title: The airway microbiome of intubated premature infants: characteristics and changes that predict the development of bronchopulmonary dysplasia.
abstract: BACKGROUND
  Bronchopulmonary dysplasia (BPD) is associated with perinatal inflammatory triggers. Methods targeting bacterial rRNA may improve detection of microbial colonization in premature infants. We hypothesize that respiratory microbiota differs between preterm infants who develop BPD and those unaffected and correlates with inflammatory mediator concentrations.
  
  
  METHODS
  Twenty-five infants, born at ≤32 wk of gestation and intubated in the first 24 h, were enrolled. Tracheal aspirates were obtained at intubation and on days 3, 7, and 28. Bacterial DNA was extracted, and 16S rRNA genes were amplified and sequenced. Concentrations of interleukins (IL-1β, IL-6, IL-8, IL-10, and IL-12), tumor necrosis factor-α, interferon-γ, lipopolysaccharide (LPS), and lipoteichoic acid (LTA) were measured. Chorioamnionitis was diagnosed by histology. BPD was defined as an oxygen requirement at 36 wk postmenstrual age.
  
  
  RESULTS
  Acinetobacter was the predominant genus in the airways of all infants at birth. Ten infants developed BPD and showed reduced bacterial diversity at birth. No differences were detected in bacterial diversity, cytokines, LPS, and LTA from infants with and without exposure to chorioamnionitis.
  
  
  CONCLUSIONS
  The airways of premature infants are not sterile at birth. Reduced diversity of the microbiome may be an important factor in the development of BPD and is not associated with differences in inflammatory mediators.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
authors.forename: Pablo
authors.initials: P
authors.lastname: Lohmann
authors.affiliation: 1] Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas [2] Texas Children's Microbiome Center, Department of Pathology, Texas Children's Hospital, Houston, Texas.
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Luna
authors.affiliation: 1] Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas [2] Texas Children's Microbiome Center, Department of Pathology, Texas Children's Hospital, Houston, Texas.
authors.forename: Emily B
authors.initials: EB
authors.lastname: Hollister
authors.affiliation: 1] Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas [2] Texas Children's Microbiome Center, Department of Pathology, Texas Children's Hospital, Houston, Texas.
authors.forename: Sridevi
authors.initials: S
authors.lastname: Devaraj
authors.affiliation: 1] Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas [2] Texas Children's Microbiome Center, Department of Pathology, Texas Children's Hospital, Houston, Texas.
authors.forename: Toni-Ann
authors.initials: TA
authors.lastname: Mistretta
authors.affiliation: Division of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Welty
authors.affiliation: 1] Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas [2] Texas Children's Microbiome Center, Department of Pathology, Texas Children's Hospital, Houston, Texas.
authors.forename: James
authors.initials: J
authors.lastname: Versalovic
mesh_terms: D001419:Bacteria / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism / Q000382:microbiology* / Q000401:mortality; D002821:Chorioamnionitis / Q000175:diagnosis / Q000382:microbiology; D016207:Cytokines / Q000276:immunology / Q000378:metabolism; D004269:DNA, Bacterial / Q000235:genetics; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D018836:Inflammation Mediators / Q000276:immunology / Q000378:metabolism; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D064307:Microbiota; D011247:Pregnancy; D011446:Prospective Studies; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D021521:Ribotyping; D012307:Risk Factors; D013997:Time Factors; D014132:Trachea / Q000276:immunology / Q000378:metabolism / Q000382:microbiology*
chemical_list: D016207:Cytokines; D004269:DNA, Bacterial; D018836:Inflammation Mediators; D012336:RNA, Ribosomal, 16S