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Gut bacteria and late-onset neonatal bloodstream infections in preterm infants

Phillip I Tarr1, Barbara B Warner2

  • 1Division of Gastroenterology, Hepatology, and Nutrition, Pathobiology Research Unit, Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA.

Seminars in Fetal & Neonatal Medicine
|June 28, 2016
PubMed

Insights

Late-onset neonatal bloodstream infections are often caused by gut bacteria. New strategies are needed to prevent these infections by understanding pathogen origins beyond just line care.

Area of Science:

  • Neonatology
  • Infectious Diseases
  • Microbiology

Background:

  • Late-onset neonatal bloodstream infections (LONSIs) pose significant challenges in neonatology.
  • Current interventions like hand hygiene and line care may not fully address LONSIs originating from gut bacteria.

Purpose of the Study:

  • To explore the gut origin of pathogens causing LONSIs.
  • To propose a shift from a host-centric to a bacteria-centric paradigm for understanding LONSIs.
  • To advocate for proactive strategies targeting pathogen habitats.

Main Methods:

  • Review of accumulating data on LONSIs pathogens.
  • Analysis of host-canonical versus bacteria-canonical paradigms.
  • Consideration of pre-invasive pathogen habitats.

Main Results:

  • Many pathogens causing LONSIs are of gut origin, including Gram-positive cocci.
  • LONSIs may be influenced by specific bacterial strains with high invasive potential.
  • Current reactive approaches are insufficient.

Conclusions:

  • A broader approach beyond line care is necessary to reduce LONSIs.
  • Understanding the pre-invasive habitat of gut pathogens is crucial for prevention.
  • Shifting focus to bacteria-canonical paradigms may offer new prevention strategies.

Keywords:
Gram-negative bacteriaGram-positive bacteriaGut microbesLate-onset neonatal bloodstream infections

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