{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:46:20Z","timestamp":1792118780614,"version":"4.4.0"},"reference-count":45,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2012,3,19]]},"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neonatal sepsis due to intestinal bacterial translocation is a major cause of morbidity and mortality. Understanding microbial colonisation of the gut in prematurity may predict risk of sepsis to guide future strategies to manipulate the microbiome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Prospective longitudinal study of premature infants. Stool samples were obtained weekly. DNA was extracted and the V6 hypervariable region of\n                      <jats:italic>16S rRNA<\/jats:italic>\n                      was amplified followed by high throughput pyrosequencing, comparing subjects with and without sepsis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six neonates were 24\u201327 weeks gestation at birth and had 18 samples analysed. Two subjects had no sepsis during the study period, two developed late-onset culture-positive sepsis and two had culture-negative systemic inflammation. 324 350 sequences were obtained. The meconium was not sterile and had predominance of\n                      <jats:italic>Lactobacillus, Staphylococcus<\/jats:italic>\n                      and Enterobacteriales. Overall, infants who developed sepsis began life with low microbial diversity, and acquired a predominance of\n                      <jats:italic>Staphylococcus<\/jats:italic>\n                      , while healthy infants had more diversity and predominance of\n                      <jats:italic>Clostridium, Klebsiella<\/jats:italic>\n                      and\n                      <jats:italic>Veillonella<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In very low birth weight infants, the authors found that meconium is not sterile and is less diverse from birth in infants who will develop late-onset sepsis. Empiric, prolonged antibiotics profoundly decrease microbial diversity and promote a microbiota that is associated not only with neonatal sepsis, but the predominant pathogen previously identified in the microbiome. Our data suggest that there may be a \u2018healthy microbiome\u2019 present in extremely premature neonates that may ameliorate risk of sepsis. More research is needed to determine whether altered antibiotics, probiotics or other novel therapies can re-establish a healthy microbiome in neonates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/fetalneonatal-2011-301373","type":"journal-article","created":{"date-parts":[[2012,5,6]],"date-time":"2012-05-06T20:15:10Z","timestamp":1336335310000},"page":"F456-F462","source":"Crossref","is-referenced-by-count":295,"title":["Gut microbial colonisation in premature neonates predicts neonatal sepsis"],"prefix":"10.1136","volume":"97","author":[{"given":"Juliette C","family":"Madan","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard Cowper","family":"Salari","sequence":"additional","affiliation":[{"name":"Computational Genetics, Dartmouth Medical School, Lebanon, New Hampshire, 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