{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:02:59Z","timestamp":1753891379064,"version":"3.41.2"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The study aimed to describe the dynamics and risk factors of Gram-negative bacteria (GNB) acquisition in preterm infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective multicenter French study included mothers hospitalized for preterm delivery and their newborns, followed until hospital discharge. Maternal feces and vaginal fluids at delivery, and neonatal feces from birth to discharge were tested for cultivable GNB, potential acquired resistance, and integrons. The primary outcome was the acquisition of GNB and integrons in neonatal feces, and their dynamics, evaluated by survival analysis using the actuarial method. Risk factors were analyzed using Cox models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred thirty-eight evaluable preterm dyads were included by five different centers over 16 months. GNB were isolated in 32.6% of vaginal samples, with 15.4% of strains producing extended-spectrum beta-lactamase (ESBL) or hyperproducing cephalosporinase (HCase), and in 96.2% of maternal feces, with 7.8% ESBL-GNB or HCase-GNB. Integrons were detected in 40.2% of feces and 10.6% of GNB strains. The mean (SD) length of stay of newborns was 39.5 (15.9) days; 4 died in the hospital. At least one infection episode occurred in 36.1% of newborns. The acquisition of GNB and integrons was progressive from birth to discharge. At discharge, half of newborns had ESBL-GNB or HCase-GNB, independently favored by a premature rupture of membranes (Hazard Ratio (HR), 3.41, 95% confidence interval (CI), 1.71; 6.81), and 25.6% had integrons (protective factor: multiple gestation, HR, 0.367, 95% CI, 0.195; 0.693).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In preterm newborns, the acquisitions of GNB, including resistant ones, and integrons are progressive from birth to discharge. A premature rupture of membranes favored the colonization by ESBL-GNB or Hcase-GNB.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmicb.2023.1148319","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T04:28:29Z","timestamp":1678768109000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamics of the digestive acquisition of bacterial carriage and integron presence by French preterm newborns according to maternal colonization: The DAIR3N multicentric study"],"prefix":"10.3389","volume":"14","author":[{"given":"Alice","family":"Patry","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Bothorel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana\u00efs","family":"Labrunie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"Renesme","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Lehours","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melinda","family":"Benard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damien","family":"Dubois","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laure","family":"Ponthier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvain","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karine","family":"Norbert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"Villeneuve","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Jouvencel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Leysenne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delphine","family":"Chainier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandrine","family":"Luce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carole","family":"Gr\u00e9laud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Cecile","family":"Ploy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine","family":"Bedu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabien","family":"Garnier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1001\/jamapediatrics.2014.3351","article-title":"Survival and morbidity of preterm children born at 22 through 34 weeks' gestation in France in 2011: results of the EPIPAGE-2 cohort study","volume":"169","author":"Ancel","year":"2015","journal-title":"JAMA Pediatr."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1093\/jac\/dkq167","article-title":"Quantitative multiplex real-time PCR for detecting class 1, 2 and 3 integrons","volume":"65","author":"Barraud","year":"2010","journal-title":"J. Antimicrob. Chemother."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1016\/j.ijantimicag.2014.06.008","article-title":"Value of integron detection for predicting antibiotic resistance in patients with gram-negative septicaemia","volume":"44","author":"Barraud","year":"2014","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1093\/jac\/dkab348","article-title":"Integrons, a predictive biomarker for antibiotic resistance in acute sepsis: the IRIS study","volume":"77","author":"Barraud","year":"2021","journal-title":"J. Antimicrob. Chemother."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1467","DOI":"10.3389\/fmicb.2018.01467","article-title":"Antibiotic resistance Acquisition in the First Week of life","volume":"9","author":"Barraud","year":"2018","journal-title":"Front. Microbiol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s10096-014-2232-6","article-title":"Neonatal sepsis: the gut connection","volume":"34","author":"Basu","year":"2015","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1007\/s00248-017-0985-z","article-title":"The threat of antimicrobial resistance on the human microbiome","volume":"74","author":"Brinkac","year":"2017","journal-title":"Microb. Ecol."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1146\/annurev-genet-102209-163504","article-title":"Integrons","volume":"44","author":"Cambray","year":"2010","journal-title":"Annu. Rev. 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Neonatol."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2366","DOI":"10.1128\/AAC.00044-07","article-title":"Enterobacteriaceae bloodstream infections: presence of integrons, risk factors, and outcome","volume":"51","author":"Daikos","year":"2007","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1093\/jac\/dkab431","article-title":"Integron detection for prediction of trimethoprim\/sulfamethoxazole susceptibility in children with Enterobacterales urinary tract infections","volume":"77","author":"Elias","year":"2022","journal-title":"J. Antimicrob. Chemother."},{"year":"2014","author":"Eucast Jehl","key":"ref14"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"845","DOI":"10.2307\/2530698","article-title":"A proportional hazards model for interval-censored failure time data","volume":"42","author":"Finkelstein","year":"1986","journal-title":"Biometrics"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.resmic.2007.12.007","article-title":"Is meconium from healthy newborns actually sterile?","volume":"159","author":"Jim\u00e9nez","year":"2008","journal-title":"Res. Microbiol."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2891","DOI":"10.1111\/1462-2920.12238","article-title":"Vertical mother-neonate transfer of maternal gut bacteria via breastfeeding","volume":"16","author":"Jost","year":"2014","journal-title":"Environ. Microbiol."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/S0140-6736(15)00474-2","article-title":"Access to effective antimicrobials: a worldwide challenge","volume":"387","author":"Laxminarayan","year":"2016","journal-title":"Lancet"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1086\/345880","article-title":"Multidrug resistance among Enterobacteriaceae is strongly associated with the presence of integrons and is independent of species or isolate origin","volume":"187","author":"Leverstein-van Hall","year":"2003","journal-title":"J. Infect. Dis."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.ddtec.2014.02.001","article-title":"General principles of antibiotic resistance in bacteria","volume":"11","author":"Martinez","year":"2014","journal-title":"Drug Discov. Today Technol."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"5224","DOI":"10.1128\/JCM.41.11.5224-5226.2003","article-title":"Evaluation of genotyping large numbers of Escherichia coli isolates by enterobacterial repetitive intergenic consensus-PCR","volume":"41","author":"Meacham","year":"2003","journal-title":"J. Clin. Microbiol."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1560","DOI":"10.1093\/jac\/dkz079","article-title":"Proteae: a reservoir of class 2 integrons?","volume":"74","author":"Mendes Moreira","year":"2019","journal-title":"J. Antimicrob. Chemother."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1086\/430711","article-title":"Unnoticed spread of integron-carrying Enterobacteriaceae in intensive care units","volume":"41","author":"Nijssen","year":"2005","journal-title":"Clin. Infect. Dis."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"19","DOI":"10.2471\/BLT.14.139790","article-title":"Neonatal cause-of-death estimates for the early and late neonatal periods for 194 countries: 2000\u20132013","volume":"93","author":"Oza","year":"2015","journal-title":"Bull. World Health Organ."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"15317","DOI":"10.1038\/srep15317","article-title":"The commensal infant gut meta-mobilome as a potential reservoir for persistent multidrug resistance integrons","volume":"5","author":"Ravi","year":"2015","journal-title":"Sci. Rep."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1038\/s41564-018-0292-6","article-title":"Prediction of the intestinal resistome by a three-dimensional structure-based method","volume":"4","author":"Rupp\u00e9","year":"2019","journal-title":"Nat. Microbiol."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1177\/1753495X18775899","article-title":"The matter of the reproductive microbiome","volume":"12","author":"Schoenmakers","year":"2019","journal-title":"Obstet. Med."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1677","DOI":"10.1016\/S1473-3099(21)00050-5","article-title":"Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS)","volume":"21","author":"Thomson","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/ijpo.12217","article-title":"The prenatal gut microbiome: are we colonized with bacteria in utero?","volume":"12","author":"Walker","year":"2017","journal-title":"Pediatr. 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