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Updated: Aug 20, 2025
Probiotic Studies in Neonatal Mice Using Gavage
Published on: January 27, 2019
Impact of a multi-strain probiotic administration on peri-rectal colonization with drug-resistant Gram-negative
Marwyn Sowden1, Evette van Niekerk1, Andre Nyandwe Hamama Bulabula2
1Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Insights
A multi-strain probiotic significantly reduced drug-resistant Gram-negative bacteria colonization in preterm neonates. This intervention proved effective in preventing early and late gut colonization by these resistant bacteria.
Area of Science:
- Neonatal Medicine
- Microbiology
- Clinical Trials
Background:
- Drug-resistant Gram-negative bacteria (DR-GNB) pose a significant threat to hospitalized preterm neonates globally.
- Investigating interventions to prevent DR-GNB colonization is crucial for improving neonatal outcomes.
Purpose of the Study:
- To evaluate the efficacy of a multi-strain probiotic in reducing rectal colonization with DR-GNB in preterm neonates.
- To assess the impact of probiotics on both early and late stages of gut colonization.
Main Methods:
- A double-blind, placebo-controlled, randomized clinical trial.
- 200 preterm neonates were randomized to receive either a multi-strain probiotic (n=100) or a placebo (n=100).
- Peri-rectal colonization with DR-GNB was assessed at enrolment, day 7, and day 14.
Main Results:
- Initial DR-GNB colonization was observed in 15% of neonates at enrolment.
- Rapid acquisition of DR-GNB occurred, increasing to 77% by day 7 and 83% by day 14.
- Probiotic group showed a 57% reduction in DR-GNB colonization by day 7 (OR: 0.43) and a 93% reduction by day 14 (OR: 0.07).
Conclusions:
- Preterm neonates experience significant DR-GNB colonization early in life.
- A multi-strain probiotic effectively reduces both early and late neonatal gut colonization with DR-GNB.
- Probiotic intervention offers a promising strategy to combat DR-GNB in vulnerable preterm infants.
Background:
Infections caused by drug resistant Gram-negative bacteria (DR-GNB) are a major health concern for hospitalized preterm neonates, globally. The aim of this study was to investigate the effect of a multi-strain probiotic on the incidence of rectal colonization with DR-GNB in preterm neonates.
Methods:
A double-blind, placebo-controlled, randomized clinical trial was conducted including 200 neonates, randomly allocated to a multi-strain probiotic (n = 100) or placebo (n = 100).
Results:
Fifteen percent of the neonates showed peri-rectal colonization with DR-GNB on the day of enrolment indicating probable maternal-to-neonate (vertical) bacterial transmission or environmental acquisition at time of delivery, with no difference between groups. Acquisition of further DR-GNB colonization was rapid, with an increase from 15% on the day enrolment to 77% by day 7 and 83% by day 14 of life. By day 7 (corresponding to early gut colonization), neonates in the probiotic group were 57% less likely to have peri-rectal DR-GNB colonization [OR: 0.43 (0.20-0.95); p = 0.04] and by day 14 (corresponding to late gut colonization), neonates in the probiotic group were 93% less likely to have peri-rectal DR-GNB colonization [OR: 0.07 (0.02-0.23); p < 0.001].
Conclusion:
Hospitalized neonates showed substantial peri-rectal colonization with DR-GNB at enrolment and further rapid acquisition of DR-GNB in the first 2 weeks of life. The use of a multi-strain probiotic was effective in reducing early and late neonatal gut colonization with DR-GNB.
Clinical Trial Registration:
The trial was registered at the Pan African Clinical Trial Registry (PACTR202011513390736).
