Effects of Probiotic Supplementation on the Gut Microbiota and Antibiotic Resistome Development in Preterm Infants
Open Access
- 16 November 2018
- journal article
- research article
- Published by Frontiers Media SA in Frontiers in Pediatrics
- Vol. 6, 347
- https://doi.org/10.3389/fped.2018.00347
Abstract
Objectives: In 2014 probiotic supplementation (Lactobacillus acidophilus and Bifidobacterium longum subspecies infantis; Infloran®) was introduced as standard of care to prevent necrotizing enterocolitis (NEC) in extremely preterm infants in Norway. We aimed to evaluate the influence of probiotics and antibiotic therapy on the developing gut microbiota and antibiotic resistome in extremely preterm infants, and to compare with very preterm infants and term infants not given probiotics. Study design: A prospective, observational multicenter study in six tertiary-care neonatal units. We enrolled 76 infants; 31 probiotic-supplemented extremely preterm infants Results: Median (IQR) birth weight was 835 (680–945) g and 1,290 (1,150–1,445) g in preterm infants exposed and not exposed to probiotics, respectively. Two extremely preterm infants receiving probiotic developed NEC requiring surgery. At 7 days of age we found higher median relative abundance of Bifidobacterium in probiotic supplemented infants (64.7%) compared to non-supplemented preterm infants (0.0%) and term control infants (43.9%). Lactobacillus was only detected in small amounts in all groups, but the relative abundance increased up to 4 months. Extremely preterm infants receiving probiotics had also much higher antibiotic exposure, still overall microbial diversity and resistome was not different than in more mature infants at 4 weeks and 4 months. Conclusion: Probiotic supplementation may induce colonization resistance and alleviate harmful effects of antibiotics on the gut microbiota and antibiotic resistome. Clinical Trial Registration: Clinicaltrials.gov: NCT02197468. https://clinicaltrials.gov/ct2/show/NCT02197468This publication has 58 references indexed in Scilit:
- Association of the gut microbiota mobilome with hospital location and birth weight in preterm infantsPediatric Research, 2017
- Antibiotic resistance potential of the healthy preterm infant gut microbiomePeerJ, 2017
- New Medical and Surgical Insights Into Neonatal Necrotizing EnterocolitisJAMA Pediatrics, 2017
- Prevention of necrotizing enterocolitis with probiotics: a systematic review and meta-analysisPeerJ, 2016
- Bifidobacterium breve BBG-001 in very preterm infants: a randomised controlled phase 3 trialThe Lancet, 2015
- Power and sample-size estimation for microbiome studies using pairwise distances and PERMANOVABioinformatics, 2015
- Development of the preterm infant gut microbiome: a research priorityMicrobiome, 2014
- STAMP: statistical analysis of taxonomic and functional profilesBioinformatics, 2014
- Probiotic Effects on Late-onset Sepsis in Very Preterm Infants: A Randomized Controlled TrialPEDIATRICS, 2013
- An antibiotic policy to prevent emergence of resistant bacilliThe Lancet, 2000