Perinatal Antibiotic Exposure Alters Neonatal Gut Microbiota in Preterm Infants: Clinical Implications for Infection Risk and Microbial Maturation

Highlights

• Perinatal antibiotic exposure (maternal and/or neonatal) is associated with significant shifts in the gut microbiota of preterm infants, favoring pathogenic bacteria over beneficial species.
• Combined maternal and neonatal antibiotic exposure leads to greater dysbiosis and higher gut-blood microbial correlations, suggesting increased risk for bloodstream infections.
• Exclusive breastfeeding supports the recovery and maintenance of beneficial gut flora, particularly Bifidobacterium spp., even after antibiotic exposure.
• The presence of causative pathogens in the gut preceding bloodstream infection highlights the gut as a reservoir and potential source for neonatal sepsis.

Study Background and Disease Burden