The developing premature infant gut microbiome is a major factor shaping the microbiome of neonatal intensive care unit rooms

Abstract

1.1BackgroundThe neonatal intensive care unit (NICU) contains a unique cohort of patients with underdeveloped immune systems and nascent microbiome communities. Patients often spend several months in the same room and it has been previously shown that the gut microbiomes of these infants often resemble the microbes found in the NICU. Little is known, however, about the identity, persistence and absolute abundance of NICU room-associated bacteria over long stretches of time. Here we couple droplet digital PCR (ddPCR), 16S rRNA gene surveys, and recently published metagenomics data from infant gut samples to infer the extent to which the NICU microbiome is shaped by its room occupants.\n\nResultsOver 2,832 swabs, wipes, and air samples were collected from sixteen private-style NICU rooms housing very low birthweight (<1,500 g), premature (<31 weeks gestation) infants. For each infant, room samples were collected daily, Monday through Friday, for one month. The first samples from the first infant and last samples from the last infant were collected 383 days apart. Twenty-two NICU locations spanning room surfaces, hands, electronics, sink basins, and air were collected. Results point to an incredibly simple room community where 5-10 taxa, mostly skin associated, account for over 50% of 16S reads. Biomass estimates reveal 4-5 orders of magnitude difference between the least to the most dense microbial communities, air and sink basins, respectively. Biomass trends from bioaerosol samples and petri dish dust collectors suggest occupancy to be a main driver of suspended biological particles within the NICU. Using a machine learning algorithm to classify the origin of room samples, we show that each room has a unique microbial fingerprint. Several important taxa driving this model were dominant gut colonizers of infants housed within each room.\n\nConclusionsDespite regular cleaning of hospital surfaces, bacterial biomass was detectable at varying densities. A room specific microbiome signature was detected, suggesting microbes seeding NICU surfaces are sourced from reservoirs within the room and that these reservoirs contain actively dividing cells. Collectively, the data suggests that hospitalized infants, in combination with their caregivers, shape the microbiome of NICU rooms.