Associations between antibiotic exposure intensity, intestinal microbiome perturbations, and outcomes in premature neonates with bacteremia.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-06-09 DOI:10.1038/s41372-025-02330-0

Hope Hendricks, Shani Israel, Jörn-Hendrik Weitkamp, Suman Pakala, Seesandra Rajagopala, Ritu Banerjee

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引用次数: 0

Abstract

Background: Neonatal microbiome dysbiosis is associated with infectious complications.

Methods: Prospective weekly stools were collected over 1 year from hospitalized preterm infants with birthweight ≤2000 g and postnatal age (PNA) ≤2 months. Neonates with bacteremia (cases) were matched to uninfected controls. Stools were analyzed using whole metagenome sequencing. Intensity of antibiotic exposure was compared using an Antibiotic Spectrum Index (ASI).

Results: We analyzed 398 stools from 40 cases and 39 controls. Cases had lower α diversity beyond 4 weeks PNA. Cases with subsequent infections after index bacteremia had persistently lower α diversity, while cases without subsequent infections demonstrated recovery of microbiome diversity. Compared to controls, cases had greater ASI at multiple timepoints, higher Enterococcus spp. and lower anaerobe abundance.

Conclusions: Compared to controls, premature neonates with bacteremia had intestinal microbiomes with lower α diversity, higher Enterococcus spp. and lower anaerobe abundance. These changes were associated with recurrent infectious complications.

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抗生素暴露强度、肠道微生物群紊乱和早产新生儿菌血症结局之间的关系。

背景：新生儿微生物群失调与感染并发症有关。方法：收集出生体重≤2000 g、出生月龄≤2个月的住院早产儿1年内每周的前瞻性粪便。感染菌血症的新生儿（病例）与未感染的对照组相匹配。采用全宏基因组测序对粪便进行分析。使用抗生素光谱指数（ASI）比较抗生素暴露强度。结果：我们分析了40例病例和39例对照组的398例粪便。超过4周PNA的患者α多样性降低。指数菌血症后继发感染的患者α多样性持续降低，未继发感染的患者α多样性恢复。与对照组相比，病例在多个时间点有更大的ASI，更高的肠球菌和更低的厌氧菌丰度。结论：与对照组相比，菌血症早产儿肠道菌群α多样性较低，肠球菌含量较高，厌氧菌丰度较低。这些变化与复发性感染并发症有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.