Microflora Formation in Newborns Depending on the Mother Microbiological Profile and Locality Altitude ()
1. Introduction
Microflora formation in newborns has potential to influence and impact the physical and neurocognitive development; numerous species and strains of bacteria exist in the neonatal microbiota [1] [2]. According to the UN Commission on Sustainable Development, the well-being of half of humanity in the XXI century related to the quality of development and development of mountainous territories [3]. As it is known, the species composition of human microflora is constantly changing, and its stability is considered as a relative due to alterations caused by bacterial infections [4], pharmacodynamic and pharmacokinetic of selected antibiotics [5], lifestyle and the dietary alterations inducing temporary microbial shifts within one day [6] [7]. Newborns early life immune system is not stable. It is rapidly adapting to environmental conditions and interventions aimed to protect organism against various pathogens and disorders [8] as represented in Figure 1. Conditions for initial microbiota colonization in infants are resulting in a symbiotic relationship between the colonizing bacteria and intestinal epithelial with lymphoid tissues [9] as represented in Table 1.
2. Research Methods
Studies conducted in various heights in the southern region of Kyrgyzstan, under examination of 133 women in labor aged from 17 to 43 years old, and 133 newborns. Examined people divided into three groups according to the locality altitude in which they are living:
1) Residents of the lowlands, Kurshab at 1012 m above the sea level;
2) The inhabitants of the middle mountains, Zhalpak-Tash at 2000 - 2500 m above the sea level;
3) The inhabitants of the highlands Sary-Tash, at 3325 m above the sea level.
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Table 1. Phases of intestinal colonization of the infant intestine.
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Figure 1. Interventions that Broadly Enhance Host Defense against Infectious Disease in Early Life There are key windows of opportunity during prenatal life and early postnatal life to enhance host resistance to specific infections via homologous i.e., pathogen and thus classic antigen specific responses (top panels)-as well as broadly protective heterologous (“non-specific”) responses (bottom panels). (A) Maternal immunization leverages passive transfer of maternal IgG antibodies across the placenta that can protect the fetus and newborn. The specificity of the maternal IgG reflects past maternal exposures thereby targeting specific pathogens. (B) Top panel shows that breastfeeding provides secretory IgA, with specificities reflecting maternal microbiota, transferred across the gut along with maternal IgG bound to antigen; whereas the bottom panel shows that breastmilk also contains soluble factors, including cytokines, lipids, and fatty acids, that broadly enhance mucosal resistance to infection. (C) Early life immunization of the newborn or young infant reduces risk for infection with (C-top) specifically-targeted pathogens; (C-bottom) live attenuated vaccines such as Bacille Calmette Gue’rin (BCG) provide broader heterologous (“non-specific”) protection, possibly via ‘‘trained immunity’’ mediated by epigenetic reprograming of monocytes. (D) Probiotics reduce infection. Mechanisms underlying probiotic effects remain under study and may include, for example, (D-top panel) enhancement of colonization resistance wherein bacteriocin production by probiotic bacteria targets specific pathogens without affecting commensal flora, and (D-bottom) mucosal PRR signaling-mediated enhancement of immune development, including intestinal epithelial cell expression of antimicrobial protein and peptide (APPs) as well as innate lymphoid cells and mucosal Th17 and Treg development (reprinted with permission of Elsevier) [8].
Healthy women in labor and newborns considered according to the inclusion criteria. Studies conducted all year round. Our purpose was to determine quantitative and qualitative values of various bacterial growth and colonization in the healthy women in labor and newborns microscopically. Variables were excluded in this research. Bacteriological studies carried out in accordance with the Order of the Ministry of Health of the Kyrgyz Republic No. 4 from January 11.2010.11, “Methodological instructions for bacteriological methods of laboratory research of clinical material”. Work carried out at the Laboratory of Microbiology, Immunology and Virology of the Institute of Medical Problems of the Southern Branch of the National Academy of Sciences of the Kyrgyz Republic.
Microbiological methods such as isolation of bacteria, method of culture and identification of microbiota applied in this study. Types of samples: throat and skin swabs, nasal mucus, urine culture tested for microflora content.
3. Results and Discussions
In this study the throat microflora of women in labor and newborns in lowland conditions examined, during which the C. albicans bacteria [10] [11] detected in 19.4% mothers and in 6.9% of newborns, respectively (Figure 2). In the midland and highland conditions, this microflora was not found in the pharynx. In pharynx microflora of women in labor and newborns, C. krusei [12] bacteria observed only in lowland conditions. In the midland and highland, C. albicans bacteria not detected. S. aureus [13] found in all three studied groups: in lowlands, it was 8.4% in women in labor and 5.5% in newborns. In midland conditions, the S. aureus bacteria found as 23.3% in women in labor, and in newborns, it was 20%, which is 17.3% and 26.6% higher than in the lowland group. In highlands of women in labor, S. aureus noted as 35.4% of cases and in 25.8% in newborns, which is almost 3 times more in comparison with the lowland group.
In the study of nasal microflora (Figure 3), we found the C. albicans species in case of women in labor were 77.7%, while in newborns C. albicans species were 2 times less. In women of the midlands, this indicator reduced and amounted to 53%, while in newborns it found only in 13% of cases, which was amounted to 34.6% in relation to the lowlandgroup. In women of the alpine group, this indicator was 45%, while in newborns the C. albicans bacteria not found. C. krusei bacteria found in the women in labor in low and middle mountain conditions noted as almost 40% of cases, in newborns two times less. Figure 3 is showing microflora of nose in highland conditions, where C. albicans not detected in newborns. S. aureus bacteria in all groups were three times less in newborns comparing to the women in labor.
S. epidermidis bacteria dominated in the urine culture of women in labor at highlands, midlands and lowlands, as well as in newborns at lowland and highlands, at highest percentage (Figure 4). In newborns, urine culture at midlands contained dominated S. aureus bacteria. In the lowland conditions, in 72 women in labor C. albicans presented as 11%, S. aureus was 15%, and S. epidermidis was 25%. E. coli found 22%, P. rettrgeri was 22%, P. mirabilis was 31%, and P. vulgaris was 15%. In newborns urine culture C. albicans was detected 13%, S. aureuswas 12%, and S. epidermidis was 20%, microbe species of the P. rettgeri, P. mirabilis, P. vulgaris and Klebsiella observed too. In the midland conditions, 30 women in labor and 30 newborns examined where from the pathogenic microflora the following bacteria species detected:
S. aureus was 40%, S. epidermidis was 50%, C. albicans was 9% - 30%, and E. coli bacteria were 15%. In highlands, 31 women in labor and newborns examined where for women in labor the highest percentage of microflora dominated by S. Epidermidis species.
Skin swab microflora of women in labor and newborns analyzed for presence of bacteria. In lowlands, the S. aureus type was prevailed, while in case of midlands prevailed bacterium was S. epidermidis (Figure 5). In the newborns of highlands, E. coli was prevailed, as in the examined lowlands it found as 75%. All microflora representatives in the woman in labor and in newborns were 79%, in the woman in labor of midlands were 66%, and in newborns were 58%. In the highlands of the examined women in labor microflora bacteria were 31.1%, while in newborns were 22%.
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Figure 2. Microflora of the throat of women in labor and newborns.
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Figure 3. Microflora of the nose in women in labor and newborns.
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Figure 4. Microflora of the urine culture in various altitudes for woman in labor and newborns.
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Figure 5. Skin swab microflora of woman in labor and newborns.
In the lowland conditions, skin swab microflora examination was performed for 72 women in labor, where C. albicans was 22.2%, C. krusei was 18%, S. aureus was 22%, S. epidermidis was 12.5%, E. coli was 19.4%. In newborns, C. albicans found as 18.0%, C. krusei was 16.6%, S. aureus was 19.4%, S. epidermidis was 9.7%, and E. coli was 11% - 15.2%. As can be seen from the table, a high percentage of S. aureus observed for women in labor and newborns.
In the midland conditions, 30 women in labor and newborns examined. In the women in labor C. albicans were detected as 56.6%, C. krusei was 36.6%, S. aureus was 23.3%, S. epidermidis was 60% and E. coli was 30%. In newborns, representatives of candida fungi found: C. albicans was 3.3%, and C. krusei was 26.6%, S. aureus was 43.3%, S. epidermidis was 53.6% and E. coli was 36.6%. In case of highlands 31 inhabitants including woman in labor and newborns examined, where microflora of woman in labor showed C. albicans as 51%, C. krusei was 54%, S. aureus was 67.7%, S. epidermidis was 93.5%, and E. coli was 51%. In the newborns C. albicans was 38.7%, C. krusei was 29%, S. aureus was 35.4%, S. epidermidis was 61%, and E. coli was 58%.
4. Conclusion
Throat examination of woman in labor and newborns in midlands and highlands showed no candida detected. In the low mountain conditions 1012 meters above sea level, a higher percentage of candida observed for women in labor, while in newborns epidermal staphylococcus dominated. Nose microflora in lowlands showed a high percentage of C. albicans and S. aureus bacteria in both mothers and newborns. In the midlands, the large number of S. aureus observed for women in labor, and in newborns, S. epidermidis found, while in the newborns of highlands, this yeast not detected. In newborns, urine culture at midlands contained dominated S. aureus bacteria. Skin swab microflora of women in labor and newborns analyzed for presence of bacteria. In lowlands, the S. aureus type was prevailed, while in case of midlands prevailed bacterium was S. epidermidis.