BackgroundThe neonatal cutaneous mycobiome has not been characterized in preterm infants. Invasive fungal infections in preterm neonates are associated with high mortality. The immaturity of the preterm skin predisposes neonates to invasive infection by skin colonizers. We report the clinical and host determinants that influence the skin mycobiome.MethodsSkin swabs from the antecubital fossa, forehead, and gluteal region of 15 preterm and 15 term neonates were obtained during the first 5 weeks of life. The mycobiome was sequenced using the conserved pan-fungal ITS2 region. Blood samples were used to genotype immune modulating genes. Clinical metadata was collected to determine the clinical predictors of the abundance and diversity of the skin mycobiome.ResultsThe neonatal mycobiome is characterized by few taxa. Alpha diversity of the mycobiome is influenced by antibiotic exposure, the forehead body site, and the neonatal intensive care unit (NICU) environment. Beta diversity varies with mode of delivery, diet, and body site. The host determinants of the cutaneous microbiome include single-nucleotide polymorphisms in TLR4, NLRP3, CARD8, and NOD2.ConclusionThe neonatal cutaneous mycobiome is composed of few genera and is influenced by clinical factors and host genetics, the understanding of which will inform preventive strategies against invasive fungal infections.

中文翻译：

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早产儿和足月新生儿的真菌皮肤微生物组和宿主决定因素

背景新生儿皮肤真菌组尚未在早产儿中表征。早产儿侵袭性真菌感染与高死亡率有关。早产皮肤的不成熟使新生儿容易受到皮肤定植者的侵袭性感染。我们报告了影响皮肤真菌群落的临床和宿主决定因素。方法在生命的前 5 周内从 15 名早产儿和 15 名足月新生儿的肘窝、前额和臀部区域获取皮肤拭子。使用保守的泛真菌 ITS2 区域对真菌生物组进行测序。血液样本用于对免疫调节基因进行基因分型。收集临床元数据以确定皮肤真菌群落丰度和多样性的临床预测因子。结果新生儿真菌群落的特点是分类群很少。真菌群落的 Alpha 多样性受抗生素暴露、前额身体部位和新生儿重症监护病房 (NICU) 环境的影响。Beta 多样性因分娩方式、饮食和身体部位而异。皮肤微生物组的宿主决定因素包括 TLR4、NLRP3、CARD8 和 NOD2 中的单核苷酸多态性。侵袭性真菌感染。