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Enteral feeding of premature infants with Lactobacillus GG
M R Millar1, C Bacon, S L Smith
1Department of Microbiology, Royal Hampshire County Hospital, Winchester.
Insights
This study found that the probiotic Lactobacillus GG can colonize the immature gut of premature infants. However, it did not reduce harmful bacteria or improve clinical outcomes in these vulnerable infants.
Area of Science:
- Neonatal Medicine
- Microbiology
- Gastroenterology
Background:
- The immature gut of premature infants is susceptible to nosocomial pathogens.
- Probiotics are explored for their potential to modulate gut microbiota and prevent infections.
Purpose of the Study:
- To assess Lactobacillus GG colonization in premature infants' guts.
- To determine if Lactobacillus GG reduces nosocomial pathogens.
- To evaluate the clinical impact of Lactobacillus GG on premature infants.
Main Methods:
- Randomized controlled trial involving 20 preterm infants (≤33 weeks gestational age).
- Infants received either standard milk feeds or milk feeds supplemented with Lactobacillus GG (10^8 CFU twice daily for 2 weeks).
- Clinical progress and fecal pathogen reservoirs were monitored.
Main Results:
- Lactobacillus GG successfully colonized the premature infant gut.
- No significant reduction in the fecal reservoir of enterobacteriaceae, enterococci, yeasts, or staphylococci was observed.
- No positive clinical benefits or improved outcomes were evident for infants receiving Lactobacillus GG.
Conclusions:
- While Lactobacillus GG can colonize the immature gut, it does not appear to reduce pathogen load or offer clinical advantages in preterm infants.
- Further research may be needed to explore other probiotic strains or different administration strategies for this population.
Abstract:
The objectives of this study were to determine whether or not the probiotic Lactobacillus GG can colonise the immature bowel of premature infants and if so, does colonisation result in a reduction of the size of the bowel reservoir of nosocomial pathogens such as enterobacteriaceae, enterococci, yeasts or staphylococci, and does colonisation with Lactobacillus GG have any effect on the clinical progress and outcome. Twenty preterm infants with a gestational age of 33 weeks or less who were resident on a neonatal unit were studied from the initiation of milk feeds until discharge. The infants were randomised to receive either milk feeds or milk feeds supplemented with Lactobacillus GG 10(8) colony forming units twice a day for two weeks. The clinical features of the two groups of infants were similar. Orally administered Lactobacillus GG was well tolerated and did colonise the bowel of premature infants. However, colonisation with Lactobacillus GG did not reduce the faecal reservoir of potential pathogens and there was no evidence that colonisation had any positive clinical benefit for this particular group of infants.