RT Journal Article
SR Electronic
T1 The preterm microbiome in UK infants exposed to modern intensive care infection control practices
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP Fa39
OP Fa40
DO 10.1136/archdischild.2011.300164.77
VO 96
IS Suppl 1
A1 J Perry
A1 N Embleton
A1 M Narayanan
A1 J Kerr
A1 E Marrs
A1 S Migorrian
A1 J Berrington
YR 2011
UL http://fn.bmj.com/content/96/Suppl_1/Fa39.5.abstract
AB Background The importance of the microbiome to the health of preterm infants is increasingly recognised. Much of the data on microbiome development in preterm infants is from 15–30 years ago: infants, nursery practices, infection control measures and antibiotic use are now very different. Objective To describe gut colonisation in modern preterm infants (<32 weeks) in comparison to existing data and explore differences in infants developing necrotising enterocolitis (NEC). Methods The first stool, and weekly stool was collected as routine surveillance from birth to 8 weeks. A standard operating procedure was developed to identify the maximum numbers of species and strains of organisms present by standard culture. Results 100 stools came from 38 infants, median gestational age 27 weeks (23–32 weeks), birth weight 895 g (520–1850 g). 35 received breast milk, 29 received fluconazole prophylaxis. Stools grew a median of three separately identifiable species/strains of organisms (range 0–8). The commonest organism was CONS (40% of stools, 55% of babies). Only six infants were ever colonised with lactobacilli, 1 with bifidobacteria and none with fungi. Eight infants had NEC (4 surgical). Those with NEC had more Enterococci (75% vs 23%) and Klebsiella (62% vs 32%). Conclusions Compared to historical data we identified less species diversity, more colonisation with coagulase negative staphylococci, less lacto- and bifidobacteria, and no fungi. Infants developing NEC had different colonisation patterns. Current exposures on NICU result in a significantly abnormal microbiome and may predispose to NEC.