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Updated: Jan 2, 2026

Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Fungal cutaneous microbiome and host determinants in preterm and term neonates
Anshu A Paul1, Kristi L Hoffman2, Joseph L Hagan1
1Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Background:
The neonatal cutaneous mycobiome has not been characterized in preterm infants. Invasive fungal infections in preterm neonates are associated with high mortality. The immaturity of the preterm skin predisposes neonates to invasive infection by skin colonizers. We report the clinical and host determinants that influence the skin mycobiome.
Methods:
Skin swabs from the antecubital fossa, forehead, and gluteal region of 15 preterm and 15 term neonates were obtained during the first 5 weeks of life. The mycobiome was sequenced using the conserved pan-fungal ITS2 region. Blood samples were used to genotype immune modulating genes. Clinical metadata was collected to determine the clinical predictors of the abundance and diversity of the skin mycobiome.
Results:
The neonatal mycobiome is characterized by few taxa. Alpha diversity of the mycobiome is influenced by antibiotic exposure, the forehead body site, and the neonatal intensive care unit (NICU) environment. Beta diversity varies with mode of delivery, diet, and body site. The host determinants of the cutaneous microbiome include single-nucleotide polymorphisms in TLR4, NLRP3,CARD8, and NOD2.
Conclusion:
The neonatal cutaneous mycobiome is composed of few genera and is influenced by clinical factors and host genetics, the understanding of which will inform preventive strategies against invasive fungal infections.
Insights
The skin microbiome of preterm infants is simple and affected by antibiotics and the NICU environment. Understanding these factors and host genetics can help prevent invasive fungal infections.
Area of Science:
- Neonatal dermatology
- Fungal microbiome research
- Infectious disease prevention
Background:
- The skin microbiome in preterm infants remains largely uncharacterized.
- Preterm neonates are susceptible to invasive fungal infections due to immature skin.
- Identifying factors influencing the skin mycobiome is crucial for preventing infections.
Purpose of the Study:
- To characterize the neonatal cutaneous mycobiome in preterm infants.
- To identify clinical and host determinants of the skin mycobiome.
- To inform strategies for preventing invasive fungal infections in neonates.
Main Methods:
- Collected skin swabs from preterm and term neonates (n=30) over 5 weeks.
- Sequenced the fungal ITS2 region to analyze the mycobiome.
- Genotyped immune-modulating genes and collected clinical data.
Main Results:
- The neonatal mycobiome is characterized by low diversity.
- Antibiotic exposure, body site (forehead), and NICU environment impact mycobiome diversity.
- Delivery mode, diet, and body site influence mycobiome composition.
- Host genetics (TLR4, NLRP3, CARD8, NOD2 polymorphisms) are associated with the cutaneous microbiome.
Conclusions:
- The neonatal skin mycobiome is simple and influenced by clinical factors and host genetics.
- Understanding these influences can guide the development of preventive strategies against invasive fungal infections.
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