Specific class of intrapartum antibiotics relates to maturation of the infant gut microbiota: a prospective cohort study.

OBJECTIVE: To evaluate the potential impact of intrapartum antibiotics, and their specific classes, on the infant gut microbiota in the first year of life. DESIGN: Prospective study of infants in the New Hampshire Birth Cohort Study (NHBCS). SETTINGS: Rural New Hampshire, USA. POPULATION OR SAMPLE: Two hundred and sixty-six full-term infants from the NHBCS. METHODS: Intrapartum antibiotic use during labour and delivery was abstracted from medical records. Faecal samples collected at 6 weeks and 1 year of age were characterised by 16S rRNA sequencing, and metagenomics analysis in a subset of samples. EXPOSURES: Maternal exposure to antibiotics during labour and delivery. MAIN OUTCOME MEASURE: Taxonomic and functional profiles of faecal samples. RESULTS: Infant exposure to intrapartum antibiotics, particularly to two or more antibiotic classes, was independently associated with lower microbial diversity scores as well as a unique bacterial community at 6 weeks (GUnifrac, P = 0.02). At 1 year, infants in the penicillin-only group had significantly lower α diversity scores than infants not exposed to intrapartum antibiotics. Within the first year of life, intrapartum exposure to penicillins was related to a significantly lower increase in several taxa including Bacteroides, use of cephalosporins was associated with a significantly lower rise over time in Bifidobacterium and infants in the multi-class group experienced a significantly higher increase in Veillonella dispar. CONCLUSIONS: Our findings suggest that intrapartum antibiotics alter the developmental trajectory of the infant gut microbiome, and specific antibiotic types may impact community composition, diversity and keystone immune training taxa. TWEETABLE ABSTRACT: Class of intrapartum antibiotics administered during delivery relates to maturation of infant gut microbiota.

Parity, early menopause and the incidence of bladder cancer in women: a case-control study and meta-analysis.

INTRODUCTION: Incidence rates of bladder cancer are notably higher in men than in women. While there is evidence that reproductive and hormonal risk factors may influence risk of bladder cancer, data are inconclusive. MATERIALS AND METHODS: We examined reproductive, menstrual and hormonal use history in our population-based case-control study of bladder cancer in New Hampshire (NH), USA (n=207 women cases and n=463 women controls). Additionally, we performed a meta-analysis of the published literature. We used unconditional logistic regression analysis to compute adjusted odds ratios associated with each risk factor in the NH study. We combined these estimates with those from the published literature using inverse variance effects models. RESULTS: In the NH study, a slightly decreased odds ratio was found among women who had ever had a birth compared to nulliparous women and an elevated odds ratio among women who underwent surgical menopause (bilateral oophorectomy), especially at an early age. No overall associations were found with oral contraceptive use or hormone replacement therapy. These findings were generally in agreement with the meta-analytic results for which the combined relative risk (RR) estimate was reduced among ever parous women (combined RR estimate for ever parous versus nulliparous=0.66, 95% confidence intervals [95% CI] 0.55-0.79) and elevated among those undergoing an early menopause (combined RR estimate for early versus late menopause=1.59, 95% CI 1.31-1.92). No consistent risk was observed for the other factors. DISCUSSION: Some reproductive and menstrual factors appear to be related to the incidence of bladder cancer among women; but whether effects are due to female hormones is uncertain.

Mycoplasmosis in captive crows and robins from Minnesota.

Mycoplasma sturni is a recently described organism previously associated with conjunctivitis in European starlings (Sturnus vulgaris), northern mockingbirds (Mimus polyglottos) and blue jays (Cyanocitta cristata). Herein we describe the isolation of M. sturni from an American crow (Corvus brachyrhynchos) presenting with conjunctivitis. A nested-PCR was designed for identification of M. sturni in clinical specimens and the sensitivity of the reaction was found to be 10 colony-changing units. The organism was found in asymptomatic American crows caged with a nestmate of the crow with conjunctivitis. Mycoplasma sturni also was found in asymptomatic American robins (Turdus migratorius) and in a European starling (Sturnus vulgaris) housed at the same facility as the crows. Heterogenity of M. sturni isolates from different host species was found by random amplified polymorphic DNA (RAPD) analyses. Heterogeneity also was found among M. sturni isolates recovered from American crows. We suggest that M. sturni can successfully infect American crows and American robins with or without the presence of clinical disease. Furthermore, we demonstrate that nested-PCR is an effective method for the detection of M. sturni and that substantial genetic heterogeneity exists among natural isolates of this bacterial pathogen.

Diagnosis and treatment of conjunctivitis in house finches associated with mycoplasmosis in Minnesota.

An ongoing outbreak of Mycoplasma gallisepticum-associated conjunctivitis in house finches (Carpodacus mexicanus) that began in 1994 in the eastern United States has been spreading westward. House finches presenting with the clinical signs of M. gallisepticum-associated conjunctivitis were first seen at the Wildlife Rehabilitation Center of Minnesota (Minnesota, USA) in July of 1996, and 42 cases were admitted from 26 December 1996 to 10 August 1997. A nested PCR was designed for sensitive and specific detection of the presence of the organism. Twelve birds were treated with oral enrofloxacin (15 mg/kg, twice daily for 21 days) and ophthalmic gentamicin (twice daily for 21 days). All treated birds showed resolution of clinical signs. Following treatment, finches were held for up to 6 mo and tested for the presence of M. gallisepticum by culture and nested polymerase chain reaction (PCR). Eight of twelve finches (67%) were positive for M. gallisepticum by nested-PCR and four (33%) were positive by culture. The results suggest that oral enrofloxacin and opthalmic gentamicin are not an effective treatment for the eradication of M. gallisepticum in house finches. Further, the results show that nested PCR is an effective method for detection of M. gallisepticum in house finches and was more sensitive than culture.

Type I external skeletal fixation of radial fractures in microchiropterans.

An adult male big brown bat (Eptesicus fuscus) and an adult female hoary bat (Lasiurus cinereus) were presented with open transverse middiaphyseal left radial fractures. Initial repair was attempted by intramedullary pinning. When the fractures did not heal, intramedullary pins were removed and type I external skeletal fixators were placed. The fractures healed, and the big brown bat regained normal flight but the hoary bat did not.