PROJECT SUMMARY
Despite recent emphasis on the microbiome, there are few skin microbiome studies in infants; even fewer have
been performed in preterm infants. Currently, there is a significant gap in our knowledge of the normal evolution
of the preterm infant skin microbiome from birth to an independent, site-specific cutaneous microbiome.
Preliminary studies show that preterm infants have limited microbial diversity and different predominant
cutaneous microbes compared to full-term infants. This lack of a robust, diverse skin microbiome may render
preterm infants susceptible to pathogenic skin bacteria that cause disease, particularly neonatal sepsis. The
research goals of this mentored career-development award are to: 1) characterize the establishment of the
neonatal skin microbiome in a cohort of preterm infants from birth to 4 weeks and compare to demographic and
clinical variables, 2) recruit a cohort of term infants to determine if the preterm infant skin microbiome is
significantly different than term infants, and 3) analyze cultured pathogens with the skin microbiome in late-onset
neonatal sepsis (LOS). Our methods represent a departure from the currently available studies, which provide
opportunistic sampling of the neonatal skin microbiome rather than sampling at defined timepoints. This study will
vertically-advance the field by sampling the preterm skin microbiome systematically after birth. The role of the
skin microbiome in neonatal sepsis has also not been described, and the design of this study will provide a better
understanding of changes in the skin microbiome before late onset sepsis. Together, these aims will provide
insight into the normal and abnormal development of the preterm infant skin microbiome. Future studies will then
leverage the neonatal skin microbiome via therapeutic and preventative strategies to lower the incidence of LOS.
This K23 is the next logical step in the training program started under my KL2 award, and the final step in my
transition to an independent physician scientist. This proposal describes mentored research and training activities
designed to launch a novel neonatal skin microbiome research program, the first in the field of pediatric
dermatology. Five training and career development goals, facilitated by my mentoring team, are required to
accomplish this. These include: extend my understanding of research design, deepen my knowledge of
microbiome and relevant laboratory science, gain working knowledge of statistics/bioinformatics (including
advanced metagenomic analyses), learn to lead an independent laboratory, and expand my professional network
within microbiome science. The University of Florida provides a rich environment with expertise in the neonatal
microbiome and metagenomics, ideal to extend my previous work as I develop a novel neonatal skin microbiome
research program. The resources at UF will be augmented by additional skin microbiome expertise and
laboratory resources from Dr. Pammi at Baylor College of Medicine and Diversigen Inc.
