Altered gut microbiota is associated with feeding intolerance in preterm infants

Abstract

Background. Feeding intolerance (FI) is a common complication that may cause great harm to preterm infants. The mechanism of FI remains unclear, but probiotics may help prevent and alleviate its symptoms. We hypothesized that the alteration in gut microbiota may be associated with the development of FI. Our study aimed to investigate the association between gut microbiota and FI in preterm infants. Methods. Ninety-seven preterm infants were divided into the FI group (N=42) and the feeding tolerance (FT) group (N=55) depending on whether the infants were diagnosed with FI. The fecal samples of each infant were collected on the 7th day after birth. Fecal microbiota was analyzed by 16S rRNA sequencing. Plasma motilin were detected on day-1, 7, 14, and 21. Results. The microbial diversity of the FI group was significantly lower than that of the FT group. The abundance levels of phylum Proteobacteria, class Gammaproteobacteria, genera such as Escherichia/Shigella were higher in the FI group than in the FT group. The abundance levels of phylum Firmicutes, class Negativicutes, and genus Veillonella were higher in the FT group than in the FI group. The motilin levels on days 7 and 14 were negatively correlated with the FI-enriched genera Planomicrobium and Vibrio, respectively. Our study also found gut microbiota was correlated with FI clinical characteristics, including gestational age, birth weight, age of FI diagnosis, age of FI disappearance, and FI duration. Conclusions. Altered gut microbiota is associated with FI in preterm infants. FI cases typically have lower microbial diversity, a decreased abundance of beneficial bacteria, and an increased abundance of pathogenic bacteria. Gut microbiota is correlated with the clinical characteristics of FI. The decrease in motilin secretion caused by some bacteria may lead to the occurrence of FI.

Dynamics and Crosstalk between Gut Microbiota, Metabolome, and Fecal Calprotectin in Very Preterm Infants: Insights into Feeding Intolerance

“…Altered gut microbiome have been implicated in the progressions of FI. Several studies have explored the microbial alterations in preterm infants with FI, revealing reduced diversity, changes in microbial distribution, and an increased relative abundance of the Proteobacteria phylum and Klebsiella genus [11][12][13][14][15]. However, due to variations in study populations, sampling time points, and sampling frequency, definitive conclusions have not yet been reached.…”

A digital twin of the infant microbiome to predict neurodevelopmental deficits

“…As an example, we found that most preterm infants would benefit from increased enteral feeding amounts as expected, but the reduction in risk of SHCG was not as impactful as microbiome supplantation, and further, there was a smaller subset of infants for which increasing enteral feeding amounts would greatly increase the risk of SHCG. Feeding intolerance of preterm infants has been linked to dysbiosis of the gut microbiome ( 74 , 75 ), and certain randomized controlled trials of probiotic administration to preterm infants in the NICU demonstrate decreased incidences of feeding intolerance ( 76 – 78 ). Therefore, our methodology is additionally able to resolve when non–microbiome-based interventions may be more appropriate, and also when such interventions would likely be inappropriate given the underlying microbiome structure of the infant such as ramping up enteral feeds.…”

Characteristics of Gut Microbiota in Small for Gestational Age Infants with Very Low Birth Weight

“…The influence of the microbiome on compensatory growth or extrauterine growth restriction (EUGR) was not included because the weight of most of the SGA infants was still below the 10th percentile at the time of discharge. Feeding, weight gain, and catch-up growth are related to microbial community structure [ 10 , 22 , 52 , 53 , 54 , 55 ]. In a rat model, the decrease in the abundance of Lactobacillus was significantly associated with catch-up growth [ 10 ].…”