The impact of probiotics on antibiotic resistance in newborns: A systematic review.

BACKGROUND AND OBJECTIVES: Newborns, particularly premature ones, are vulnerable to bacterial infections and often receive antibiotics, disrupting their normal intestinal microbiota. Probiotics have multiple health benefits and are recommended for restoring balance, but caution is needed due to potential consequences, such as promoting antibiotic resistance. Therefore, this study aimed to conduct a systematic review to assess current knowledge regarding the impact of probiotics on antibiotic resistance in newborns. METHODS: This systematic review is aligned with the PRISMA 2020 statement. The search involved three electronic databases (PubMed, Scopus, and Web of Science) and the keywords used were "newborn", "probiotic", and "antibiotic resistance". Titles/abstracts were independently analyzed, followed by full-text assessments. Data extraction and synthesis were conducted, assessing outcomes like antibiotic resistance gene and mobile gene elements quantity and quality, vancomycin resistant enterococci colonization, antibiotic-resistant bacteria colonization, and microbiota changes. It was only included randomized controlled trials and cohort studies focusing on human newborns. RESULTS: In the study selection process, 1,970 articles were identified and six were included in this review. The results varied, with two studies suggesting a positive impact of probiotics on antibiotic resistance, one a negative impact, while three others found no significant impact. Microbiota changes were also addressed across four studies, where the findings included promotion of beneficial bacteria and reduction of potential pathogens. Bias risk was evaluated using Joanna Briggs Institute tools. CONCLUSION: Our findings did not allow for clear conclusions to be drawn, due to the observed heterogeneity between studies, highlighting the need for further studies.

Antimicrobial resistance and virulence profiles of Enterobacterales isolated from two-finger and three-finger sloths (Choloepus hoffmanni and Bradypus variegatus) of Costa Rica.

Background: Wildlife has been recently recognized as an environmental reservoir for antimicrobial resistance (AMR). However, less information on this topic is available in animals released back into the wild after rehabilitation in wildlife facilities, compared with studies performed exclusively in captive or free-ranging wildlife. This study aimed to evaluate the potential influence of captivity and/or treatment while in captivity of wild sloths on the AMR and virulence profiles of sloths' Enterobacterales. Methods: Oral and rectal swab samples were collected from 39 two-finger (Choloepus hoffmanni) and three-finger sloths (Bradypus variegatus) of Costa Rica (n = 78) and analyzed using conventional bacteriological techniques. A generalized linear mixed model was applied to estimate the isolates' multiple antimicrobial resistance and virulence indices as a function of animal status. Results: A considerable level of resistance was detected, especially for Citrobacter youngae and Escherichia coli, with 17.5% of isolates classified as multidrug-resistant. Virulence indices of isolates from rehabilitated sloths were significantly higher than the ones from sloths being hand-reared for shorter periods. Conclusions: To our knowledge, this is the first description of sloths' antimicrobial resistant Enterobacterales, suggesting that sloths' rehabilitation and consequent exposure to humans, may promote the selection of bacteria with higher virulence. Ultimately, these bacteria may represent a threat to human and animal health due to their zoonotic potential and AMR and virulence profiles.

Antibiotic Resistance and Virulence Profiles of Gram-Negative Bacteria Isolated from Loggerhead Sea Turtles (Caretta caretta) of the Island of Maio, Cape Verde.

Previous studies revealed high levels of antimicrobial resistance (AMR) in loggerhead sea turtles (Caretta caretta), describing this species as prime reservoir of antimicrobial-resistant bacteria. This study aimed to characterise, for the first time, the AMR and virulence profiles of Gram-negative bacteria isolated from 33 nesting loggerhead turtles of the island of Maio, Cape Verde. Cloacal, oral, and egg content swab samples (n = 99) were collected and analysed using conventional bacteriological techniques. Shewanella putrefaciens, Morganella morganii, and Vibrio alginolyticus were isolated from the samples under study. The isolates obtained from this loggerhead subpopulation (North-East Atlantic) revealed lower levels of AMR, compared with the results of studies performed in other subpopulations (e.g., Mediterranean). However, the detection of resistance to carbapenems and multiple antimicrobial resistance indices higher than 0.20, raises concern about the potential association of these animals to points of high antimicrobial exposure. Furthermore, virulence phenotypic characterisation revealed that the isolates presented complex virulence profiles, including the ability to produce biofilms. Finally, due to their pathogenic potential, and considering the evidence of illegal consumption of turtle-related products on the island of Maio, the identified bacteria may represent a significant threat to public health.