Bifidobacterium bacteraemia is rare with routine probiotics use in preterm infants: A further case report with literature review

Area of Science:

• Neonatal Medicine
• Microbiology
• Gastroenterology

Background:

• Prophylactic oral probiotics are widely used to prevent necrotising enterocolitis (NEC) in preterm infants.
• Necrotising enterocolitis poses a significant threat to the health and survival of premature neonates.
• The safety profile of probiotics in extremely vulnerable infant populations requires ongoing scrutiny.

Approach:

• A case study documenting a rare clinical event in an extremely low birth weight preterm infant.
• Utilized whole genome sequencing to compare the bacterial isolate with the probiotic strain.
• Investigated a potential link between probiotic administration and sub-clinical bacteraemia.

Key Points:

• First reported case of sub-clinical bacteraemia due to Bifidobacterium longum subsp. infantis in a preterm infant receiving routine probiotics.
• The isolated bacterial strain was genetically confirmed to likely originate from the administered probiotic product.
• This event occurred after 10 years of routine probiotic use at a major UK hospital.

Conclusions:

• While generally safe and effective, probiotic administration in preterm infants carries a potential, albeit rare, risk of bacteraemia.
• This case highlights the importance of continued surveillance and investigation into the safety of probiotic interventions in neonatal intensive care units.
• Further research may be warranted to understand the specific conditions predisposing extremely low birth weight infants to such events.