Microbial Interactions, Infections, and Interventions in Neonatal Health

Dear Colleagues,

Investments in research involving preterm neonates have enabled significant advances in neonatology which, combined with the creation of Neonatal Intensive Care Units (NICUs), have led to substantial reductions in neonatal mortality and improved survival in preterm newborns. Within NICUs, several medical devices may be required to support life and promote development outside the womb, including central venous catheters, parenteral nutrition, mechanical ventilation, etc.

However, the use of such devices, along with prematurity itself and the prolonged administration of broad-spectrum antimicrobials, constitutes important risk factors for the development of healthcare-associated infections (HAIs). These infections represent one of the major challenges in NICUs, as they significantly increase morbidity and mortality rates, compromise neonatal development, prolong hospitalization, and increase healthcare costs.

Prematurity alone is a major risk factor for HAIs because the neonatal immune system is still immature, and natural protective barriers such as the skin and mucosal surfaces are not yet fully developed. Invasive devices, in turn, serve as entry points for microorganisms present in the hospital environment. Moreover, antimicrobials, often administered prophylactically due to the severity of the newborn’s condition, exert selective pressure by preventing colonization by commensal microbiota, thereby facilitating the colonization of mucosal surfaces by hospital-associated microorganisms, many of which may be pathogenic and resistant to antimicrobial agents.

In this context, expanding scientific knowledge on host–microorganism interactions, the pathogenesis of infections, and innovative strategies for preventing and managing HAIs in neonatal units is essential. Therefore, this Special Issue will gather original research articles and comprehensive reviews addressing topics such as NICU infections, risk factors associated with HAIs, the impact of the hospital environment on infection dissemination, improvements in neonatal care practices that contribute to infection prevention, microbial interactions during the neonatal period, immune responses, and antimicrobial resistance. Our goals are to strengthen the scientific understanding of microbial dynamics and their influence on neonatal outcomes and to promote research that supports safer clinical care, more effective infection prevention strategies and the improved health and well-being of newborns worldwide.

Dr. Ralciane De Paula Menezes
Prof. Dr. Carlos H. G. Martins
Guest Editors

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