Younge Noelle E, Parris D Joshua, Hatch Daniel, Barnes Angel, Brandon Debra H
Department of Pediatrics, Duke University School of Medicine, Durham, NC, United States of America.
Kimberly-Clark Corporation, Neenah, WI, United States of America.
PLoS One. 2024 Aug 1;19(8):e0306333. doi: 10.1371/journal.pone.0306333. eCollection 2024.
To evaluate the impact of diaper change frequency, clinical characteristics, and skin health metrics on development of the skin microbiota in preterm infants.
A randomized controlled parallel design was used.
Medically stable preterm infants born <33 weeks' gestation were randomized to receive diaper changes at a frequency of every 3-hours or every 6-hours. Skin swabs were collected longitudinally from the diapered skin (buttocks) and chest. Skin pH and transepidermal water loss were measured with each sample collection. Stool samples were collected from the diaper. The microbiome at each site was characterized by 16S rRNA gene sequencing. Associations between microbiome features, diaper change frequency, and other covariates were examined using mixed effect models and redundancy analysis.
A total of 1179 samples were collected from 46 preterm infants, beginning at a median postnatal age of 44 days and continuing through hospital discharge. Alpha-diversity of the skin microbiota increased over time, but did not differ significantly between 3-hour (n = 20) and 6-hour (n = 26) diaper change groups. Alpha-diversity of the skin microbiota was inversely correlated with skin pH, but not transepidermal water loss. Microbiota community structure differed significantly between body sites (buttocks, chest, and stool) and between individuals. Among samples collected from the diapered skin, diaper change frequency, infant diet, antibiotic exposure, and delivery mode accounted for minor proportions of the variation in microbiota community structure between samples. Relative abundances of multiple genera differed between 3- and 6-hour diaper change groups over time.
DISCUSSION/CONCLUSION: The diversity and composition of the diapered skin microbiota is dynamic over time and differs from other body sites. Multiple factors including interindividual effects, diaper change frequency, diet, and antibiotics contribute to variation in the diapered skin microbiota.
评估更换尿布频率、临床特征和皮肤健康指标对早产儿皮肤微生物群发育的影响。
采用随机对照平行设计。
对孕周小于33周且病情稳定的早产儿进行随机分组，分别接受每3小时或每6小时更换一次尿布的干预。纵向采集尿布覆盖部位（臀部）和胸部的皮肤拭子。每次采集样本时测量皮肤pH值和经表皮水分流失。从尿布中采集粪便样本。通过16S rRNA基因测序对每个部位的微生物群进行表征。使用混合效应模型和冗余分析检查微生物群特征、更换尿布频率和其他协变量之间的关联。
从46名早产儿中总共采集了1179份样本，从出生后中位年龄44天开始，持续至出院。皮肤微生物群的α多样性随时间增加，但每3小时更换尿布组（n = 20）和每6小时更换尿布组（n = 26）之间无显著差异。皮肤微生物群的α多样性与皮肤pH值呈负相关，但与经表皮水分流失无关。微生物群落结构在身体部位（臀部、胸部和粪便）之间以及个体之间存在显著差异。在从尿布覆盖皮肤采集的样本中，更换尿布频率、婴儿饮食、抗生素暴露和分娩方式在样本间微生物群落结构变化中所占比例较小。随着时间推移，每3小时和每6小时更换尿布组中多个菌属的相对丰度存在差异。
讨论/结论：尿布覆盖皮肤微生物群的多样性和组成随时间动态变化，且与其他身体部位不同。包括个体间效应、更换尿布频率、饮食和抗生素在内的多种因素导致尿布覆盖皮肤微生物群存在差异。
