The very low birth weight infant microbiome and childhood health

Groër, Maureen; Gregory, Katherine E.; Louis‐Jacques, Adetola; Thibeau, Shelley; Walker, W. Allan

doi:10.1002/bdrc.21115

Cited by 80 publications

(76 citation statements)

References 105 publications

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“…We also know that breast milk as an exclusive source of nutrition in full-term infants stimulates health-promoting bacteria, known as “pioneer” bacteria that directly influence the development of host defense [29]. We also know that expressed breast milk from mothers delivering prematurely protects the infant from NEC [17, 18].…”

Section: Discussionmentioning

confidence: 99%

Influence of maternal breast milk ingestion on acquisition of the intestinal microbiome in preterm infants

et al. 2016

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BackgroundThe initial acquisition and early development of the intestinal microbiome during infancy are important to human health across the lifespan. Mode of birth, antibiotic administration, environment of care, and nutrition have all been shown to play a role in the assembly of the intestinal microbiome during early life. For preterm infants, who are disproportionately at risk of inflammatory intestinal disease (i.e., necrotizing enterocolitis), a unique set of clinical factors influence the establishment of the microbiome. The purpose of this study was to establish the influence of nutritional exposures on the intestinal microbiome in a cohort of preterm infants early in life.ResultsPrincipal component analysis of 199 samples from 30 preterm infants (<32 weeks) over the first 60 days following birth showed that the intestinal microbiome was influenced by postnatal time (p < 0.001, R 2 = 0.13), birth weight (p < 0.001, R 2 = 0.08), and nutrition (p < 0.001, R 2 = 0.21). Infants who were fed breast milk had a greater initial bacterial diversity and a more gradual acquisition of diversity compared to infants who were fed infant formula. The microbiome of infants fed breast milk were more similar regardless of birth weight (p = 0.049), in contrast to the microbiome of infants fed infant formula, which clustered differently based on birth weight (p < 0.001). By adjusting for differences in gut maturity, an ordered succession of microbial phylotypes was observed in breast milk-fed infants, which appeared to be disrupted in those fed infant formula. Supplementation with pasteurized donor human milk was partially successful in promoting a microbiome more similar to breast milk-fed infants and moderating rapid increases in bacterial diversity.ConclusionsThe preterm infant intestinal microbiome is influenced by postnatal time, birth weight, gestational age, and nutrition. Feeding with breast milk appears to mask the influence of birth weight, suggesting a protective effect against gut immaturity in the preterm infant. These findings suggest not only a microbial mechanism underpinning the body of evidence showing that breast milk promotes intestinal health in the preterm infant but also a dynamic interplay of host and dietary factors that facilitate the colonization of and enrichment for specific microbes during establishment of the preterm infant microbiota.Electronic supplementary materialThe online version of this article (doi:10.1186/s40168-016-0214-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Influence of maternal breast milk ingestion on acquisition of the intestinal microbiome in preterm infants

et al. 2016

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“…The dysbiosis after a short 5-day treatment of the premature skin might resolve but the influence of the altered skin microbiome on the evolving gut microbiome is unknown. Dysbiosis of the gut has been associated with physical and behavioral problems such as allergy, asthma, obesity, and psychological disorders [22]. Though mechanistic insights into the relationship between dysbiosis and disease is largely lacking, these studies suggest that broad-spectrum antibiotics should be used with care.…”

Section: Discussionmentioning

confidence: 99%

Active Surveillance Cultures and Targeted Decolonization Are Associated with Reduced Methicillin-Susceptible <b><i>Staphylococcus aureus</i></b> Infections in VLBW Infants

et al. 2017

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Background: Methicillin-susceptible Staphylococcus aureus (MSSA) is a major contributor to infectious episodes of very low birth weight infants (VLBWI), resulting in significant morbidity and mortality. Objective: To examine the efficacy and safety of surveillance cultures and the decolonization of MSSA-colonized VLBWI. Methods: VLBWI admitted to our neonatal wards in 2011-2016 were retrospectively analyzed. Rates of MSSA-attributable infections were compared before and after the implementation of active surveillance cultures and the decolonization of MSSA-colonized patients. The mupirocin susceptibility of isolated MSSA strains was routinely tested. Results: A total of 1,056 VLBWI were included in the study, 552 in the pre-intervention period and 504 in the post-intervention period. The implementation of surveillance cultures and decolonization of colonized patients resulted in a 50% reduction of incidence rates per 1,000 patient-days of MSSA-attributable infections (1.63 [95% CI 1.12-2.31] vs. 0.83 [95% CI 0.47-1.35], p = 0.024). No adverse effects were observed from application of the decolonization protocol with mupirocin and octenidin. No mupirocin-resistant MSSA strains were detected during the study period. Conclusion: Implementation of an active surveillance and decolonization protocol resulted in a reduction of MSSA-attributable infections in VLBWI.

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“…24 Antibiotic-induced gut microbiota dysbioses in this population have been linked to the pathogenesis of necrotizing enterocolitis, [25][26][27] late onset sepsis, 28,29 and other adverse health outcomes. 30 While these correlations exist, the underlying etiologies remain unclear, motivating the study of microbiota development in the context of antibiotic therapy in this vulnerable population that accounts for nearly 10% of all births in the United States.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic perturbation of the preterm infant gut microbiome and resistome

Gasparrini¹,

Crofts²,

Gibson³

et al. 2016

Gut Microbes

100

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The gut microbiota plays important roles in nutrient absorption, immune system development, and pathogen colonization resistance. Perturbations early in life may be detrimental to host health in the short and the long-term. Antibiotics are among the many factors that influence the development of the microbiota. Because antibiotics are heavily administered during the first critical years of gut microbiota development, it is important to understand the effects of these interventions. Infants, particularly those born prematurely, represent an interesting population because they receive early and often extensive antibiotic therapy in the first months after birth.Gibson et al. recently demonstrated that antibiotic therapy in preterm infants can dramatically affect the gut microbiome. While meropenem, ticarcillin-clavulanate, and cefotaxime treatments were associated with decreased species richness, gentamicin and vancomycin had variable effects on species richness. Interestingly, the direction of species richness response could be predicted based on the abundance of 2 species and 2 genes in the microbiome prior to gentamicin or vancomycin treatment. Nonetheless, all antibiotic treatments enriched the presence of resistance genes and multidrug resistant organisms. Treatment with different antibiotics further resulted in unique population shifts of abundant organisms and selection for different sets of resistance genes. In this addendum, we provide an extended discussion of these recent findings, and outline important future directions for elucidating the interplay between antibiotics and preterm infant gut microbiota development.

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The very low birth weight infant microbiome and childhood health

Cited by 80 publications

References 105 publications

Influence of maternal breast milk ingestion on acquisition of the intestinal microbiome in preterm infants

Influence of maternal breast milk ingestion on acquisition of the intestinal microbiome in preterm infants

Active Surveillance Cultures and Targeted Decolonization Are Associated with Reduced Methicillin-Susceptible <b><i>Staphylococcus aureus</i></b> Infections in VLBW Infants

Antibiotic perturbation of the preterm infant gut microbiome and resistome

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