Exploring the Role of Gut Bacteria in Health and Disease in Preterm Neonates

Area of Science:

• Neonatal Medicine
• Microbiology
• Gastroenterology

Background:

• Very preterm infants (<1500g) have a 15% mortality rate and high morbidity, including necrotising enterocolitis (NEC), early-onset neonatal sepsis (EONS), and late-onset neonatal sepsis (LONS).
• Preterm birth is often linked to microbial invasion, leading to early disruption of the preterm infant gut microbiome.
• Bacterial colonization patterns in preterm infants differ significantly from term infants due to various factors like maternal health, delivery mode, feeding, and NICU environment.

Purpose of the Study:

• To review the role of gut bacteria in meconium and stool of preterm neonates.
• To investigate the association between gut dysbacteriosis and NEC/LONS in very preterm infants.
• To explore the link between gut bacteria at birth, postnatal dysbiosis, and mortality/morbidity in very preterm infants.

Main Methods:

• Review of existing literature on gut bacteria in preterm neonates.
• Analysis of studies examining meconium and stool bacterial composition.
• Synthesis of research on the relationship between gut dysbiosis and NEC/LONS.

Main Results:

• Over 50% of preterm meconium contains bacteria, with higher proportions in lower gestational ages.
• Reduced gut bacterial diversity is observed in preterm infants at risk for LONS and NEC.
• While dysbiosis, particularly involving Proteobacteria and Firmicutes, often precedes NEC, the precise association remains inconclusive.

Conclusions:

• Gut bacteria at birth and postnatal dysbiosis are implicated in the mortality and morbidity of very preterm infants.
• Further research is needed to clarify the exact mechanisms linking gut microbiome alterations to NEC and LONS.
• Understanding these microbial dynamics is crucial for developing targeted interventions for preterm infant health.