Respiratory distress syndrome (RDS) is a common complication of prematurity and it is the main cause of death in newborns.However, it is difficult to define the exact prognosis of RDS in the first days of life. Furthermore, due to the increased prevalence of drug-resistant bacteria in recent years and the limitations of culture and other detection methods, determining a course of treatment for RDS is quite difficult (4). The complexity of the bacteria in the respiratory tract contributes to the diversity of this micro-ecosystem. Various pathogenic and commensal bacteria can collaborate, coexist, or restrict the growth of other bacteria, and commensal bacteria may become pathogenic under certain circumstances. Therefore, to establish better clinical guidelines for the treatment of RDS, we need to understand the diversity and relationships between the microflora to detect pathogens.Until now, there have been poor evidences regarding the bacterial composition and dynamic changes in the respiratory tract during the neonatal period. Therefore, a prospective study examining the composition and diversity of the microflora and their relationships with RDS prognosis is advocated. In this study we aim to investigate the relation between microbial composition of respiratory tract and RDS course in preterm neonates. We will collect specimens of sputum (SS) and bronchopulmonary lavage liquid (BAL), if patient is intubated. The CFU values will be calculated to evaluate the bacterial load per gram of sample (CFU/g). The presence of bacterial pathogens and common intestinal viruses will be detected using a qualitative PCR by film array biofire diagnostics. The identification of bacterial species will be performed by sequencing the 16S rDNA coding region. New insight obtained with the results of this research, may open new perspectives in prevention and therapy of conditions that significantly affect survival probability of preterm neonates.
