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Updated: Oct 9, 2025
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Influence of the Incubator as Direct Patient Environment on Bacterial Colonization of Neonates
Isabel Lange1, Birgit Edel2, Kristin Dawczynski3
1Institute for Infectious Diseases and Infection Control, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany.
Insights
Neonatal intensive care units face high healthcare-associated infection risks. This study links infant colonization to incubator contamination using genomic sequencing, revealing transmission pathways.
Area of Science:
- Neonatal Medicine
- Infectious Disease Epidemiology
- Microbiology
Background:
- Healthcare-associated infections (HAIs) are a critical concern in neonatal intensive care units (NICUs).
- Incubators represent a direct patient environment and a potential source of microbial contamination.
- Understanding microbial transmission is vital for preventing infections in vulnerable neonates.
Purpose of the Study:
- To investigate the correlation between microbial colonization of very low birthweight infants and their associated incubators.
- To identify potential transmission routes of microorganisms within the NICU environment.
Main Methods:
- Collection of microbiological samples from neonates (rectal and throat swabs) and incubators (Poliwipes® sponges).
- Whole genome sequencing (Illumina technology) was employed for bacterial species found in both infant and incubator samples.
- Analysis focused on identifying clonal pairs to confirm transmission events.
Main Results:
- 52 microbiological species matches were identified between neonates and their incubators.
- Whole genome sequencing of 30 matches revealed 26 clonal pairs.
- Dominant species in clonal pairs included Enterococcus faecalis (12) and Staphylococcus aureus (10).
Conclusions:
- Combined screening swabs, incubator surface sampling, and whole genome sequencing effectively demonstrated microorganism transmission.
- Evidence suggests a risk of non-physiological colonization in neonatal infants due to incubator contamination.
- This study highlights the importance of monitoring the incubator environment to prevent neonatal infections.
Background:
Preventing healthcare-associated infections (HAI) in neonatal intensive care units is a challenge of highest priority. For further insight into the incubator as direct patient environment and potential source for contamination, we present data correlating microbiological samples of very low birthweight infants in the form of colonization results of surveillance screenings with samples of their associated incubator in this study.
Methods:
Samples were taken via rectal and throat swabs of neonates as well as Polywipe® sponges for the incubator. If the same bacterial species was found in corresponding neonate and incubator samples, whole genome sequencing via Illumina technology was performed.
Results:
52 microbiological species matches were found, and 30 matches were sequenced where we found 26 clonal pairs (12 E. faecalis, 10 S. aureus, 2 E. coli, 1 E. cloacae, and 1 E. faecium).
Conclusion:
The combinations of measurements of weekly screenings swabs, probing of surfaces with Polywipes®, and whole genome sequencing showed transmissions of microorganism and risk for potential non-physiological colonization of neonatal infants.
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