Profound Pathogen-Specific Alterations in Intestinal Microbiota Composition Precede Late-Onset Sepsis in Preterm Infants: A Longitudinal, Multicenter, Case-Control Study

Abstract Background The role of intestinal microbiota in the pathogenesis late-onset sepsis (LOS) preterm infants is largely unexplored but could provide opportunities for microbiota-targeted preventive and therapeutic strategies. We hypothesized that composition changes before onset sepsis, with causative bacteria are isolated later blood culture. Methods This multicenter case-control study included born under 30 weeks gestation. Fecal samples collected from 5 days preceding LOS diagnosis were analyzed using a molecular detection technique. cases subdivided into 3 groups: gram-negative, gram-positive, coagulase-negative Staphylococci (CoNS). Results Forty 40 matched controls included. In gram-negative LOS, pathogen be identified at least 1 fecal prior to all cases, whereas controls, this was absent (P = .015). abundance these pathogens increased clinical onset. gram-positive (except CoNS) combined, sample 92% samples, present 33% control .004). Overall, (expect predicted day an area curve 0.78. Conclusions Profound preclinical microbial alterations underline gut involved has potential as early noninvasive biomarker.