Gut microbiota composition and dysbiosis signatures associated with complex gastrointestinal and urological conditions in neonates: a case series study

Abstract

During the first year of life, the gut microbiota (GM) is influenced by several factors, including delivery mode, feeding practices (breast milk vs. formula milk), antibiotic therapy, and preterm birth. Surgical interventions and complex congenital conditions may further alter microbial colonization, potentially contributing to complications and systemic inflammation. This study aimed to investigate alterations in the GM of newborns with complex surgical, urological, and gastrointestinal conditions, including Hirschsprung's disease. GM composition was analyzed in five newborns with complex clinical conditions to investigate potential associations between microbial alterations and underlying diseases. A consistent reduction in beneficial commensal bacteria, particularly Bifidobacterium and Lactobacillus spp., was observed, alongside an increased abundance of potential opportunistic pathogens, mainly belonging to the phylum Proteobacteria. These findings revealed common signatures of dysbiosis, as well as potential disease-specific microbial patterns. The findings suggest that early-life factors, including antibiotic exposure, prematurity, complex clinical conditions, and surgical interventions, may substantially affect microbial colonization. These alterations may be associated with an increased risk of complications and systemic inflammation. Further studies involving larger cohorts are needed to clarify the relationships between GM alterations and clinical outcomes in these vulnerable newborns.