Document Detail


Gut microbial colonisation in premature neonates predicts neonatal sepsis.
MedLine Citation:
PMID:  22562869     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Neonatal sepsis due to intestinal bacterial translocation is a major cause of morbidity and mortality. Understanding microbial colonisation of the gut in prematurity may predict risk of sepsis to guide future strategies to manipulate the microbiome.
METHODS: Prospective longitudinal study of premature infants. Stool samples were obtained weekly. DNA was extracted and the V6 hypervariable region of 16S rRNA was amplified followed by high throughput pyrosequencing, comparing subjects with and without sepsis.
RESULTS: Six neonates were 24-27 weeks gestation at birth and had 18 samples analysed. Two subjects had no sepsis during the study period, two developed late-onset culture-positive sepsis and two had culture-negative systemic inflammation. 324 350 sequences were obtained. The meconium was not sterile and had predominance of Lactobacillus, Staphylococcus and Enterobacteriales. Overall, infants who developed sepsis began life with low microbial diversity, and acquired a predominance of Staphylococcus, while healthy infants had more diversity and predominance of Clostridium, Klebsiella and Veillonella.
CONCLUSIONS: In very low birth weight infants, the authors found that meconium is not sterile and is less diverse from birth in infants who will develop late-onset sepsis. Empiric, prolonged antibiotics profoundly decrease microbial diversity and promote a microbiota that is associated not only with neonatal sepsis, but the predominant pathogen previously identified in the microbiome. Our data suggest that there may be a 'healthy microbiome' present in extremely premature neonates that may ameliorate risk of sepsis. More research is needed to determine whether altered antibiotics, probiotics or other novel therapies can re-establish a healthy microbiome in neonates.
Authors:
Juliette C Madan; Richard Cowper Salari; Deepti Saxena; Lisa Davidson; George A O'Toole; Jason H Moore; Mitchell L Sogin; James A Foster; William H Edwards; Paul Palumbo; Patricia L Hibberd
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2012-05-06
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  97     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-19     Completed Date:  2013-02-05     Revised Date:  2013-08-05    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F456-62     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03753, USA. juliette.c.madan@hitchcock.org
Data Bank Information
Bank Name/Acc. No.:
GENBANK/UNKNOWN
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use*
Bacterial Translocation
Base Sequence
Colony Count, Microbial
Enterobacteriaceae / genetics,  isolation & purification
Gastrointestinal Tract / microbiology*
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / drug therapy,  microbiology*
Infant, Very Low Birth Weight
Longitudinal Studies
Meconium / microbiology
Molecular Sequence Data
RNA, Messenger
Risk Factors
Sepsis / microbiology*
Staphylococcus / genetics,  isolation & purification
Grant Support
ID/Acronym/Agency:
K24 AT003683/AT/NCCAM NIH HHS; P20 RR018787/RR/NCRR NIH HHS; P20RR016454/RR/NCRR NIH HHS; P20RR16448/RR/NCRR NIH HHS; P30 CA023108/CA/NCI NIH HHS; R01 AI083256/AI/NIAID NIH HHS; R01 AI59694/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/RNA, Messenger
Comments/Corrections

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