Article

Clostridia in premature neonates' gut: incidence, antibiotic susceptibility, and perinatal determinants influencing colonization.

Université Paris Descartes, EA4065, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France.
PLoS ONE (impact factor: 4.09). 01/2012; 7(1):e30594. DOI:10.1371/journal.pone.0030594 pp.e30594
Source: PubMed

ABSTRACT Although premature neonates (PN) gut microbiota has been studied, data about gut clostridial colonization in PN are scarce. Few studies have reported clostridia colonization in PN whereas Bacteroides and bifidobacteria have been seldom isolated. Such aberrant gut microbiota has been suggested to be a risk factor for the development of intestinal infections. Besides, PN are often treated by broad spectrum antibiotics, but little is known about how antibiotics can influence clostridial colonization based on their susceptibility patterns. The aim of this study was to report the distribution of Clostridium species isolated in feces from PN and to determine their antimicrobial susceptibility patterns. Additionally, clostridial colonization perinatal determinants were analyzed.
Of the 76 PN followed until hospital discharge in three French neonatal intensive care units (NICUs), 79% were colonized by clostridia. Clostridium sp. colonization, with a high diversity of species, increased throughout the hospitalization. Antibiotic courses had no effect on the clostridial colonization incidence although strains were found susceptible (except C. difficile) to anti-anaerobe molecules tested. However, levels of colonization were decreased by either antenatal or neonatal (during more than 10 days) antibiotic courses (p = 0.006 and p = 0.001, respectively). Besides, incidence of colonization was depending on the NICU (p = 0.048).
This study shows that clostridia are part of the PN gut microbiota. It provides for the first time information on the status of clostridia antimicrobial susceptibility in PN showing that strains were susceptible to most antibiotic molecules. Thus, the high prevalence of this genus is not linked to a high degree of resistance to antimicrobial agents or to the use of antibiotics in NICUs. The main perinatal determinant influencing PN clostridia colonization appears to be the NICU environment.

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Keywords

aberrant gut microbiota
 
Antibiotic courses
 
antibiotics
 
antimicrobial agents
 
antimicrobial susceptibility patterns
 
broad spectrum antibiotics
 
clostridia antimicrobial susceptibility
 
clostridia colonization
 
clostridial colonization incidence
 
clostridial colonization perinatal determinants
 
Clostridium species
 
first time information
 
French neonatal intensive care units
 
gut clostridial colonization
 
hospitalization
 
intestinal infections
 
main perinatal determinant influencing PN clostridia colonization
 
NICU environment
 
PN gut microbiota
 
premature neonates