title: Clostridia in premature neonates' gut: incidence, antibiotic susceptibility, and perinatal determinants influencing colonization.
abstract: BACKGROUND
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Université Paris Descartes, EA4065, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Ferraris
authors.forename: Marie José
authors.initials: MJ
authors.lastname: Butel
authors.forename: Florence
authors.initials: F
authors.lastname: Campeotto
authors.forename: Michel
authors.initials: M
authors.lastname: Vodovar
authors.forename: Jean Christophe
authors.initials: JC
authors.lastname: Rozé
authors.forename: Julio
authors.initials: J
authors.lastname: Aires
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D058491:Bacterial Load; D003013:Clostridium / Q000254:growth & development / Q000502:physiology; D003015:Clostridium Infections / Q000151:congenital / Q000188:drug therapy* / Q000453:epidemiology* / Q000209:etiology*; D005243:Feces / Q000382:microbiology; D041981:Gastrointestinal Tract / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000453:epidemiology* / Q000209:etiology*; D054892:Metagenome / Q000502:physiology; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents