The Influence Of Cefotaxime Sodium On The Neonatal Intestinal Flora

Background:The neonatal period is the critical period of microorganism colonization to the intestinal flora. The fetus intrauterine and childbirth is sterile, but as time goes on, a lot of bacteria from the skin, vagina, anus, respiratory, and oral enter human body, began to colonize in different parts. The process of intestinal microorganism colonization is affected by many factors, such as gestational age, delivery way, feeding patterns, motherhood, birth weight, disease, antibiotics and probiotic application, environment and geographical factors etc. From birth to adult, the intestinal flora has experienced the procedure from simple to complex, unstable to stable, similar to adults until 2 years old and maintains the stability and dynamic balance. Bifidobacterium and Lactobacillus are the main anaerobic bacteria in the gut, not only have the function of nutrition, but also have the anti-infection, improving vitamin metabolism, preventing constipation, improving liver function, enhancing immune function, and prevention of intestinal cancer. Bifidobacterium and Lactobacillus can promote the development and mature of the immune system in infant through promoting the intestinal mucosa SIgA systems mature, also have significantly effect to reduce allergic disease, diabetes and childhood obesity. Bacteroides is also an important component of human intestinal flora, to play an important role in the fat metabolism, the immune barrier, and maintaining the stability of intestinal flora. At present, Enterobacteriaceae bacteria are the main gram-negative bacilli causing nosocomial infection, which can cause respiratory tract, urinary tract, abdominal cavity, and blood infections. Cefotaxime sodium is third generation cephalosporins, owns wide antimicrobial spectrum, has strong activity for Escherichia coli, Singular proteus, Klebsiella bacteria genera, Salmonella and so on, which is of great importance in the treatment of neonatal septicemia, pneumonia and other infectious diseases.16SrDNA is the gene of rRNA coding prokaryotes ribosome small subunits, which is the most common and useful "molecular clock" in bacteria systematics study. The sequence of 16SrDNA is highly conserved, can accurately indicate the genetic relationship between the bacteria. We commonly use real-time fluorescent quantitative PCR based on ordinary PCR technology, which is convenient and speedy.Objective:Our aim is to investigate the numbers of intestinal flora such as Bifidobacterium, Lactobacillus, Bacteroides, and Enterobacteriaceae with different ages of birth in neonatal period and the changes after intravenous application with cefotaxime sodium in newborn with infectious diseases. Another purpose is to analyze the influence factors of bacterial colonization in the intestines such as gestational age, delivery way, feeding patterns, maternal times, and birth weight.Methods:100 full-term newborns were enrolled in this study from August to December in 2013 in the Children’s Hospital affiliated to Zhejiang University School of Medicine. Stool specimens were taken during the hospitalization. The content of Bifidobacterium, Lactobacillus, Bacteroides, Enterobacteriaceae in stool samples were detected by real-time PCR. The difference of the numbers of neonatal intestinal flora among different age groups was compared.Results:The results showed that the number of Bifidobacteria was significantly increased with the increase of day age, and the number of Lactobacillus was increased, but relatively slowly, while the increasing of Enterobacteriaceae and Bacteroides was not obvious. In the group of 3 to 28 days age, the numbers of Bifidobacteria and Enterobacteriaceae were significantly decreased in patients with cefotaxime sodium than that without cefotaxime sodium (P<0.05), and there were no significant difference in the numbers of Lactobacillus and Bacteroidetes before and after using cefotaxime sodium (P>0.05). In the 3 to 7 days age group, after the use of cefotaxime sodium, the quantity of Bifidobacteria was significantly decreased (P<0.05), however the numbers of Lactobacillus, Bacteroides, and Enterobacteriaceae had no obviously changes (P> 0.05). In the group of 8 to 14 days age, the numbers of Bifidobacterium, Lactobacillus, Bacteroides, and Enterobacteriaceae were no obvious changes regardless of the use of cefotaxime sodium (P>0.05). In the 15 to 21 days of age group, the number of Enterobacteriaceae in the patients with cefotaxime sodium was significantly decreased than that without cefotaxime sodium(P<0.05), while Bifidobacterium, Lactobacillus, and Bacteroides had no obvious changes (P>0.05). In the 22 to 28 days age group, the numbers of Bifidobacterium and Enterobacteriaceae in patients with cefotaxime sodium were significantly decreased than that without cefotaxime sodium (P<0.05), whereas the number of Lactobacillus and Bacteroides have no significant changes(P>0.05).Conclusion:Bifidobacteria, Lactobacillus, Bacteroides and Enterobacteriaceae were significantly increased within the 3 days after born; and the number of Bifidobacteria increased most obviously with the age growth. Enterobacteriaceae and Bifidobacteria were significantly decreased after the use of cefotaxime sodium, while the changes of Bacteroidetes and Lactobacillus had not reached significant; The effect of cefotaxime sodium on the numbers of Enterobacteriaceae and Bifidobacteria was different in different days aged newborns. The results suggest that the use of intravenous antibiotics in the neonatal period such as cefotaxime sodium can cause the changes of intestinal flora, and need to be paid more attention.