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Effects of feeding premature infants with Lactobacillus GG on gut fermentation
E M Stansbridge1, V Walker, M A Hall
1Department of Clinical Biochemistry, Southampton University Medical School, Southampton General Hospital.
Insights
Probiotic Lactobacillus GG did not alter essential gut fermentation in premature infants. While ethanol levels slightly increased, it showed no significant clinical impact, making it a safe option for infant gut health.
Area of Science:
- Neonatal research
- Microbiology
- Gastroenterology
Background:
- Premature infants often experience altered gut microbiota and fermentation.
- Probiotics are explored to modulate infant gut health.
- Lactobacillus GG is a commonly studied probiotic strain.
Purpose of the Study:
- To investigate the effect of Lactobacillus GG on gut carbohydrate fermentation in preterm infants.
- To assess changes in fecal short-chain fatty acids (SCFAs) and ethanol.
- To evaluate urinary 2,3-butanediol as a marker of fermentation.
Main Methods:
- Randomized controlled trial involving 20 preterm infants.
- Intervention group received Lactobacillus GG (10^8 CFU twice daily for two weeks).
- Measurements included fecal SCFAs, ethanol, urinary 2,3-butanediol, and microbial cultures.
Main Results:
- Lactobacillus GG successfully colonized the gut in 9 infants.
- No significant differences in fecal SCFAs (acetic, propionic, butyric acid) were observed between groups.
- Increased detection and concentration of fecal ethanol in the probiotic group.
- Urinary 2,3-butanediol was detected in similar proportions in both groups.
Conclusions:
- Lactobacillus GG supplementation did not adversely affect nutritionally important SCFAs in preterm infants.
- A minor increase in fecal ethanol excretion was noted but deemed clinically insignificant.
- Lactobacillus GG appears to be a safe probiotic for modulating gut fermentation in premature neonates.
Abstract:
The study aimed to find out whether gut colonisation of premature babies with a probiotic, Lactobacillus GG, modified enteric carbohydrate fermentation. Twenty preterm infants were randomised to receive Lactobacillus GG 10(8) colony forming units twice a day for two weeks or to a control group. Faecal short chain fatty acids (SCFAs), ethanol, and urinary 2,3-butanediol, were measured in parallel with microbiological studies. Lactobacillus GG colonised nine babies. From 1-28 days of age faecal SCFAs did not differ significantly from controls. Median and ranges were (treated and controls, respectively): acetic acid: 173 (trace-799), 166 (trace-700); propionic acid: 44 (trace-169), 37 (11-229); butyric acid: 31 (5-107), 37 (2-118) mumol/g dry weight. Ethanol was detected in more faecal samples from treated babies (65% v 37%), and at higher concentration (6.3 (trace-40) v 3.3 (0.6-8.8; one 229) mumol/g). 2,3-Butanediol was found in 66% of urine samples from treated babies and 58% from controls. On 83% of these occasions Klebsiella sp, Enterobacter sp, or Serratia sp were cultured from faeces. Lactobacillus GG had no obvious adverse effects on nutritionally important SCFAs. The small increase in ethanol excretion is unlikely to have clinical significance.