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Published on: January 27, 2019
The Microbiome of Infants Recruited to a Randomised Placebo-controlled Probiotic Trial (PiPS Trial)
Michael Millar1, Jo Seale1, Melanie Greenland2
1Department of Infection, Barts Health NHS Trust, London, UK.
Insights
Probiotics did not alter the gut microbiome in preterm infants. Early antibiotic use, however, was linked to increased Proteobacteria, suggesting antibiotics significantly impact infant gut microbial colonization.
Area of Science:
- Microbiology
- Neonatal Medicine
- Gastroenterology
Background:
- Necrotizing enterocolitis (NEC) in preterm infants is linked to gut microbial dysbiosis.
- Probiotics are hypothesized to reduce NEC risk, while antibiotics may increase it.
- A previous trial found Bifidobacterium breve BBG-001 did not affect NEC incidence.
Purpose of the Study:
- To compare the fecal microbiome of preterm infants receiving probiotics versus placebo.
- To assess the impact of early antibiotic treatment on the infant gut microbiome.
- To investigate the relationship between probiotics, antibiotics, and microbial colonization patterns.
Main Methods:
- Analysis of fecal samples from a subset of preterm infants from the PiPS trial.
- 16S rRNA gene sequencing to characterize the gut microbiome.
- Statistical analysis, including stepwise logistic regression, to identify associations.
Main Results:
- No significant differences in microbial richness or diversity between probiotic and placebo groups.
- Early antibiotic exposure was associated with altered gut microbial colonization patterns.
- A relative abundance of Proteobacteria was observed in infants with early antibiotic exposure.
Conclusions:
- The influence of probiotics on the preterm infant microbiome remains uncertain.
- Antibiotic exposure significantly modulates microbial colonization in preterm infants.
- Further research is needed to understand the long-term effects of antibiotics on the infant gut microbiome.
Abstract:
The microbial dysbiosis associated with necrotizing enterocolitis (NEC) in preterm infants suggests that early exposure to probiotics may decrease and antibiotics may increase NEC risk. However, administration of Bifidobacterium breve strain BBG-001 to preterm infants did not affect NEC incidence in a multicenter randomised controlled phase 3 trial (PiPS trial). Using a subset of these subjects we compared the fecal microbiome of probiotic and placebo groups and assessed the impact of early antibiotic treatment. Extracted DNA from 103 fecal samples collected at 36weeks post-menstrual age underwent PCR amplification of a fragment of the 16S rRNA gene. Heatmaps were constructed showing the proportions of sequences from bacterial families present at >1% of the community. Stepwise logistic regression assessed the association between early antibiotic exposure and microbiome group. There was no difference in the microbial richness and diversity of the microbiome of preterm infants following treatment with probiotic or a placebo. Conversely, early antimicrobial exposure was associated with different patterns of colonisation, specifically a relative abundance of Proteobacteria. These findings highlight that the potential influence of probiotics on the microbiome of preterm infants remains unclear whereas the modulatory effect of antibiotic exposure on microbial colonisation requires further research.
