steroid use, Apgar score, and type and initiation of enteral nutrition. Results: The incidence of NEC was 9.0% in the group of infants who did not receive early antibiotics (n = 269), compared with 3.9% in those who did receive early antibiotics (n = 2562). The incidence remained lower in the early antibiotic group after stepwise statistical adjustments for NICU (OR, 0.57; 95% CI, 0.35-0.94, P <.05) and other potential confounders (OR, 0.25; 95% CI, 0.12-0.47; P <.0001). Conclusions: In this large international cohort of preterm VLBW infants, a small proportion of infants did not receive antibiotics just after birth, and these infants had a higher incidence of NEC. It is important to better understand the role of such variables as time, type, and duration of antibiotic treatment on NEC incidence, immune development, gut colonization, and antibiotic resistance in the NICU.

Originalsprog	Engelsk
Tidsskrift	Journal of Pediatrics
Vol/bind	227
Sider (fra-til)	P128-134.E2
ISSN	0022-3476
DOI	https://doi.org/10.1016/j.jpeds.2020.06.032
Status	Udgivet - 2020

Finansiering

This study is part of the NEOMUNE Project, sponsored by the Innovation Fund Denmark (12-132401, to P.S.). Data from Rush University Children's Hospital were provided with support from the National Institutes of Health (NR010009). H-C.L. was supported by the Taiwan China Medical University Hospital (DMR-107-183). J.M. and S.Y. were supported by Sanming Project of Medicine in Shenzhen (SZSM201612045) and Funding for the Construction of Key Medical Disciplines in Shenzhen (Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University). J.v.G. is director of the Dutch Human Milk Bank and a member of the National Health Council. B.C. serves on scientific advisory boards for Nestlé Nutrition Institute and Danone/Nutricia. K.S. is the Director of the Human Milk Bank in Perth Australia and has received support from Medela and Nestlé Nutrition Institute. P.S. has received grant support from ARLA Foods, Medela, Danone/Nutricia, Biofiber-Damino, Mead Johnson Nutrition, and Nestlé Nutrition Institute. F.B. has received travel support for invited lectures from Abbot Nutrition and Nestlé Nutrition Institute and for participation in an expert working group from Danone/Nutricia. N.E. has received speakers' honoraria from Nestlé Nutrition Institute and Danone/Nutricia, and his department has received research support from Prolacta Bioscience and Danone/Nutricia. The other authors declare no conflicts of interest.

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10.1016/j.jpeds.2020.06.032

https://europepmc.org/articles/pmc7686259?pdf=renderLicens: Andet

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Citationsformater

Li, Y., Shen, R. L., Ayede, A. I., Berrington, J., Bloomfield, F. H., Busari, O. O., Cormack, B. E., Embleton, N. D., van Goudoever, J. B., Greisen, G., He, Z., Huang, Y., Li, X., Lin, H. C., Mei, J., Meier, P. P., Nie, C., Patel, A. L., Sangild, P. T., ... Zhou, P. (2020). Early Use of Antibiotics Is Associated with a Lower Incidence of Necrotizing Enterocolitis in Preterm, Very Low Birth Weight Infants: The NEOMUNE-NeoNutriNet Cohort Study. Journal of Pediatrics, 227, P128-134.E2. https://doi.org/10.1016/j.jpeds.2020.06.032

Early Use of Antibiotics Is Associated with a Lower Incidence of Necrotizing Enterocolitis in Preterm, Very Low Birth Weight Infants: The NEOMUNE-NeoNutriNet Cohort Study. / Li, Yanqi; Shen, René Liang; Ayede, Adejumoke I. et al.
I: Journal of Pediatrics, Bind 227, 2020, s. P128-134.E2.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Li, Y, Shen, RL, Ayede, AI, Berrington, J, Bloomfield, FH, Busari, OO, Cormack, BE, Embleton, ND, van Goudoever, JB, Greisen, G, He, Z, Huang, Y, Li, X, Lin, HC, Mei, J, Meier, PP, Nie, C, Patel, AL, Sangild, PT, Skeath, T, Simmer, K, Uhlenfeldt, S, de Waard, M, Ye, S, Ye, X, Zhang, C, Zhu, Y & Zhou, P 2020, 'Early Use of Antibiotics Is Associated with a Lower Incidence of Necrotizing Enterocolitis in Preterm, Very Low Birth Weight Infants: The NEOMUNE-NeoNutriNet Cohort Study', Journal of Pediatrics, bind 227, s. P128-134.E2. https://doi.org/10.1016/j.jpeds.2020.06.032

@article{28520f055ce74a4bae9f7d3508fdcf16,

title = "Early Use of Antibiotics Is Associated with a Lower Incidence of Necrotizing Enterocolitis in Preterm, Very Low Birth Weight Infants: The NEOMUNE-NeoNutriNet Cohort Study",

abstract = "Objective: To determine whether commencement of antibiotics within 3 postnatal days in preterm, very low birth weight (VLBW; ≤1500 g) infants is associated with the development of necrotizing enterocolitis (NEC). Study design: Preplanned statistical analyses were done to study the association between early antibiotic treatment and later NEC development, using the NEOMUNE-NeoNutriNet cohort of VLBW infants from 13 neonatal intensive care units (NICUs) in 5 continents (n = 2831). NEC incidence was compared between infants who received early antibiotics and those who did not, with statistical adjustments for NICU, gestational age, birth weight, sex, delivery mode, antenatal steroid use, Apgar score, and type and initiation of enteral nutrition. Results: The incidence of NEC was 9.0\% in the group of infants who did not receive early antibiotics (n = 269), compared with 3.9\% in those who did receive early antibiotics (n = 2562). The incidence remained lower in the early antibiotic group after stepwise statistical adjustments for NICU (OR, 0.57; 95\% CI, 0.35-0.94, P <.05) and other potential confounders (OR, 0.25; 95\% CI, 0.12-0.47; P <.0001). Conclusions: In this large international cohort of preterm VLBW infants, a small proportion of infants did not receive antibiotics just after birth, and these infants had a higher incidence of NEC. It is important to better understand the role of such variables as time, type, and duration of antibiotic treatment on NEC incidence, immune development, gut colonization, and antibiotic resistance in the NICU.",

author = "Yanqi Li and Shen, \{Ren{\'e} Liang\} and Ayede, \{Adejumoke I.\} and Janet Berrington and Bloomfield, \{Frank H.\} and Busari, \{Olubunmi O.\} and Cormack, \{Barbara E.\} and Embleton, \{Nicholas D.\} and \{van Goudoever\}, \{Johannes B.\} and Gorm Greisen and Zhongqian He and Yan Huang and Xiaodong Li and Lin, \{Hung Chih\} and Jiaping Mei and Meier, \{Paula P.\} and Chuan Nie and Patel, \{Aloka L.\} and Sangild, \{Per T.\} and Thomas Skeath and Karen Simmer and Signe Uhlenfeldt and \{de Waard\}, Marita and Sufen Ye and Xuqiang Ye and Chunyi Zhang and Yanna Zhu and Ping Zhou",

year = "2020",

doi = "10.1016/j.jpeds.2020.06.032",

language = "English",

volume = "227",

pages = "P128--134.E2",

journal = "Journal of Pediatrics",

issn = "0022-3476",

publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Early Use of Antibiotics Is Associated with a Lower Incidence of Necrotizing Enterocolitis in Preterm, Very Low Birth Weight Infants

T2 - The NEOMUNE-NeoNutriNet Cohort Study

AU - Li, Yanqi

AU - Shen, René Liang

AU - Ayede, Adejumoke I.

AU - Berrington, Janet

AU - Bloomfield, Frank H.

AU - Busari, Olubunmi O.

AU - Cormack, Barbara E.

AU - Embleton, Nicholas D.

AU - van Goudoever, Johannes B.

AU - Greisen, Gorm

AU - He, Zhongqian

AU - Huang, Yan

AU - Li, Xiaodong

AU - Lin, Hung Chih

AU - Mei, Jiaping

AU - Meier, Paula P.

AU - Nie, Chuan

AU - Patel, Aloka L.

AU - Sangild, Per T.

AU - Skeath, Thomas

AU - Simmer, Karen

AU - Uhlenfeldt, Signe

AU - de Waard, Marita

AU - Ye, Sufen

AU - Ye, Xuqiang

AU - Zhang, Chunyi

AU - Zhu, Yanna

AU - Zhou, Ping

PY - 2020

Y1 - 2020

N2 - Objective: To determine whether commencement of antibiotics within 3 postnatal days in preterm, very low birth weight (VLBW; ≤1500 g) infants is associated with the development of necrotizing enterocolitis (NEC). Study design: Preplanned statistical analyses were done to study the association between early antibiotic treatment and later NEC development, using the NEOMUNE-NeoNutriNet cohort of VLBW infants from 13 neonatal intensive care units (NICUs) in 5 continents (n = 2831). NEC incidence was compared between infants who received early antibiotics and those who did not, with statistical adjustments for NICU, gestational age, birth weight, sex, delivery mode, antenatal steroid use, Apgar score, and type and initiation of enteral nutrition. Results: The incidence of NEC was 9.0% in the group of infants who did not receive early antibiotics (n = 269), compared with 3.9% in those who did receive early antibiotics (n = 2562). The incidence remained lower in the early antibiotic group after stepwise statistical adjustments for NICU (OR, 0.57; 95% CI, 0.35-0.94, P <.05) and other potential confounders (OR, 0.25; 95% CI, 0.12-0.47; P <.0001). Conclusions: In this large international cohort of preterm VLBW infants, a small proportion of infants did not receive antibiotics just after birth, and these infants had a higher incidence of NEC. It is important to better understand the role of such variables as time, type, and duration of antibiotic treatment on NEC incidence, immune development, gut colonization, and antibiotic resistance in the NICU.

AB - Objective: To determine whether commencement of antibiotics within 3 postnatal days in preterm, very low birth weight (VLBW; ≤1500 g) infants is associated with the development of necrotizing enterocolitis (NEC). Study design: Preplanned statistical analyses were done to study the association between early antibiotic treatment and later NEC development, using the NEOMUNE-NeoNutriNet cohort of VLBW infants from 13 neonatal intensive care units (NICUs) in 5 continents (n = 2831). NEC incidence was compared between infants who received early antibiotics and those who did not, with statistical adjustments for NICU, gestational age, birth weight, sex, delivery mode, antenatal steroid use, Apgar score, and type and initiation of enteral nutrition. Results: The incidence of NEC was 9.0% in the group of infants who did not receive early antibiotics (n = 269), compared with 3.9% in those who did receive early antibiotics (n = 2562). The incidence remained lower in the early antibiotic group after stepwise statistical adjustments for NICU (OR, 0.57; 95% CI, 0.35-0.94, P <.05) and other potential confounders (OR, 0.25; 95% CI, 0.12-0.47; P <.0001). Conclusions: In this large international cohort of preterm VLBW infants, a small proportion of infants did not receive antibiotics just after birth, and these infants had a higher incidence of NEC. It is important to better understand the role of such variables as time, type, and duration of antibiotic treatment on NEC incidence, immune development, gut colonization, and antibiotic resistance in the NICU.

U2 - 10.1016/j.jpeds.2020.06.032

DO - 10.1016/j.jpeds.2020.06.032

M3 - Journal article

C2 - 32553865

AN - SCOPUS:85089452948

SN - 0022-3476

VL - 227

SP - P128-134.E2

JO - Journal of Pediatrics

JF - Journal of Pediatrics

ER -