Article

The intestinal bacterial colonisation in preterm infants: A review of the literature

Department of Pediatrics, VU University Medical Center, Amsterdamo, North Holland, Netherlands
Clinical Nutrition (Impact Factor: 4.48). 07/2006; 25(3):361-8. DOI: 10.1016/j.clnu.2006.03.002
Source: PubMed

ABSTRACT

The aim of this study is to review the normal development of the intestinal microflora of preterm infants and the factors influencing its development. Preterm infants have an increased intestinal permeability, which may lead to bacterial translocation to systemic organs and tissues. In combination with immaturity of the immune system the risk to systemic infections might be increased. Especially potential pathogenic bacteria are able to translocate. The intestinal microflora of breast-fed term infants, dominated by bifidobacteria and lactobacilli, is thought to suppress the growth of potentially pathogenic bacteria. Many attemps have been made to stimulate the presence of bifidobacteria and lactobacilli with changes in the diet and ingredients-like prebiotics and probiotics. After selection, six studies were included reviewing the intestinal bacterial colonisation of preterm infants. In general, these studies show that the intestinal bacterial colonisation with beneficial bacteria is delayed in preterm infants. The number of potentially pathogenic bacteria is high. Antibiotics influence the intestinal colonisation. Many preterm infants receive prophylactic antibiotics at birth. As antibiotics delay the normal intestinal colonisation, caution should be given to the treatment with broadspectrum antibiotics in preterm infants at birth and every attempt has to be made to restrict the period of treatment.

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    • "These results suggest an increased activity of DSS because of antepartum antibiotic exposure, as assessed by disease severity and colonic damage, compared to the control. This is in agreement with other studies where the use of broad-spectrum antibiotics in the antepartum period was shown to alter expression of genes involved in gastrointestinal tract development, particularly the architecture and functionality of the intestinal barrier [15]. It is important to emphasize, however, that the course of systemic inflammation as measured by CRP showed different response as the ATB-DSS group had lower level of CRP compared to that of Control-DSS group, which is in contrast to histological and disease severity indices, suggesting a different mode of action. "

    Full-text · Article · Nov 2015 · PLoS ONE
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    • "These results suggest an increased activity of DSS because of antepartum antibiotic exposure, as assessed by disease severity and colonic damage, compared to the control. This is in agreement with other studies where the use of broad-spectrum antibiotics in the antepartum period was shown to alter expression of genes involved in gastrointestinal tract development, particularly the architecture and functionality of the intestinal barrier [15]. It is important to emphasize, however, that the course of systemic inflammation as measured by CRP showed different response as the ATB-DSS group had lower level of CRP compared to that of Control-DSS group, which is in contrast to histological and disease severity indices, suggesting a different mode of action. "
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    • "In previous studies in preterm and term infants, supplementation with neutral oligosaccharides stimulated a bifidogenic intestinal microflora with a decrease of pathogens. [10], [15], [16] Newborn infants have an immune system which is skewed towards a Th-2 profile. [17] Human milk oligosaccharides have been shown to influence the modulation of the balance of Th1/Th2 immunity. "
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    ABSTRACT: In preterm infants, a decreased immunological response and lower serological effectiveness are observed after immunizations due to ineffectiveness of both humoral and cellular immune mechanisms. To determine the effect of 80% neutral oligosaccharides [small-chain galacto-oligosaccharides/long-chain fructo-oligosaccharides (scGOS/lcFOS)] in combination with 20% pectin-derived acidic oligosaccharides (pAOS) on antibody concentrations after DTaP-IPV-Hib immunization in preterm infants. In this randomized clinical trial, preterm infants with gestational age <32 weeks and/or birth weight <1500 g received enteral supplementation with scGOS/lcFOS/pAOS or placebo (maltodextrin) between days 3 and 30 of life. Blood samples were collected at 5 and 12 months of age. In total, 113 infants were included. Baseline and nutritional characteristics were not different in both groups. Geometric mean titers were not different after prebiotic supplementation at 5 months, Ptx (37/44 EU/ml), FHA (78/96 EU/ml), Prn (78/80 EU/ml), Diphtheria (0.40/0.57 IU/ml), Tetanus (0.74/0.99 IU/ml) and Hib (0.35/0.63 µg/ml), and at 12 months Ptx (55/66 EU/ml), FHA (122/119 EU/ml), Prn (116/106 Eu/ml), Diphtheria (0.88/1.11 IU/ml), Tetanus (1.64/1.79 IU/ml) and Hib (2.91/2.55 µg/ml). Enteral supplementation of neutral (scGOS/lcFOS) and acidic oligosaccharides (pAOS) does not improve the immunization response in preterm infants. Controlled-Trials.com ISRCTN16211826 ISRCTN16211826.
    Full-text · Article · Aug 2013 · PLoS ONE
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