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The intestinal bacterial colonisation in preterm infants: a review of the literature

Elisabeth A M Westerbeek1, Anemone van den Berg, Harrie N Lafeber

  • 1Department of Pediatrics, Subdivision of Neonatology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.

Clinical Nutrition (Edinburgh, Scotland)
|May 9, 2006
PubMed

Insights

Preterm infants often have delayed gut colonization by beneficial bacteria, increasing infection risk. Strategies to promote healthy intestinal microflora are crucial for these vulnerable infants.

Area of Science:

  • Neonatal research
  • Microbiology
  • Pediatric medicine

Background:

  • Preterm infants exhibit increased intestinal permeability and immature immune systems, elevating risks of bacterial translocation and systemic infections.
  • The intestinal microflora of healthy, breast-fed term infants, rich in bifidobacteria and lactobacilli, is crucial for suppressing pathogenic bacterial growth.
  • Altering diet with prebiotics and probiotics aims to enhance beneficial bacteria in the infant gut.

Purpose of the Study:

  • To review the normal development of intestinal microflora in preterm infants.
  • To identify factors influencing the intestinal microflora development in preterm infants.
  • To assess the impact of interventions and antibiotics on gut colonization in preterm neonates.

Main Methods:

  • Systematic review of six selected studies on intestinal bacterial colonization in preterm infants.
  • Analysis of factors affecting microflora development, including feeding practices and antibiotic use.
  • Evaluation of strategies to promote beneficial bacteria like bifidobacteria and lactobacilli.

Main Results:

  • Intestinal bacterial colonization with beneficial bacteria is generally delayed in preterm infants.
  • Preterm infants show a higher prevalence of potentially pathogenic bacteria in their gut.
  • Antibiotic use, particularly prophylactic broad-spectrum antibiotics, significantly impacts and delays normal intestinal colonization.

Conclusions:

  • Delayed colonization and a higher load of pathogenic bacteria pose risks to preterm infants.
  • Interventions like prebiotics and probiotics show potential but require careful consideration.
  • Judicious use and restricted duration of broad-spectrum antibiotics are recommended to support healthy gut microbiome development in preterm neonates.

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