Bacterial colonization and gut development in preterm neonates

被引:99
作者
Cilieborg, Malene S. [1 ,2 ]
Boye, Mette [2 ]
Sangild, Per T. [1 ]
机构
[1] Univ Copenhagen, Dept Human Nutr, Fac Life Sci, DK-1870 Frederiksberg C, Denmark
[2] Tech Univ Denmark, Natl Vet Inst, DK-1790 Copenhagen, Denmark
关键词
Gut colonization; Preterm neonates; Preterm pig model; LOW-BIRTH-WEIGHT; FORMULA-FED INFANTS; NECROTIZING ENTEROCOLITIS; INTESTINAL FLORA; ENTERAL NUTRITION; PREMATURE-INFANTS; FECAL MICROFLORA; BREAST-MILK; BIFIDOBACTERIUM BREVE; MICROBIAL ECOLOGY;
D O I
10.1016/j.earlhumdev.2011.12.027
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Necrotizing enterocolitis (NEC) develops in 5-10% of preterm infants in association with enteral feeding and bacterial colonization. It remains unclear how diet and bacteria interact to protect or provoke the immature gastrointestinal tract. Understanding the factors that control bacterial colonization may provide the clue to prevent NEC, and studies in infants must be combined with animal models to understand the mechanisms of the microbiota-epithelium interactions. Analyses of infant fecal samples show that the density and distribution of bacterial species are highly variable with no consistent effects of gestational age, delivery mode, diet or probiotic administration, while low bacterial diversity and bacterial overgrowth are commonly associated with NEC. A series of recent studies in preterm pigs show that the mucosa-associated microbiota is affected by delivery method, prematurity and NEC progression and that diet has limited effects. Overgrowth of specific groups (e.g. Clostridia) appears to be a consequence of NEC, rather than the cause of NEC. Administration of probiotics either decreases or increases NEC sensitivity in preterm pigs, while in preterm infants probiotics have generally decreased NEC incidence and overall mortality. The optimal nature and amount of probiotic bacteria are unknown and host defense factors appear more important for NEC sensitivity than the nature of the gut microbiota. Host defense is improved by feeding the optimal amount of enteral diets, such as mother's colostrum or milk, that help the immature intestinal immune system to respond appropriately to the highly variable bacterial colonization. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:S41 / S49
页数:9
相关论文
共 103 条
[31]   Stool microflora in extremely low birthweight infants [J].
Gewolb, IH ;
Schwalbe, RS ;
Taciak, VL ;
Harrison, TS ;
Panigrahi, P .
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION, 1999, 80 (03) :F167-F173
[32]   Necrotising enterocolitis: The state of the science [J].
Gibbs, Kathleen ;
Lin, Jing ;
Holzman, Ian R. .
INDIAN JOURNAL OF PEDIATRICS, 2007, 74 (01) :67-72
[33]   Reciprocal Expression and Signaling of TLR4 and TLR9 in the Pathogenesis and Treatment of Necrotizing Enterocolitis [J].
Gribar, Steven C. ;
Sodhi, Chhinder P. ;
Richardson, Ward M. ;
Anand, Rahul J. ;
Gittes, George K. ;
Branca, Maria F. ;
Jakub, Adam ;
Shi, Xia-hua ;
Shah, Sohail ;
Ozolek, John A. ;
Hackam, David J. .
JOURNAL OF IMMUNOLOGY, 2009, 182 (01) :636-646
[34]   Maternal breast-milk and intestinal bifidobacteria guide the compositional development of the Bifidobacterium microbiota in infants at risk of allergic disease [J].
Groenlund, M. -M. ;
Gueimonde, M. ;
Laitinen, K. ;
Kociubinski, G. ;
Groenroos, T. ;
Salminen, S. ;
Isolauri, E. .
CLINICAL AND EXPERIMENTAL ALLERGY, 2007, 37 (12) :1764-1772
[35]   Fecal microflora in healthy infants born by different methods of delivery:: Permanent changes in intestinal flora after cesarean delivery [J].
Grönlund, MM ;
Lehtonen, OP ;
Eerola, E ;
Kero, P .
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, 1999, 28 (01) :19-25
[36]   Breast milk: A source of bifidobacteria for infant gut development and maturation? [J].
Gueimonde, Miguel ;
Laitinen, Kirsi ;
Salminen, Seppo ;
Isolauri, Erika .
NEONATOLOGY, 2007, 92 (01) :64-66
[37]   Sever Sepsis After Probiotic Treatment With Escherichia coli NISSLE 1917 [J].
Guenther, Katrin ;
Straube, Eberhardt ;
Pfister, Wolfgang ;
Guenther, Albrecht ;
Huebler, Axel .
PEDIATRIC INFECTIOUS DISEASE JOURNAL, 2010, 29 (02) :188-189
[38]   FACTORS INFLUENCING THE PRESENCE OF FECAL LACTOBACILLI IN EARLY INFANCY [J].
HALL, MA ;
COLE, CB ;
SMITH, SL ;
FULLER, R ;
ROLLES, CJ .
ARCHIVES OF DISEASE IN CHILDHOOD, 1990, 65 (02) :185-188
[39]   Effects of mode of delivery and necrotising enterocolitis on the intestinal microflora in preterm infants [J].
Hällström, M ;
Eerola, E ;
Vuento, R ;
Janas, M ;
Tammela, O .
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2004, 23 (06) :463-470
[40]   Analysis of intestinal flora development in breast-fed and formula-fed infants by using molecular identification and detection methods [J].
Harmsen, HJM ;
Wildeboer-Veloo, ACM ;
Raangs, GC ;
Wagendorp, AA ;
Klijn, N ;
Bindels, JG ;
Welling, GW .
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, 2000, 30 (01) :61-67