Targeting Perinatal Pathogens in the Vaginal Microbiome Adam J. Ratner, MD, MPH Departments of Pediatrics and Microbiology, New York University School of Medicine, USA
Asymptomatic mucosal colonization is an initial and crucial step in a wide range of bacterial diseases. For example, the perinatal pathogens Streptococcus agalactiae (Group B Streptococcus; GBS) and Escherichia coli can colonize maternal lower genital and gastrointestinal tract mucosal surfaces in late pregnancy. Peripartum transmission of these species may begin a series of events culminating in life-threatening early-onset (EO) neonatal sepsis. Current preventive strategies for EO sepsis involve either intrapartum antibiotic prophylaxis (IAP) for GBS-colonized mothers or, in investigational settings, vaccination against specific bacterial species. Despite the importance of maternal colonization to EO sepsis pathogenesis, interactions between GBS or E. coli and the vaginal or gastrointestinal microbiomes are not yet well understood. Investigations of the role of maternal microbiomes in establishment and maintenance of GBS or E. coli colonization, changes in microbiome composition in the presence or absence of these species, and the impact of IAP or vaccination targeting perinatal pathogens on maternal microbiome structure are warranted. A more detailed understanding of such factors may allow for the development of microbiome-targeted (or at least “microbiome-aware”) strategies to reduce the risk of EO sepsis and minimize off-target effects. I will discuss the potential benefits and challenges of this approach and describe studies directed at understanding the interplay between perinatal pathogens and host microbiomes.
Credits: None available.
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