eLife assessment
This interesting and important study follows up on the authors' observations that lower glucose parental nutrition leads to lower rates of sepsis from Staphylococcus epidermis in a preterm pig model. Sepsis in early life, particularly in premature infants, has significant morbidity and mortality and the authors present convincing evidence that glycemic state affects hepatic metabolism-dependent immune function and improved clearance of coagulase-negative staphylococcal infection. The authors provide a robust multi-omic dataset for the use of the scientific community. However, there are also several concerns that will limit the impact of the work, including that the model does not reflect early onset sepsis that is observed in premature infants, and the question of whether low glucose parental nutrition (PN) is protective versus high glucose PN is harmful as the levels of glucose in the high PN were incredibly high.