title: The first microbial environment of infants born by C-section: the operating room microbes.
abstract: BACKGROUND
  Newborns delivered by C-section acquire human skin microbes just after birth, but the sources remain unknown. We hypothesized that the operating room (OR) environment contains human skin bacteria that could be seeding C-section born infants.
  
  
  RESULTS
  To test this hypothesis, we sampled 11 sites in four operating rooms from three hospitals in two cities. Following a C-section procedure, we swabbed OR floors, walls, ventilation grids, armrests, and lamps. We sequenced the V4 region of the 16S rRNA gene of 44 samples using Illumina MiSeq platform. Sequences were analyzed using the QIIME pipeline. Only 68 % of the samples (30/44, >1000 sequences per site) yielded sufficient DNA reads to be analyzed. The bacterial content of OR dust corresponded to human skin bacteria, with dominance of Staphylococcus and Corynebacterium. Diversity of bacteria was the highest in the ventilation grids and walls but was also present on top of the surgery lamps. Beta diversity analyses showed OR dust bacterial content clustering first by city and then by hospital (t test using unweighted UniFrac distances, p < 0.05).
  
  
  CONCLUSIONS
  We conclude that the dust from ORs, collected right after a C-section procedure, contains deposits of human skin bacteria. The OR microbiota is the first environment for C-section newborns, and OR microbes might be seeding the microbiome in these babies. Further studies are required to identify how this OR microbiome exposure contributes to the seeding of the neonatal microbiome. The results might be relevant to infant health, if the current increase in risk of immune and metabolic diseases in industrialized societies is related to lack of natural exposure to the vaginal microbiome during labor and birth.
authors.affiliation: Division of Translational Medicine, New York University School of Medicine, 550 1st Avenue, BCD 690, New York, NY, 10016, USA.
authors.forename: Hakdong
authors.initials: H
authors.lastname: Shin
authors.affiliation: Division of Translational Medicine, New York University School of Medicine, 550 1st Avenue, BCD 690, New York, NY, 10016, USA.|Department of Veterans Affairs New York Harbor Healthcare System, New York, NY, USA.
authors.forename: Zhiheng
authors.initials: Z
authors.lastname: Pei
authors.affiliation: Division of Translational Medicine, New York University School of Medicine, 550 1st Avenue, BCD 690, New York, NY, 10016, USA.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Martinez
authors.affiliation: Hospital Universitario, Medical Science Campus, University of Puerto Rico, Puerto Rico, USA.
authors.forename: Juana I
authors.initials: JI
authors.lastname: Rivera-Vinas
authors.affiliation: Hospital Universitario, Medical Science Campus, University of Puerto Rico, Puerto Rico, USA.
authors.forename: Keimari
authors.initials: K
authors.lastname: Mendez
authors.affiliation: School of Architecture, University of Puerto Rico, Puerto Rico, USA.
authors.forename: Humberto
authors.initials: H
authors.lastname: Cavallin
authors.affiliation: Division of Translational Medicine, New York University School of Medicine, 550 1st Avenue, BCD 690, New York, NY, 10016, USA. Maria.Dominguez-Bello@nyumc.org.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Dominguez-Bello
mesh_terms: D001419:Bacteria / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D002585:Cesarean Section; D003352:Corynebacterium / Q000235:genetics / Q000302:isolation & purification; D004269:DNA, Bacterial / Q000235:genetics; D004391:Dust; D005260:Female; D005430:Floors and Floorcoverings; D006801:Humans; D007231:Infant, Newborn; D064307:Microbiota / Q000235:genetics; D009518:New York; D009873:Operating Rooms; D036801:Parturition; D011247:Pregnancy; D011647:Puerto Rico; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D017422:Sequence Analysis, DNA; D012867:Skin / Q000382:microbiology*; D013210:Staphylococcus / Q000235:genetics / Q000302:isolation & purification; D014621:Vagina / Q000382:microbiology
chemical_list: D004269:DNA, Bacterial; D004391:Dust; D012336:RNA, Ribosomal, 16S