Chapter 3 : The Neonatal Intestinal Microbial Flora, Immunity, and Infections

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This chapter summarizes the understanding in the neonatal intestinal microbial flora, immunity, and infections, with particular emphasis on the preterm intestinal flora and immunity development. It aims at widening the general microbiologist’s knowledge of the issue of and other as infectious agents of neonates in the context of the neonate having a complex intestinal flora, which includes species and where endogenous infections occur. Infants, particularly premature infants, are made more susceptible to disease by reduced natural epidermal and epithelial barriers and secreted products that comprise part of the innate immune system. The majority of studies have been of duodenal and stool samples, which represent the small and large intestines, respectively. The study also included the postmortem flora of a 3-month-old infant who had died of toxic dyspepsia and endocardial fibrosis. From 1986 to 1989, was the most common isolate reported to the U.S. National Nosocomial Infections Surveillance System, followed by , , , and coagulasenegative staphylococci (CoNS). Contaminated enteral nutrition can cause nosocomial bloodstream infections and may contribute to necrotizing enterocolitis (NEC). A section focuses on the general topic of infections through contaminated enteral feeding. The major species involved in neonatal infection is , which causes 60 to 93% of CoNS bacteremias. Occasionally, CoNS are acquired from the mother at birth, but the majority of CoNS colonization is acquired nosocomially, predominantly from the hands of health care workers.

Citation: Townsend S, Forsythe S. 2008. The Neonatal Intestinal Microbial Flora, Immunity, and Infections, p 61-100. In Farber J, Forsythe S, Doyle M (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555815608.ch3

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Bacterial Proteins
Major Histocompatibility Complex Class I
Infection and Immunity
Bacterial Pathogenesis
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Table 1

Toll-like receptors

Citation: Townsend S, Forsythe S. 2008. The Neonatal Intestinal Microbial Flora, Immunity, and Infections, p 61-100. In Farber J, Forsythe S, Doyle M (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555815608.ch3
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Table 2

Summary of premature neonate immune deficiencies

Citation: Townsend S, Forsythe S. 2008. The Neonatal Intestinal Microbial Flora, Immunity, and Infections, p 61-100. In Farber J, Forsythe S, Doyle M (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555815608.ch3
Generic image for table
Table 3

Organisms associated with neonatal bloodstream infections

Citation: Townsend S, Forsythe S. 2008. The Neonatal Intestinal Microbial Flora, Immunity, and Infections, p 61-100. In Farber J, Forsythe S, Doyle M (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555815608.ch3
Generic image for table
Table 4

Clinical stages of NEC

Citation: Townsend S, Forsythe S. 2008. The Neonatal Intestinal Microbial Flora, Immunity, and Infections, p 61-100. In Farber J, Forsythe S, Doyle M (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555815608.ch3

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