Maternal-infant antibiotic resistance genes transference: what do we know?

ABSTRACT

Resistance to antibiotics is becoming a worldwide threat as infections caused by multidrug-resistant pathogenic microorganisms can overcome antibiotic treatments and spread quickly in the population. In the context of early life, newborns are at increased risk as their immune system is still under development, so infections and acquisition of resistance during childhood have short- and long-term consequences for the health. The moment of birth is the first exposure of infants to possible antibiotic-resistant microorganisms that may colonize their gut and other body sites. Different factors including mode of delivery, previous antibiotic exposure of the mother, gestational age and consumption of antibiotics in early-life have been described to modulate the neonate’s microbiota, and thus, the resistome. Other factors, such as lactation, also impact the establishment and development of gut microbiota, but little is known about the role of breastmilk in transferring Antibiotic Resistant Genes (ARG). A deeper understanding of vertical transmission of antibiotic resistance from mothers to their offspring is necessary to determine the most effective strategies for reducing antibiotic resistance in the early life. In this review, we aim to present the current perspective on antibiotic resistances in mother-infant dyads, as well as a new insight on the study of the human gut and breastmilk resistome, and current strategies to overcome this public health problem, toward highlighting the gaps of knowledge that still need to be closed.

KEYWORDS:

• Antibiotic
• resistome
• microbiota
• gut
• breastmilk
• infant
• mother
• pregnancy

Abbreviations

ARG	=	: antibiotic resistant genes
ARM	=	: antibiotic resistant microorganisms
HMO	=	: human milk oligosaccharides
MGE	=	: mobile genetic elements
WHO	=	: World Health Organization
CDC	=	: Centers for Disease Control and Prevention

Acknowledgments

We acknowledge Generalitat Valenciana-European Social Fund (ACIF/2021) for the predoctoral fellowship grant to Anna Samarra. Manuel Bernabeu wishes to thank the Post-PhD Program of University of Barcelona for the requalification of the Spanish University System from the Ministry of Universities of the Government of Spain, modality “Margarita Salas”, financed by the European Union, Next Generation EU. Maria Esteban-Torres thanks the support received from the MSCA-IF postdoctoral grant (MicroMi-898088). Raul Cabrera-Rubio wishes to thank Generalitat-Valenciana for the grant Plan GenT project (CDEIGENT 2020). Finally, authors also acknowledge support of Institute of Agrochemistry and Food Technology (IATA-CSIC). IATA-CSIC is a Centre of Excellence Severo Ochoa (CEX2021-001189-S MCIN/AEI/10.13039/501100011033).

Disclosure statement

No potential conflict of interest was reported by the authors.

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Contribution statement

All authors contributed to the conceptualization, critical review, revision, and approval of the final version of this manuscript.

Data sharing

Data sharing is not applicable to this article, as no new data were created or analyzed in this report.

Additional information

Funding

This work was supported by PROMETEO/GVA under grant “NeoHealth” project PROMETEO ref. 2020/012.