抗生素暴露强度、肠道微生物群扰动与早产败血症新生儿结局之间的关联。
Associations between antibiotic exposure intensity, intestinal microbiome perturbations, and outcomes in premature neonates with bacteremia.
作者信息
Hendricks Hope, Israel Shani, Weitkamp Jörn-Hendrik, Pakala Suman, Rajagopala Seesandra, Banerjee Ritu
机构信息
Division of Pediatric Infectious Diseases, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, TN, USA.
出版信息
J Perinatol. 2025 Jun 9. doi: 10.1038/s41372-025-02330-0.
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.
背景
新生儿微生物群失调与感染性并发症相关。
方法
对出生体重≤2000g且出生后年龄（PNA）≤2个月的住院早产儿，在1年多的时间里每周前瞻性收集粪便。将患有菌血症的新生儿（病例）与未感染的对照进行匹配。使用全宏基因组测序分析粪便。使用抗生素谱指数（ASI）比较抗生素暴露强度。
结果
我们分析了来自40例病例和39例对照的398份粪便。病例在PNA超过4周后α多样性较低。菌血症后发生后续感染的病例α多样性持续较低，而未发生后续感染的病例微生物群多样性恢复。与对照相比，病例在多个时间点的ASI更高，肠球菌属更高，厌氧菌丰度更低。
结论
与对照相比，患有菌血症的早产儿肠道微生物群的α多样性较低，肠球菌属较高，厌氧菌丰度较低。这些变化与反复出现的感染性并发症相关。
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