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Chapter 3 : The Neonatal Intestinal Microbial Flora, Immunity, and Infections
Category: Applied and Industrial Microbiology
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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 Enterobacter sakazakii and other Enterobacteriaceae as infectious agents of neonates in the context of the neonate having a complex intestinal flora, which includes Enterobacter 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, Escherichia coli was the most common isolate reported to the U.S. National Nosocomial Infections Surveillance System, followed by enterococci, Pseudomonas aeruginosa, Staphylococcus aureus, 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 Staphylococcus epidermidis, 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.
Toll-like receptors a
Summary of premature neonate immune deficiencies a
Organisms associated with neonatal bloodstream infections
Clinical stages of NEC a