Gut microbiome alteration in MORDOR I: a community-randomized trial of mass azithromycin distribution.
Nat Med
; 25(9): 1370-1376, 2019 09.
Article
en En
| MEDLINE
| ID: mdl-31406349
ABSTRACT
The MORDOR I trial1, conducted in Niger, Malawi and Tanzania, demonstrated that mass azithromycin distribution to preschool children reduced childhood mortality1. However, the large but simple trial design precluded determination of the mechanisms involved. Here we examined the gut microbiome of preschool children from 30 Nigerien communities randomized to either biannual azithromycin or placebo. Gut microbiome γ-diversity was not significantly altered (P = 0.08), but the relative abundances of two Campylobacter species, along with another 33 gut bacteria, were significantly reduced in children treated with azithromycin at the 24-month follow-up. Metagenomic analysis revealed functional differences in gut bacteria between treatment groups. Resistome analysis showed an increase in macrolide resistance gene expression in gut microbiota in communities treated with azithromycin (P = 0.004). These results suggest that prolonged mass azithromycin distribution to reduce childhood mortality reduces certain gut bacteria, including known pathogens, while selecting for antibiotic resistance.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Infecciones por Campylobacter
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Azitromicina
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Metagenómica
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Microbioma Gastrointestinal
Tipo de estudio:
Clinical_trials
País/Región como asunto:
Africa
Idioma:
En
Revista:
Nat Med
Asunto de la revista:
BIOLOGIA MOLECULAR
/
MEDICINA
Año:
2019
Tipo del documento:
Article