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The bacterial colonization of the large bowel of pre-term low birth weight neonates
Insights
Preterm infants fed breast milk show distinct gut bacteria colonization patterns, with early facultative anaerobes and delayed bifidobacteria. This altered microflora may increase their risk for necrotizing enterocolitis.
Area of Science:
- Microbiology
- Neonatalogy
- Gastroenterology
Background:
- The intestinal microflora plays a critical role in infant health and development.
- Premature infants, particularly those with low birth weight, have unique physiological characteristics that may influence gut colonization.
- Neonatal necrotizing enterocolitis (NEC) is a serious condition affecting premature infants, with altered gut microbiota implicated in its pathogenesis.
Purpose of the Study:
- To investigate the bacterial colonization patterns in the large bowel of preterm, low birth weight neonates fed expressed breast milk.
- To compare the gut microbiota of these preterm infants with full-term breast-fed and formula-fed neonates.
- To explore the potential link between the intestinal microflora composition in preterm infants and their predisposition to necrotizing enterocolitis.
Main Methods:
- Serial fecal sample culturing was performed on preterm neonates (n=11) nourished by expressed breast milk.
- Comparison groups included full-term breast-fed neonates (n=8) and full-term formula-fed neonates (n=7).
- Bacterial populations, including facultative anaerobes, bifidobacteria, Bacteroides spp., and clostridia, were identified and quantified.
Main Results:
- Preterm infants exhibited high counts of facultative anaerobic bacteria from early life.
- Bifidobacteria colonization was delayed in preterm infants, appearing late in the first week or after day 5.
- Early and stable colonization by Bacteroides spp. was observed in preterm infants, differing from both full-term groups.
Conclusions:
- The intestinal microflora of preterm, low birth weight infants differs significantly from that of full-term infants, regardless of feeding method.
- The observed colonization patterns, characterized by abundant facultative anaerobes and delayed bifidobacteria, may contribute to the increased susceptibility of preterm infants to necrotizing enterocolitis.
- Infant feeding regimens have a discernible effect on the development of intestinal microbial populations.
Abstract:
The bacterial colonization of the large bowel of 11 pre-term, low birth weight neonates who were nourished by expressed breast milk was examined by culturing serial faecal samples and compared to that observed in eight breast-fed and seven formula-fed full-term neonates. Pre-term neonates were colonized by high counts of facultatively anaerobic bacteria from the first days of life while bifidobacteria colonized only six babies during the first week and appeared in only one baby before day 5. Bacteroides spp. and clostridia were isolated from seven and six pre-term babies respectively during week 1 and were first observed on day 2. The intestinal colonization of pre-term infants differed from that in full-term breast-fed infants in the high counts of facultatively anaerobic bacteria and late appearance of bifidobacteria, and from both groups of full-term infants in the early stable colonization by Bacteroides spp. It is postulated that the composition of the normal intestinal microflora of pre-term low birth weight babies contributes to their predisposition to neonatal necrotizing enterocolitis. Results are discussed in relation to the effect of infant feeding regimens on intestinal microbial populations.