Hospital Regimens Including Probiotics Guide the Individual Development of the Gut Microbiome of Very Low Birth Weight Infants in the First Two Weeks of Life

Abstract

Background: It is unknown to what extent the microbiome of preterm infants is influenced by hospital regimens including the use of different probiotics when it comes to the prevention of necrotizing enterocolitis (NEC). Methods: Prospective controlled multicenter cohort study including very low birth weight infants from three neonatal intensive care units (NICUs) between October 2015 and March 2017. During this time span, stool was sampled every other day during the first two weeks and samples were subjected to amplicon-based microbiome analyses. Out of these, seventeen negative controls were processed (German Registry of Clinical Trials (No.: DRKS00009290)). Results: The groups (3 × 18 infants) showed no statistically significant difference regarding gestational age, birth weight, APGAR scores and oxygen demand. 2029 different taxa were detected, including Enterococcus and Staphylococcus, as well as the probiotic genera Lactobacillus and Bifidobacterium predominating. The bacterial load was found to increase earlier on when probiotics were used. Without probiotics administration, Lactobacillus and Bifidobacterium contributed only marginally to the fecal microbiome. Some infants did not respond to probiotic administration. The samples from all centers participating reached a very similar diversity after two weeks while the microbiome samples from all three centers clustered significantly yet varied from each other. Conclusion: Probiotics proved to be safe and initiated an earlier increase of bacterial load (with marked individual divergences), which might play a crucial role in the prevention of neonatal morbidities. Meconium was found not to be free of bacterial DNA, and oral antibiotics did not influence the fecal microbiome development negatively, and hospital regimes led to a center-specific, distinct cluster formation.

Early Gut Microbiota Colonisation of Premature Infants Fed with Breastmilk or Formula with or without Probiotics: A Cohort Study

“…As a well-known probiotic strain, the colonisation of Bifidobacterium can remodel gut microbiota via its inhibiting effect on the colonisation of pathogens [6]. Our results are similar to those in a multicenter cohort study by Kurath-Koller et al [20] that the bacterial load was increased in two weeks' time after probiotics were used in preterm neonates. At the end of follow-up, the biodiversity of the three groups tends to be the same in our study, indicating that the species diversity of gut microbiota grows closer to each other.…”

Early-Life Development of the Bifidobacterial Community in the Infant Gut

“…Several studies have reported the effect of gestational age and preterm delivery, on the development of the microbiota, at a general level by using 16S rRNA gene-based sequencing [ 36 , 37 , 38 , 39 , 40 ]. Although some studies have reported low levels or no bifidobacteria in the infants’ gut [ 41 , 42 ], this has been linked to potential methodological biases or geographical differences [ 43 ], whilst most of the studies have found Bifidobacterium among the dominant microbial genera in infants. However, limited information is still available at the bifidobacterial community level.…”

Evolution of Gut Microbiome and Metabolome in Suspected Necrotizing Enterocolitis: A Case-Control Study

“…Finally, several factors may affect the gut microbiota of preterm infants, e.g., hospital regimens, even with regard to the putative use of probiotics to blunt NEC. In a very recent publication, Kurath-Koller et al showed the efficacy of some probiotics in improving the gut microbiome of very low birth weight infants during the first two weeks of age, in a triple-center cohort study [ 33 ]. In our mono-centric study, the very low birth weight had an impact on the fecal metabolome of both healthy and NEC-1 children, but not on their gut microbiota nor on their microbiome.…”