Evidence map›Paper›PMID 40813371›Full record

ArticleNature communications2025

Impact of early life antibiotic and probiotic treatment on gut microbiome and resistome of very-low-birth-weight preterm infants.

Raymond Kiu, Elizabeth M Darby, Cristina Alcon-Giner, Antia Acuna-Gonzalez, Anny Camargo, Lisa E Lamberte, Sarah Phillips, Kathleen Sim, Alexander G Shaw, Paul Clarke and 3 more

Abstract read
In one paragraph

Article in Nature communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

30 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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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

13 authors.

Raymond KiuDepartment of Microbes, Infection and Microbiomes, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, UK. r.k.o.kiu@bham.ac.uk.ORCID http://orcid.org/0000-0002-4483-1215
Elizabeth M Darby *Department of Microbes, Infection and Microbiomes, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, UK.ORCID http://orcid.org/0000-0002-6990-3537
Cristina Alcon-Giner *Food, Microbiome and Health, Quadram Institute Bioscience, Norwich Research Park, Norwich, UK.
Antia Acuna-Gonzalez *Food, Microbiome and Health, Quadram Institute Bioscience, Norwich Research Park, Norwich, UK.
Anny CamargoFood, Microbiome and Health, Quadram Institute Bioscience, Norwich Research Park, Norwich, UK.
Lisa E LamberteInstitute of Microbiology and Infection, University of Birmingham, Birmingham, UK.
Sarah PhillipsFood, Microbiome and Health, Quadram Institute Bioscience, Norwich Research Park, Norwich, UK.
Kathleen SimFaculty of Medicine, Imperial College London, London, UK.
Alexander G ShawFaculty of Medicine, Imperial College London, London, UK.
Paul ClarkeNorfolk and Norwich University Hospital, Norwich, UK.ORCID http://orcid.org/0000-0001-6203-7632
Willem van SchaikDepartment of Microbes, Infection and Microbiomes, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, UK.ORCID http://orcid.org/0000-0001-5832-0988
J Simon KrollFaculty of Medicine, Imperial College London, London, UK.
Lindsay J HallDepartment of Microbes, Infection and Microbiomes, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, UK. l.hall.3@bham.ac.uk.ORCID http://orcid.org/0000-0001-8938-5709

Funding

RCUK | Biotechnology and Biological Sciences Research Council (BBSRC) BB/R012490/1RCUK | Biotechnology and Biological Sciences Research Council (BBSRC) BB/S017941/1RCUK | Biotechnology and Biological Sciences Research Council (BBSRC) BB/X011054/1Wellcome TrustWellcome Trust (Wellcome) 100974/C/13/Z
6 · The paper itself

Abstract

Preterm infants (<37 weeks' gestation) are commonly given broad-spectrum antibiotics due to their risk of severe conditions like necrotising enterocolitis and sepsis. However, antibiotics can disrupt early-life gut microbiota development, potentially impairing gut immunity and colonisation resistance. Probiotics (e.g., certain Bifidobacterium strains) may help restore a healthy gut microbiota. In this study, we investigated the effects of probiotics and antibiotics on the gut microbiome and resistome in two unique cohorts of 34 very-low-birth-weight, human-milk-fed preterm infants - one of which received probiotics. Within each group, some infants received antibiotics (benzylpenicillin and/or gentamicin), while others did not. Using shotgun metagenomic sequencing on 92 longitudinal faecal samples, we reconstructed >300 metagenome-assembled genomes and obtained ~90 isolate genomes via targeted culturomics, allowing strain-level analysis. We also assessed ex vivo horizontal gene transfer (HGT) capacity of multidrug-resistant (MDR) Enterococcus using neonatal gut models. Here we show that probiotic supplementation significantly reduced antibiotic resistance gene prevalence, MDR pathogen load, and restored typical early-life microbiota profile. However, persistent MDR pathogens like Enterococcus, with high HGT potential, underscore the need for continued surveillance. Our findings underscore the complex interplay between antibiotics, probiotics, and HGT in shaping the neonatal microbiome and support further research into probiotics for antimicrobial stewardship in preterm populations.

Indexed as

Anti-Bacterial AgentsGastrointestinal MicrobiomeInfant, Very Low Birth WeightProbioticsDrug Resistance, Multiple, BacterialEnterococcusFecesFemaleGene Transfer, HorizontalHumansInfant, NewbornInfant, PrematureMaleMetagenomeMetagenomicsMilk, HumanAnti-Bacterial Agents

Identifiers

PMID40813371
PMCPMC12354744

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.