Longitudinal changes in the gut microbiome of infants on total parenteral nutrition

Abstract

Background: Animal studies suggest that total parenteral nutrition (TPN) may alter bacterial colonization of the intestinal tract and contribute to complications. Progressive changes in gut microbiome of infants receiving TPN are not well understood. Methods: Infants with and without TPN/soy lipid were enrolled in a prospective, longitudinal study. Weekly fecal samples were obtained for the first 4 weeks of life. High throughput pyrosequencing of 16S rDNA was used for compositional analysis of the gut microbiome. Results: 47 infants were eligible for analyses, 25 infants received TPN and 22 infants did not (control). Although similar between TPN and control groups in the first week, fecal bacterial alpha diversity was significantly lower in the TPN group compared to controls at week 4 (Shannon index 1.0 vs 1.5, P-value = 0.03). The TPN group had significantly lower Bacteroidetes and higher Verrucomicrobia abundance compared to controls (P-values <0.05), and these differences became more pronounced over time. At the genus level, TPN was associated with lower abundance of Bacteroides and Bifidobacterium in all weeks. Conclusions: TPN is associated with significant loss of biodiversity and alterations in the pattern of gut microbial colonization of infants over time. TPN-associated dysbiosis may predispose infants to adverse NICU outcomes.

Enteral Nutrition in Pediatric Patients Undergoing Hematopoietic SCT Promotes the Recovery of Gut Microbiome Homeostasis

“…Although post-HSCT enteral feeding is being increasingly recommended [37][38][39], intravenous nutrient intake (PN) is still the first-line nutritional approach for the patients who received HSCT due to its compliance, but it has been associated with several clinical and microbiological adverse effects, including infections and GM dysbiosis [18][19][20][21][22][23][24]. So far, the central role of the GM composition and biodiversity in patients undergoing HSCT has been largely evaluated in several publications, highlighting the disruption of the gut microbial mutualistic asset after the transplant (i.e., until 30 days post-HSCT) compared to the baseline, due to all HSCT conventional treatments that can alter the GM recovery possibilities post-HSCT [4,5,7].…”

“…EN, also called "tube-feeding", is the method by which food is directly delivered inside the patient's gastrointestinal tract, while PN is an effective strategy of delivering nutrients directly into the bloodstream. Nowadays, it is well known that total PN, the first-line approach for HSCT patients, is associated with different clinical adverse effects such as infections [18][19][20] and metabolic disorders [21], as well as with gut mucosal atrophy [22], cell dysfunction [23], and alterations in GM composition [24]. Conversely, EN has been indicated as a possible solution to overcome all these adverse effects.…”

Probiotic Supplementation during the Perinatal and Infant Period: Effects on gut Dysbiosis and Disease

“…The colonization of pathogenic microbes, which leads to dysbiosis in preterm infants, is linked to the delayed introduction of human milk, early antibiotic intervention, a high rate of caesarean delivery, and total parenteral nutrition [152]. This last factor is associated with a lower abundance of Bacteroides and Bifidobacterium and a significant loss of biodiversity [153].…”

The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition

“…Data regarding the changes in the microbiome of humans receiving parenteral nutrition are limited. However, studies performed in newborns receiving parenteral nutrition have reported progressive changes in their microbiome with a significantly lower abundance of Bacteroidetes and a greater abundance of Verrucomicrobia in comparison with the controls [81]. In addition, the enrichment of Clostridium species was observed [82,83].…”