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Case series of Bifidobacterium longum bacteremia in three preterm infants on probiotic therapy

Andrea Zbinden1, Reinhard Zbinden, Christoph Berger

  • 1Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland.

Neonatology
|November 18, 2014
PubMed

Insights

Probiotic use in preterm infants for necrotizing enterocolitis (NEC) prophylaxis is common. However, this case series reports three very-low-birth-weight infants who developed Bifidobacterium longum bacteremia while receiving probiotic therapy.

Area of Science:

  • Neonatal Medicine
  • Microbiology
  • Gastroenterology

Background:

  • Probiotics are increasingly used to prevent necrotizing enterocolitis (NEC) in preterm infants.
  • This practice is widespread despite limited data on potential risks.

Observation:

  • A case series involving three very-low-birth-weight preterm infants (<30 weeks gestation, <1230g birth weight) admitted to the neonatal intensive care unit.
  • Two infants experienced transient bacteremia with Bifidobacterium longum during or shortly after probiotic therapy.
  • One infant developed NEC and bacteremia with B. longum, requiring surgery and antibiotics.

Findings:

  • Bifidobacterium longum was identified in blood cultures of all three infants.
  • Molecular and biochemical analyses confirmed the probiotic strain (Infloran®) as the source of bacteremia.
  • Clinical outcomes varied, with two infants showing transient bacteremia and one developing severe NEC.

Implications:

  • Bacteremia with Bifidobacterium longum is a potential risk associated with probiotic prophylaxis in very-low-birth-weight infants.
  • The clinical significance and safety of probiotic use in this vulnerable population warrant further investigation and cautious application.
  • Healthcare providers should consider the potential for probiotic-related infections in preterm infants.
Abstract

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