Fig. 2: In-depth profiling of the neonatal preterm infant gut resistome.

a Schematic timeline of antibiotic regimen. b Comparison of antimicrobial resistance genes (ARGs) NPS vs PS cohorts (overall n = 53 NPS, n = 39 PS). c Comparison of ARG classes count between NPS and PS (overall n = 53 NPS, n = 39 PS). d Proportions of ARG types (NPS vs PS). The inset bar chart shows the mean ARG count. e Distribution of individual ARG profiles (NPS vs PS). f Venn diagram showing the number and percentage of unique and shared ARGs. g Comparison of Chao1 (genus richness) and Shannon (ecological diversity) indices between antibiotic-treated (n = 27 NPS, n = 31 PS) and control (untreated; n = 26 NPS, n = 8 PS) groups. h Gut microbiome dynamics over the first three weeks of life, showing the top 10 genera. i Changes in taxonomic abundance (top 10 genera) in the antibiotic-treated versus control groups (NPS + PS). Shaded area indicates the antibiotic treatment period (median: 3 days). j Comparison of the number of ARGs between antibiotic-treated (n = 27 NPS, n = 31 PS) and control (untreated; n = 26 NPS, n = 8 PS) groups in both cohorts. k Comparison of the ARG count between NPS (n = 27 Antibiotic, n = 26 Control) and PS (n = 31 Antibiotic, n = 8 Control) cohorts, stratified by antibiotic exposure. l Correlation plot of Shannon diversity index versus ARG number (NPS vs PS). τ represents Kendall’s rank correlation coefficient. Shaded error bands indicate 95% confidence intervals around the regression lines. m Kendall’s correlation between the number of ARGs and relative abundance of the top 10 most abundant genera. n Genomic mapping of an extracted contig containing the mcr-9.1 gene against a public reference mcr-9.1 gene from E. coli, showing 100% nucleotide identity. In (b, c, g, j and k), the box plots represent median (line inside the box), interquartile range (IQR; middle 50% of the data, box height), data within 1.5 × IQR (whiskers), and outliers (points). In (b, c, d, g, i, j and k), statistical significance was assessed using two-sided Wilcoxon tests with Benjamini–Hochberg correction. In (l and m), correlations were assessed using two-sided Kendall’s rank correlation test. Statistical significance: *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001; ns not significant.