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    Low Diversity in Nasal Microbiome Associated With Staphylococcus aureus Colonization and Bloodstream Infections in Hospitalized Neonates

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    Author
    Zhao, Ni
    Khamash, Dina F
    Koh, Hyunwook
    Voskertchian, Annie
    Egbert, Emily
    Mongodin, Emmanuel F
    White, James R
    Hittle, Lauren
    Colantuoni, Elizabeth
    Milstone, Aaron M
    Date
    2021-09-18
    Journal
    Open Forum Infectious Diseases
    Publisher
    Oxford University Press
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1093/ofid/ofab475
    http://www.ncbi.nlm.nih.gov/pmc/articles/pmc8507450/
    Abstract
    Background: Staphylococcus aureus is a leading cause of infectious morbidity and mortality in neonates. Few data exist on the association of the nasal microbiome and susceptibility to neonatal S. aureus colonization and infection. Methods: We performed 2 matched case–control studies (colonization cohort—neonates who did and did not acquire S. aureus colonization; bacteremia cohort—neonates who did [colonized neonates] and did not [controls] acquire S. aureus colonization and neonates with S. aureus bacteremia [bacteremic neonantes]). Neonates in 2 intensive care units were enrolled and matched on week of life at time of colonization or infection. Nasal samples were collected weekly until discharge and cultured for S. aureus, and the nasal microbiome was characterized using 16S rRNA gene sequencing. Results: In the colonization cohort, 43 S. aureus–colonized neonates were matched to 82 controls. At 1 week of life, neonates who acquired S. aureus colonization had lower alpha diversity (Wilcoxon rank-sum test P < .05) and differed in beta diversity (omnibus MiRKAT P = .002) even after adjusting for birth weight (P = .01). The bacteremia cohort included 10 neonates, of whom 80% developed bacteremia within 4 weeks of birth and 70% had positive S. aureus cultures within a few days of bacteremia. Neonates with bacteremia had an increased relative abundance of S. aureus sequences and lower alpha diversity measures compared with colonized neonates and controls. Conclusions: The association of increased S. aureus abundance and decrease of microbiome diversity suggest the need for interventions targeting the nasal microbiome to prevent S. aureus disease in vulnerable neonates.
    Rights/Terms
    © The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
    Keyword
    Staphylococcus aureus
    bloodstream infection
    microbiome
    neonates
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16892
    ae974a485f413a2113503eed53cd6c53
    10.1093/ofid/ofab475
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