The Impact of Chlorinated Drinking Water on the Infant Gut Microbiota: A Randomised Controlled Trial

Water chlorination is essential for controlling harmful microbes in drinking water; however, the antimicrobial effects of chlorine-based disinfectants may negatively impact the developing infant microbiota. This trial investigated the effects of chlorinated water on the infant gut microbiome. The waTer qUality and Microbiome Study (TUMS) was a double-blinded, randomised controlled trial. Six-month old infants (n=197) received either de-chlorinated drinking water via benchtop filtration (treatment, n=99), or regular chlorinated water (control, n=98) for twelve months. Tap water and stool samples were collected at baseline and at end of intervention. Metagenomic sequencing was used for faecal microbiome analysis. Primary outcomes were differences in gut microbiota alpha and beta diversity. Secondary outcomes included changes in the differential abundance of amplicon sequence variants (ASVs) and functional profiles. This study was registered with Australian New Zealand Clinical Trial Registry: ACTRN12619000458134.饮水氯化消毒对管控饮用水中的有害微生物不可或缺，但含氯消毒剂的抗菌活性可能对正在发育的婴儿微生物群造成负面影响。本试验旨在探究氯化饮用水对婴儿肠道微生物组的影响。水质与微生物组研究（Water Quality and Microbiome Study，TUMS）为一项双盲随机对照试验。研究共纳入197名6月龄婴儿，按随机分配原则分为两组：干预组（n=99）通过台式过滤装置饮用脱氯饮用水，对照组（n=98）饮用常规氯化饮用水，干预周期为12个月。分别于干预基线及干预结束时采集自来水与粪便样本。采用宏基因组测序（Metagenomic sequencing）技术开展粪便微生物组分析。主要结局指标为肠道微生物群α多样性与β多样性的组间差异。次要结局指标包括扩增子序列变异体（amplicon sequence variants，ASVs）的差异丰度变化及功能谱改变。本研究已在澳大利亚新西兰临床试验注册中心完成注册，注册号为ACTRN12619000458134。