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Gut microbiota immaturity with DL-endopeptidase deficiency links antibiotic use to preterm late-onset sepsis - PubMed

3 hours ago
  • #late-onset sepsis
  • #preterm infants
  • #gut microbiota
  • Early antibiotic exposure increases late-onset sepsis (LOS) risk in preterm infants, potentially via gut dysbiosis.
  • Analysis of 4,938 fecal samples from preterm infants in China, the US, and the UK showed differential gut microbiota development.
  • Delayed microbiota maturation correlated with over one-third of LOS risk linked to early antibiotic exposure.
  • Deficiency of bacterial DL-endopeptidase was a hallmark of delayed microbiota development and elevated LOS risk.
  • Supplementation with DL-endopeptidase-producing bacteria (Enterococcus faecium or Limosilactobacillus reuteri) activated NOD2 via MDP, regulated macrophage function, and reduced inflammation.
  • A pilot trial showed L. reuteri supplementation enhanced fecal NOD2 activation in preterm infants.
  • Findings suggest microbiota immaturity and reduced DL-endopeptidase activity link antibiotic exposure to LOS risk.