摘要
      微生物组的早期发育已被证明会影响婴儿的总体健康和身体发育，尽管一些研究是在高收入国家进行的，但很少有来自中低收入国家的研究。作为BARNARDS研究的一部分，我们检查了2931名新生儿的直肠微生物群（使用期限长达60 d） 对15217名母亲进行blaCTX-M-15、blaNDM、blaKPC和blaOXA-48样基因筛查，分别在56.1%、18.5%、0%和4.1%的新生儿直肠拭子和47.1%、4.6%、0%、1.6%的母亲直肠拭子中检测到这些基因。碳青霉烯酶阳性细菌通过MALDI-TOF MS鉴定，并显示出高度多样性的细菌物种（57个不同的物种/属），这些细菌对大多数测试的抗生素表现出耐药性。大肠杆菌、肺炎克雷伯菌和阴沟肠杆菌/E。对最常见的分离物泄殖腔复合体进行了全基因组测序分析，揭示了不同样本分离物之间的密切关系，表明细菌在新生儿之间以及新生儿和母亲之间传播。确定了抗微生物耐药性基因（ARGs）的携带与医疗保健/环境因素之间的相关性，并且ARGs的存在是新生儿败血症和不良出生结局的预测因素。
Abstract
Early development of the microbiome has been shown to affect general health and physical development of the infant and, although some studies have been undertaken in high-income countries, there are few studies from low- and middle-income countries. As part of the BARNARDS study, we examined the rectal microbiota of 2,931 neonates (term used up to 60 d) with clinical signs of sepsis and of 15,217 mothers screening for blaCTX-M-15, blaNDM, blaKPC and blaOXA-48-like genes, which were detected in 56.1%, 18.5%, 0% and 4.1% of neonates’ rectal swabs and 47.1%, 4.6%, 0% and 1.6% of mothers’ rectal swabs, respectively. Carbapenemase-positive bacteria were identified by MALDI-TOF MS and showed a high diversity of bacterial species (57 distinct species/genera) which exhibited resistance to most of the antibiotics tested. Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae/E. cloacae complex, the most commonly found isolates, were subjected to whole-genome sequencing analysis and revealed close relationships between isolates from different samples, suggesting transmission of bacteria between neonates, and between neonates and mothers. Associations between the carriage of antimicrobial resistance genes (ARGs) and healthcare/environmental factors were identified, and the presence of ARGs was a predictor of neonatal sepsis and adverse birth outcomes.

https://www.nature.com/articles/s41564-022-01184-y