99 Intestinal Flora and Fecal Calprotectin in VLBW Infants

Abstract

Background: The early bacterial colonization of the intestine post partum may affect gut inflammation and risk for disease. Very low birth weight infants (VLBW, 100 000 CFU/g feces was 68% for lactic acid bacteria (LAB), 37% for other gram positive bacteria (GP) and 37% for gram negative bacteria (GN). LAB and GN counts in feces increased with postnatal age (p=0.001 and p<0.001). There was a positive correlation between LAB and GN counts (r=0.32, p<0.001) and between LAB and GP counts (r=0.44, p<0.001). In post-meconium samples, there was a positive correlation between GN and f-calprotectin (r=0.40, p<0.001) and between GP and f-calprotectin (r=0.22, p=0.024). Antibiotic use was associated with lower GN counts (odds ratio 4.5 [2.1–9.8] for counts < 100 000 CFU/g). Discussion: Compared to previous studies of VLBW infants, the proportion of LAB was surprisingly high. This may be explained by the fact that all infants in our study were fed breast milk. Non-LAB-bacteria (GN and GP) increase intestinal inflammation as measured by f-calprotectin and this may possibly have negative health consequences. Our results suggest that antibiotics reduce f-calprotectin by reducing GN. Probiotics may be effective in this risk population.