Bifidobacterium bacteraemia is rare with routine probiotics use in preterm infants: A further case report with literature review

Acuna-Gonzalez, Antia; Kujawska, Magdalena; Youssif, Mayada; Atkinson, Thomas G.; Grundy, Sara J.; Hutchison, A. A.; Tremlett, Catherine; Clarke, Paul; Hall, Lindsay J.

doi:10.1016/j.anaerobe.2023.102713

Cited by 6 publications

(3 citation statements)

References 21 publications

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“…The need for a personalized approach to microbiome intervention in preterm infants is supported by recent randomized controlled trials of probiotic supplementation with Bifidobacterium spp. (an Actinobacteria) in neonatal intensive care units (NICUs), which, while demonstrating some benefit for preterm infants in improving intestinal barrier function ( 60 ) and reducing inflammatory markers in the intestinal milieu ( 61 ), ultimately reducing the incidence of necrotizing enterocolitis and the length of hospital stay ( 62 ), have also documented rare adverse events related to probiotic bacteremia ( 63 ). Furthermore, the efficacy of Bifidobacterium spp.…”

Section: Discussionmentioning

confidence: 99%

A digital twin of the infant microbiome to predict neurodevelopmental deficits

Sizemore,

Oliphant,

Zheng

et al. 2024

Sci. Adv.

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Despite the recognized gut-brain axis link, natural variations in microbial profiles between patients hinder definition of normal abundance ranges, confounding the impact of dysbiosis on infant neurodevelopment. We infer a digital twin of the infant microbiome, forecasting ecosystem trajectories from a few initial observations. Using 16 S ribosomal RNA profiles from 88 preterm infants (398 fecal samples and 32,942 abundance estimates for 91 microbial classes), the model (Q-net) predicts abundance dynamics with R 2 = 0.69. Contrasting the fit to Q-nets of typical versus suboptimal development, we can reliably estimate individual deficit risk ( M δ ) and identify infants achieving poor future head circumference growth with ≈76% area under the receiver operator characteristic curve, 95% ± 1.8% positive predictive value at 98% specificity at 30 weeks postmenstrual age. We find that early transplantation might mitigate risk for ≈45.2% of the cohort, with potentially negative effects from incorrect supplementation. Q-nets are generative artificial intelligence models for ecosystem dynamics, with broad potential applications.

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Section: Discussionmentioning

confidence: 99%

A digital twin of the infant microbiome to predict neurodevelopmental deficits

Sizemore,

Oliphant,

Zheng

et al. 2024

Sci. Adv.

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“…Our probiotic protocol was initially planned and funded for 24 months, but we ceased probiotic use on September 29, 2023, when the FDA issued a warning regarding the risk of invasive, potentially fatal disease caused by use of probiotics in preterm infants. The majority of B. infantis sepsis or bacteremia case reports have occurred in babies with NEC or spontaneous intestinal perforation (SIP) 24 , and it is well known that when intestinal mucosal barrier is compromised, bacteria can translocate, leading to invasive infection. Bi dobacterium species are traditionally considered ubiquitous nonpathogenic commensal organisms and have low MICs (<0.5 mg/L) to beta-lactam antibiotics 25 , which makes them less pathogenic than the bloom of Proteobacteria that are known to proceed the development of NEC.…”

Section: Discussionmentioning

confidence: 99%

Bifidobacterium longum subsp infantis (EVC001) is Associated with Reduced Incidence of Necrotizing Enterocolitis Stage >2 and Bloody Stools in Premature Babies

Sohn,

Palacios,

Clark

2024

Preprint

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Objective To utilize an evidence-based probiotic protocol to achieve a 50% reduction in necrotizing enterocolitis (NEC) > stage 2 and bloody stools. Study design From January 2022 through September 2023, we administered daily enteral EVC001 to babies <33 6/7 weeks gestation until 36 weeks post menstrual age. We compared feeding tolerance and complications to babies admitted during the prior two-year period. Fisher’s Exact test was used to analyze proportional data and student t-test was used for continuous variables. Results 265 babies received EVC001. 277 babies formed the pre-probiotic cohort. Probiotic use was associated with decreased NEC > stage 2 (p=0.0058), reduced bloody stools (p<0.0001), decreased time to full enteral feeds (p<0.0001), and decreased total parenteral nutrition (TPN) days (p<0.0001). Conclusion Supplementation with B. infantis was associated with a decrease in NEC, a decrease in bloody stools, and improvement in feeding tolerance in premature babies.

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“…In contrast, during probiotic sepsis, the specific probiotic strain can be directly detected and genotyped, resulting in a uniquely identifiable fingerprint. Most published cases of probiotic sepsis were successfully treated, 8,9 which may be because of low pathogenicity of many of the organisms involved (especially Bifidobacterium species) and their sensitivity to standard antibiotics. 8,10,11 Benefit-risk assessment (BRA) is a complex and continuous process that occurs after a drug or intervention is launched onto the market.…”

Section: Considerations About the Fda Warningmentioning

confidence: 99%

Reevaluating the FDA's warning against the use of probiotics in preterm neonates: A societal statement by ESPGHAN and EFCNI

van den Akker,

Embleton,

Lapillonne

et al. 2024

J. pediatr. gastroenterol. nutr.

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The recent advisory issued by the United States Food and Drug Administration, cautioning against the routine administration of probiotics in preterm neonates, has sparked a lively debate within the scientific community. This commentary presents a perspective from members of the Special Interest Group on Gut Microbiota and Modifications within the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and other authors who contributed to the ESPGHAN position paper on probiotics for preterm infants, as well as representatives from the European Foundation for the Care of Newborn Infants. We advocate for a more nuanced and supportive approach to the use of certain probiotics in this vulnerable population, balancing the demonstrated benefits and risks.

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Bifidobacterium bacteraemia is rare with routine probiotics use in preterm infants: A further case report with literature review

Cited by 6 publications

References 21 publications

A digital twin of the infant microbiome to predict neurodevelopmental deficits

A digital twin of the infant microbiome to predict neurodevelopmental deficits

Bifidobacterium longum subsp infantis (EVC001) is Associated with Reduced Incidence of Necrotizing Enterocolitis Stage >2 and Bloody Stools in Premature Babies

Reevaluating the FDA's warning against the use of probiotics in preterm neonates: A societal statement by ESPGHAN and EFCNI

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Bifidobacterium bacteraemia is rare with routine probiotics use in preterm infants: A further case report with literature review

Cited by 6 publications

References 21 publications

A digital twin of the infant microbiome to predict neurodevelopmental deficits

A digital twin of the infant microbiome to predict neurodevelopmental deficits

Bifidobacterium longum subsp infantis (EVC001) is Associated with Reduced Incidence of Necrotizing Enterocolitis Stage &gt;2 and Bloody Stools in Premature Babies

Reevaluating the FDA's warning against the use of probiotics in preterm neonates: A societal statement by ESPGHAN and EFCNI

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Bifidobacterium longum subsp infantis (EVC001) is Associated with Reduced Incidence of Necrotizing Enterocolitis Stage >2 and Bloody Stools in Premature Babies