Development of Gut Colonisation in Pre-term Neonates

Abstract

SUMMARY. Twenty-eight pre-term babies of low birth weight were monitored for developing microflora in throat, stomach and faeces during the first 3 weeks of life. The flora at all levels of the gastrointestinal tract differed from that of healthy breast-fed and artificially fed full-term babies. Colonisation of throat and stomach was delayed beyond 4 days of life in 87% and 60% of babies respectively. Only 10% of babies had "normal" oral flora throughout the period of study. Flora of the stomach was sparse, and resembled faecal flora. Faecal flora was established more rapidly than throat or stomach flora, and 70% of babies were colonised during the first 4 days of life. Initially Bacteroides spp. were predominant (57% babies), but Escherichia coli and other aerobic gram-negative bacilli gradually increased in frequency. Colonisation by gram-positive bacteria was slow. Clostridium spp. were present in only 10% of babies during the first 4 days of life. Most strains were transient. Colonisation with C. butyricum (30%), C. perfringens (35%) and C. dzficife (25%) was maximum after the first 2 weeks of life. Lactic-acid-producing bacteria usually appeared late in the third week of life. Parenteral feeding immediately after birth was associated with delayed colonisation by a restricted number of species. Parenteral antibiotics (penicillin or gentamicin or both) restricted colonisation with normal oral flora, the lactic-acid-producing bacteria and penicillin-sensitive clostridia, but had little effect on E. coli even when the colonising strain was sensitive to the aminoglycoside in the regimen. Systemic spread of bacteria via the blood stream was not detected in any babies.The pattern of colonisation of the enteric tract in pre-term infants in the special-care nursery studied, differs from that of healthy full-term babies; this merits consideration when the results of bacteriological tests on this vulnerable group of infants are being interpreted.

The development of bacterial flora of premature neonates

“…In this study, the bacterial flora of the umbilicus, the mouth and faeces of the premature neonates differed in many respects from the earlier reports of studies conducted by other workers on normal healthy full-term babies (Mata & Urrutia, 1971;Long & Swenson 1977; and from a recent report by Blakey et al (1982) on pre-term babies.…”

“…The present finding 315 V. 0. ROTIMI, S. A. OLOWE AND I. AHMED however contrasts the low rate (or complete absence) of colonization of normal full-term and preterm babies previously reported (McCarthy, Snyder & Parker, 1965;Rotimi & Duerden, 1981a;Blakey et al 1982). No antifungal agent was administered to any of our babies unlike the babies in the report of Blakey et al (1982) who were all given routine antifungal (Mycostatin) therapy.…”

“…epidermidis in a large number of babies was not surprising as this species is one of the commonest components of the oral flora (McCarthy, Snyder & Parker, 1965;. Blakey et al (1982) in their report also found that Staph. epidermidiis was common oral flora oftheir preterm babies.…”

“…Campylobacter sp. were not looked for because other studies have show that they are not a component of the normal flora of neonates (Blakey et al 1982). Tables 1-3 summarize the bacterial species or group of organisms isolated from the umbilical stump, oral cavity and faeces according to age of premature babies at the time of sampling.…”

Potential probiotics from faecal specimens of breastfed Nigerian infants as a therapy for bacterial gastroenteritis

“…As earlier suggested by Blakey et al 23,25 and Sakata et al 24,26 , the absence of bacterial growth may be due to the immaturity of the digestive organs of the subject. Similarly, no lactobacilli were isolated from the faecal specimens of infants below 20 days old, which may be in accordance with the trend in the previous report of Yoshioka et al 25,27 .…”