Previous antibiotic use and the development of Kawasaki disease: a matched pair case-control study.
Anti-Bacterial Agents
/ adverse effects
Antimicrobial Stewardship
Breast Feeding
/ statistics & numerical data
Case-Control Studies
Cesarean Section
/ statistics & numerical data
Child
Child, Preschool
Dysbiosis
/ epidemiology
Female
Gastrointestinal Microbiome
/ drug effects
Humans
Infant
Logistic Models
Male
Mucocutaneous Lymph Node Syndrome
/ epidemiology
Odds Ratio
Risk Factors
Vasculitis
/ epidemiology
Kawasaki disease
antimicrobial stewardship
innate immunity
microbiota
Journal
Pediatrics international : official journal of the Japan Pediatric Society
ISSN: 1442-200X
Titre abrégé: Pediatr Int
Pays: Australia
ID NLM: 100886002
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
22
08
2019
revised:
13
03
2020
accepted:
15
04
2020
pubmed:
20
4
2020
medline:
19
5
2021
entrez:
20
4
2020
Statut:
ppublish
Résumé
Kawasaki disease (KD) is an acute febrile illness with systemic vasculitides, mostly affecting infants and young children. The etiology of KD is still unclear; however, altered gut microbiota have been recently implicated as a contributing factor for the development of vasculitis. We conducted an age- and gender-matched case-control study on 50 patients and 200 control subjects to search for potential factors leading to intestinal dysbiosis associated with KD. Data were analyzed using conditional multivariable logistic regression. Previous antibiotic administration was associated with the patients who developed KD (odds ratio [OR] 11.7, 95% confidence interval [CI] 4.7-29.1, P < 0.0001), but not other variables, including breastfeeding and group nursery. In subgroup analyses, cesarean birth was indicated as an associated factor in addition to previous antibiotic administration in infants under 12 months of age (OR: 8.0, 95% CI: 1.8-34.4, P = 0.005), but not in older children. The association between previous antibiotic administration and the onset of KD was demonstrated. Antibiotics may contribute to the development of KD by affecting the intestinal microbiota in infants and young children.
Sections du résumé
BACKGROUND
BACKGROUND
Kawasaki disease (KD) is an acute febrile illness with systemic vasculitides, mostly affecting infants and young children. The etiology of KD is still unclear; however, altered gut microbiota have been recently implicated as a contributing factor for the development of vasculitis.
METHODS
METHODS
We conducted an age- and gender-matched case-control study on 50 patients and 200 control subjects to search for potential factors leading to intestinal dysbiosis associated with KD. Data were analyzed using conditional multivariable logistic regression.
RESULTS
RESULTS
Previous antibiotic administration was associated with the patients who developed KD (odds ratio [OR] 11.7, 95% confidence interval [CI] 4.7-29.1, P < 0.0001), but not other variables, including breastfeeding and group nursery. In subgroup analyses, cesarean birth was indicated as an associated factor in addition to previous antibiotic administration in infants under 12 months of age (OR: 8.0, 95% CI: 1.8-34.4, P = 0.005), but not in older children.
CONCLUSIONS
CONCLUSIONS
The association between previous antibiotic administration and the onset of KD was demonstrated. Antibiotics may contribute to the development of KD by affecting the intestinal microbiota in infants and young children.
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1044-1048Informations de copyright
© 2020 Japan Pediatric Society.
Références
Hedrich CM, Schnabel A, Hospach T. Kawasaki disease. Front. Pediatr. 2018; 6: 198.
Nagatomo Y, Muneuchi J, Nakashima Y et al. Effective infliximab therapy for the early regression of coronary artery aneurysm in Kawasaki disease. Int. J. Cardiol. 2018; 271: 317-21.
Kawasaki T. Acute febrile muco-cutaneous lymph node syndrome in young children with unique digital desquamation. [in Japanese] Jpn. J. Allergol. 1967; 16: 178-222.
Makino N, Nakamura Y, Yashiro M et al. Nationwide epidemiologic survey of Kawasaki disease in Japan, 2015-2016. Pediatr. Int. 2019; 61: 397-403.
Esposito S, Polinori I, Rigante D. The gut microbiota-host partnership as a potential driver of Kawasaki syndrome. Front Pediatr. 2019; 7: 124.
Yamashiro Y, Nagata S, Ohtsuka Y, Oguchi S, Shimizu T. Microbiologic studies on the small intestine in Kawasaki disease. Pediatr Res. 1996; 39: 622-4.
Kinumaki A, Sekizuka T, Hamada H, Kato K, Yamashita A, Kuroda M. Characterization of the gut microbiota of Kawasaki disease patients by metagenomic analysis. Front. Microbiol. 2015; 6: 824.
Hand TW, Vujkovic-Cvijin I, Ridaura VK, Belkaid Y. Linking the microbiota, chronic disease, and the immune system. Trends Endocrinol. Metab. 2016; 27 (12): 831-43.
Ianiro G, Tilg H, Gasbarrini A. Antibiotics as deep modulators of gut microbiota: between good and evil. Gut. 2016; 65 (11): 1906-15.
Korpela K, Salonen A, Virta LJ et al. Intestinal microbiome is related to lifetime antibiotic use in Finnish pre-school children. Nat. Commun. 2016; 7: 10410.
Korpela K, de Vos WM. Early life colonization of the human gut: microbes matter everywhere. Curr. Opin. Microbiol. 2018; 44: 70-8.
Nishio H, Kanno S, Onoyama S et al. Nod1 ligands induce site-specific vascular inflammation. Arter. Thromb. Vasc. Biol. 2011; 31: 1093-9.
Murata K, Motomura Y, Tanaka T et al. Calcineurin inhibitors exacerbate coronary arteritis via the MyD88 signalling pathway in a murine model of Kawasaki disease. Clin. Exp. Immunol. 2017; 190: 54-67.
Hara T, Nakashima Y, Sakai Y, Nishio H, Motomura Y, Yamasaki S. Kawasaki disease: a matter of innate immunity. Clin.. Exp. Immunol. 2016; 186(2): 134-43.
Love BL, Mann JR, Hardin JW, Lu ZK, Cox C, Amrol DJ. Antibiotic prescription and food allergy in young children. Allergy Asthma Clin. Immunol. 2016; 12: 41.
Zhang L, Huang Y, Zhou Y, Buckley T, Wang HH. Antibiotic administration routes significantly influence the levels of antibiotic resistance in gut microbiota. Antimicrob. Agents Chemother. 2013; 57: 3659-66.
Marra F, Marra CA, Richardson K et al. Antibiotic use in children is associated with increased risk of asthma. Pediatrics 2009; 123(3): 1003-10.
Hoskin-Parr L, Teyhan A, Blocker A, Henderson AJ. Antibiotic exposure in the first two years of life and development of asthma and other allergic diseases by 7.5 yr: a dose-dependent relationship. Pediatr. Allergy. Immunol. 2013; 24(8): 762-71.