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Background <p>Neonatal microbiome dysbiosis is associated with infectious complications.</p> Methods <p>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).</p> Results <p>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 <i>Enterococcus</i> spp. and lower anaerobe abundance.</p> Conclusions <p>Compared to controls, premature neonates with bacteremia had intestinal microbiomes with lower α diversity, higher <i>Enterococcus</i> spp. and lower anaerobe abundance. These changes were associated with recurrent infectious complications.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月9日

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

摘要

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.