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Published on: July 28, 2023
Longitudinal changes in the gut microbiome of infants on total parenteral nutrition
Allison F Dahlgren1, Amy Pan1,2, Vy Lam1,2
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
Insights
Total parenteral nutrition (TPN) significantly reduces gut microbiome diversity in infants. This TPN-associated dysbiosis may increase risks for adverse outcomes in the neonatal intensive care unit (NICU).
Area of Science:
- Microbiology
- Neonatal Medicine
- Gastroenterology
Background:
- Animal studies indicate Total Parenteral Nutrition (TPN) may disrupt intestinal bacterial colonization and lead to complications.
- The progressive changes in the gut microbiome of infants receiving TPN are not fully understood.
Purpose of the Study:
- To investigate the impact of TPN on the developing gut microbiome in infants.
- To analyze changes in gut microbial composition and diversity in infants receiving TPN compared to controls.
Main Methods:
- A prospective, longitudinal study enrolled infants with and without TPN/soy lipid.
- Weekly fecal samples were collected for the first four weeks of life.
- High-throughput pyrosequencing of 16S rDNA was utilized for gut microbiome compositional analysis.
Main Results:
- Infants receiving TPN showed significantly lower fecal bacterial alpha diversity at week 4 compared to controls (Shannon index 1.0 vs 1.5, P=0.03).
- The TPN group exhibited lower abundance of Bacteroidetes and higher abundance of Verrucomicrobia compared to controls (P<0.05), with differences increasing over time.
- TPN was associated with a decreased abundance of Bacteroides and Bifidobacterium genera throughout the study period.
Conclusions:
- TPN is linked to a significant reduction in gut microbial biodiversity and altered colonization patterns in infants.
- TPN-induced dysbiosis may increase the susceptibility of infants to adverse outcomes in the neonatal intensive care unit (NICU).
Background:
Animal studies suggest that total parenteral nutrition (TPN) may alter bacterial colonization of the intestinal tract and contribute to complications. Progressive changes in gut microbiome of infants receiving TPN are not well understood.
Methods:
Infants with and without TPN/soy lipid were enrolled in a prospective, longitudinal study. Weekly fecal samples were obtained for the first 4 weeks of life. High throughput pyrosequencing of 16S rDNA was used for compositional analysis of the gut microbiome.
Results:
47 infants were eligible for analyses, 25 infants received TPN, and 22 infants did not (control). Although similar between TPN and control groups in the first week, fecal bacterial alpha diversity was significantly lower in the TPN group compared to controls at week 4 (Shannon index 1.0 vs 1.5, P-value = 0.03). The TPN group had significantly lower Bacteroidetes and higher Verrucomicrobia abundance compared to controls (P-values < 0.05), and these differences became more pronounced over time. At the genus level, TPN was associated with lower abundance of Bacteroides and Bifidobacterium in all weeks.
Conclusions:
TPN is associated with significant loss of biodiversity and alterations in the pattern of gut microbial colonization of infants over time. TPN-associated dysbiosis may predispose infants to adverse NICU outcomes.
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