The first microbial environment of infants born by C-section: the operating room microbes

Abstract

BackgroundNewborns delivered by C-section acquire human skin microbes just after birth, but the sources remain unknown. We hypothesized that the operating room (OR) environment contains human skin bacteria that could be seeding C-section born infants.ResultsTo test this hypothesis, we sampled 11 sites in four operating rooms from three hospitals in two cities. Following a C-section procedure, we swabbed OR floors, walls, ventilation grids, armrests, and lamps. We sequenced the V4 region of the 16S rRNA gene of 44 samples using Illumina MiSeq platform. Sequences were analyzed using the QIIME pipeline. Only 68 % of the samples (30/44, >1000 sequences per site) yielded sufficient DNA reads to be analyzed. The bacterial content of OR dust corresponded to human skin bacteria, with dominance of Staphylococcus and Corynebacterium. Diversity of bacteria was the highest in the ventilation grids and walls but was also present on top of the surgery lamps. Beta diversity analyses showed OR dust bacterial content clustering first by city and then by hospital (t test using unweighted UniFrac distances, p < 0.05).ConclusionsWe conclude that the dust from ORs, collected right after a C-section procedure, contains deposits of human skin bacteria. The OR microbiota is the first environment for C-section newborns, and OR microbes might be seeding the microbiome in these babies. Further studies are required to identify how this OR microbiome exposure contributes to the seeding of the neonatal microbiome. The results might be relevant to infant health, if the current increase in risk of immune and metabolic diseases in industrialized societies is related to lack of natural exposure to the vaginal microbiome during labor and birth.Electronic supplementary materialThe online version of this article (doi:10.1186/s40168-015-0126-1) contains supplementary material, which is available to authorized users.

The Bacterial Microbiome and Virome Milestones of Infant Development

“…Konya et al [31] showed an association between the bacteria found in house dust and in the infant. Due to the finding that infants born via C-section acquire a skin-like bacterial microbiome at birth, Shin et al [32] recently examined the dust found in the operating room at the time of C-section and found that the dust contains deposits of human skin bacteria. The role of this possible environmental exposure on the infant still needs to be further explored.…”

Studying Vertical Microbiome Transmission from Mothers to Infants by Strain-Level Metagenomic Profiling

“…Vertical transmission of bacteria from the body and breast milk of the mother to her infant has gained attention as an important source of microbial colonization (14, 19–21) in addition to the microbial organisms obtained from the wider environment (22, 23), including the delivery room (24). Results from early cultivation-based and cultivation-free methods (16S rRNA community profiling and a single metagenomic study) have indeed suggested that the mother could transfer microbes to the infant by breastfeeding (25) and that a vaginal delivery has the potential of seeding the infant gut with members of the mother’s vaginal community (11, 14, 26, 27) that would not be available via caesarean section.…”

Identical bacterial populations colonize premature infant gut, skin, and oral microbiomes and exhibit different in situ growth rates

“…Initial colonists are acquired maternally and from the immediate environment, but early life clinical factors (such as birth by cesarean section and neonatal antibiotic administration) can disrupt the normal acquisition process (Ding and Schloss 2014;Bäckhed et al 2015;Mueller et al 2015). Among premature infants, who generally harbor microbial communities of limited diversity and instability Sim et al 2013;Ward et al 2016), this disruption can lead to colonization by resident microbes of the neonatal intensive care unit (NICU) (Brooks et al 2014;Shin et al 2015).…”