By Cara Murez
HealthDay Reporter
THURSDAY, May 4, 2023 (HealthDay News) — About half of extremely premature babies have at least one life-threatening bacterial infection in their bloodstream after 72 hours of life.
Now, new research points to babies’ own gut microbiomes as the source.
Knowing that the bacteria most common in bloodstream infections also often colonize the intestine without initially causing disease, the researchers set out to assess whether bloodstream infections came from the intestine or from external transmission.
“This is a vulnerable population,” said study lead author Gautam Dantas, a professor of pathology and immunology at Washington University School of Medicine in St. Louis. “This is also a time when the composition of the gut microbiome is developing for the first time. These early exposures to bacteria shape the gut microbiome in ways that will likely stay with these babies for the rest of their lives.”
The researchers studied this in newborns admitted to the neonatal intensive care units (NICUs) at St. Louis Children’s Hospital, Children’s Hospital of Oklahoma University Medical Center, and Norton Children’s Hospital in Louisville, Ky.
This included doing whole genome sequencing of the bacterial strain that was causing the bloodstream infection.
The researchers used computational profiling to precisely track the identical strain within the stool so they could also identify the strains of bacteria that had colonized the infants’ intestines prior to the bloodstream infections.
Researchers found this theory that bloodstream infections started in the gut to be true in 58% of cases, seeing an almost identical disease-causing bacterial strain in the gut just before a bloodstream infection was diagnosed. sanguine.
Some of the strains of bacteria that caused bloodstream infections were shared among NICU babies, the study found.
Even in controlled settings there could be an exchange of microbes, shared by hospital staff or transferred from NICU surfaces, the study authors explained.
However, those with bloodstream infections had dramatically more of the species that caused them in their intestines in the two weeks before infection than NICU babies without infections, the study findings showed.
“We’ve also studied the gut microbiomes of full-term babies and we know those babies don’t have as many problems, but it’s clear that the type of microbes that colonize the gut in the first few months to three years of life will determine what the microbiome looks like. later. Our study also suggests that an early look at the gut microbiome in premature infants could allow us to identify those who are at high risk for dangerous bloodstream infections,” Dantas said in a university news release.
The findings were published May 3 in the journal Science Translational Medicine.
Babies born prematurely are at high risk of infections due to underdeveloped organs, according to the researchers.
Almost all premature babies were treated with preventative antibiotics until recently. However, antibiotics can disrupt the gut microbiome in a way that could allow virulent strains of antibiotic-resistant bacteria to increase.
Once born, a baby’s microbiome develops as it acquires microbes from the environment and from caregivers.
Dantas said that only babies who have confirmed bacterial infections should receive antibiotics.
“From this study, as well as previous studies from our lab, it is clear that we need to be better stewards of how antimicrobials are delivered,” Dantas said. “Antimicrobials are critical; we’re going to need them to treat infections, but we need to carefully weigh whether and when to use antimicrobials in specific situations. We need to make sure that when those antimicrobials are given, we have a very good reason.”
More information
The US National Institutes of Health has more about the microbiome.
SOURCE: Washington University School of Medicine in St. Louis, press release, May 3, 2023
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