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Lactobacillus reuteri Colonisation of Extremely Preterm Infants in a Randomised Placebo-Controlled Trial

Johanne E Spreckels1,2, Erik Wejryd1, Giovanna Marchini3

  • 1Department of Biomedical and Clinical Sciences, Linköping University, SE-581 83 Linköping, Sweden.

Microorganisms
|April 30, 2021
PubMed

Insights

Probiotic Lactobacillus reuteri DSM 17938 successfully colonizes extremely low birth weight (ELBW) infants. This colonization, along with female sex, improved head growth in ELBW infants during the neonatal period.

Area of Science:

  • Neonatology
  • Microbiome research
  • Probiotics

Background:

  • Lactobacillus reuteri DSM 17938 reduces morbidities in very low birth weight infants, but its effect on extremely low birth weight (ELBW) infants is unclear.
  • Previous trials showed improved head growth but not feeding tolerance or morbidities in preterm ELBW infants supplemented with L. reuteri.
  • Colonization by L. reuteri DSM 17938 in preterm ELBW infants requires further investigation.

Purpose of the Study:

  • To investigate the colonization of preterm ELBW infants with Lactobacillus reuteri DSM 17938.
  • To assess the impact of L. reuteri colonization on infant growth and feeding parameters.
  • To explore correlations between maternal milk composition, L. reuteri abundance, and infant outcomes.

Main Methods:

  • A randomized placebo-controlled trial involving 132 preterm ELBW infants.
  • Quantitative PCR analysis of 582 fecal DNA samples to determine L. reuteri colonization.
  • Measurement of human milk oligosaccharides in maternal milk samples.

Main Results:

  • Successful colonization with L. reuteri DSM 17938 was achieved in at least 86% of supplemented ELBW infants.
  • Colonization occurred despite prematurity, antibiotic use, and feeding methods.
  • Higher L. reuteri abundance correlated with faster achievement of full enteral feeding.
  • Female sex and L. reuteri colonization improved head growth from birth to four weeks.

Conclusions:

  • Lactobacillus reuteri DSM 17938 supplementation leads to successful and sustained colonization in extremely low birth weight infants.
  • L. reuteri colonization may positively influence head growth and feeding advancement in this vulnerable population.
  • Further research can explore optimizing probiotic strategies for ELBW infants based on colonization success and maternal milk factors.

Keywords:
Lactobacillus reuteriantibioticextremely low birth weightfeeding intolerancehuman milk oligosaccharideprematureprobioticrandomised controlled trial

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