Meconium microbiota predicts clinical early-onset neonatal sepsis in preterm neonates

Abstract

Background

Early-onset neonatal sepsis (EONS) remains one of the leading causes of morbidity and mortality related to premature birth, and its diagnosis remains difficult. Our goal was to evaluate the intestinal microbiota of the first meconium of preterm newborns and ascertain whether it is associated with clinical EONS.

Methods

In a controlled, prospective cohort study, samples of the first meconium of premature infants with a gestational age (GA) ≤32 weeks was obtained at Hospital de Clínicas de Porto Alegre and DNA was isolated from the samples. 16S rDNA based microbiota composition of preterm infants with a clinical diagnosis of EONS was compared to that of a control group.

Results

40 (48%) premature infants with clinical diagnosis of EONS and 44 (52%) without EONS were included in the analysis. The most abundant phylum detected in both groups, Proteobacteria, was more prevalent in the sepsis group (p = .034). 14% of variance among bacterial communities (p = .001) correlated with EONS. The genera most strongly associated with EONS were Paenibacillus, Caulobacter, Dialister, Akkermansia, Phenylobacterium, Propionibacterium, Ruminococcus, Bradyrhizobium, and Alloprevotella. A single genus, Flavobacterium, was most strongly associated with the control group.

Conclusion

These findings suggest that the first-meconium microbiota is different in preterm neonates with and without clinical EONS.

Keywords:

• Prematurity
• early-onset neonatal sepsis
• intestinal microbiota
• intestinal microbiome
• meconium

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article

Additional information

Funding

Study funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação Instituto de Pesquisas Econômicas (FIPE-Brazil), and the Bill and Melinda Gates Foundation.