Abstract
BackgroundThe infant skin microbiota may serve as a reservoir of bacteria that contribute to neonatal infections and stimulate local and systemic immune development. The objectives of our study were to characterize the skin microbiota of preterm and full-term infants during their birth hospitalization and describe its relationship to the microbiota of other body sites and the hospital environment.ResultsWe conducted a cross-sectional study of 129 infants, including 40 preterm and 89 full-term infants. Samples were collected from five sites: the forehead and posterior auricular scalp (skin upper body); the periumbilical region, inguinal folds, and upper thighs (skin lower body); the oral cavity; the infant’s immediate environment; and stool. Staphylococcus, Streptococcus, Enterococcus, and enteric Gram-negative bacteria including Escherichia and Enterobacter dominated the skin microbiota. The preterm infant microbiota at multiple sites had lower alpha diversity and greater enrichment with Staphylococcus and Escherichia than the microbiota of comparable sites in full-term infants. The community structure was highly variable among individuals but differed significantly by body site, postnatal age, and gestational age. Source tracking indicated that each body site both contributed to and received microbiota from other body sites and the hospital environment.ConclusionThe skin microbiota of preterm and full-term infants varied across individuals, by body site, and by the infant’s developmental stage. The skin harbored many organisms that are common pathogens in hospitalized infants. Bacterial source tracking suggests that microbiota are commonly exchanged across body sites and the hospital environment as microbial communities mature in infancy.
Highlights
The infant skin microbiota may serve as a reservoir of bacteria that contribute to neonatal infections and stimulate local and systemic immune development
Our bacterial source-tracking model indicated that the skin microbiota both acquires and contributes microbiota to other body sites, suggesting that body sites can serve as bacterial reservoirs for one another in infancy
We found that the skin microbiota of preterm infants differed from that of the full-term infants, with greater enrichment of Staphylococcus and several taxa that are typically associated with the fecal microbiota, such as Escherichia
Summary
The infant skin microbiota may serve as a reservoir of bacteria that contribute to neonatal infections and stimulate local and systemic immune development. While our understanding of the development of the fecal microbiome in infancy has expanded greatly over the past decade, acquisition and succession of the skin microbiota is less well-studied. Interactions between the infant’s developing immune system and the early-life microbiota stimulate immune development, Younge et al Microbiome (2018) 6:98 maturation, and tolerance. Microbial colonization of the skin during a limited infant developmental window leads to an influx of antigen-specific activated regulatory T cells into the skin and the development of tolerance [5]. Understanding community dynamics of the skin microbiota in early life may reveal strategies to protect against infections and the development of later diseases such as atopy [6]
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