Preterm gut microbiota and metabolome following discharge from intensive care

Area of Science:

• Microbiology
• Neonatal Health
• Gastroenterology

Background:

• The preterm infant gut microbiome is crucial for health. Neonatal intensive care unit (NICU) environments may alter its development.
• Understanding long-term gut microbial and metabolic profiles post-NICU is essential for preterm infant health outcomes.

Purpose of the Study:

• To investigate the long-term impact of neonatal intensive care unit (NICU) interventions on the gut microbiota and metabolome of preterm infants.
• To compare gut microbial and metabolic profiles between NICU stay and post-discharge (PD) periods.

Main Methods:

• Stool samples were collected from 29 preterm infants 1-3 years post-discharge (PD) and from 14 infants during their NICU stay.
• Microbiome and metabolome analyses were performed on both NICU and PD samples.
• Statistical analyses were used to assess the impact of disease diagnosis and antibiotic exposure on the microbiome.

Main Results:

• Disease diagnosis and increased antibiotic exposure during NICU stay did not significantly impact the long-term microbiome.
• Significant shifts in microbial composition were observed between NICU and PD samples, with decreases in NICU-associated organisms (e.g., K. oxytoca, E. faecalis) and increases in adult-associated organisms (e.g., Akkermansia sp., Blautia sp., Bacteroides sp.).
• Shannon diversity differed significantly between NICU and PD samples, while metabolomic profiles became more complex but remained comparable between the two periods.

Conclusions:

• The preterm gut microbiome demonstrates resilience, developing complexity comparable to healthy term infants despite NICU challenges.
• Limited environmental exposures, high antibiotic use, and serious illness on the NICU did not prevent long-term gut microbiome maturation.
• Further research is needed to elucidate the role of weaning in promoting long-term gut health in preterm infants.