Abstract
The very low birth weight (VLBW) infant is at great risk for marked dysbiosis of the gut microbiota. In the present study, a total of 36 VLBW infants were randomly divided into two groups, who were treated with combined probiotics and placebo, and 72 fecal specimens on days 14 and 28 of life were collected from them. Finally, 32 fecal specimens extracted from 16 preterm VLBW infants were qualified and analyzed using 16S rRNA gene sequencing. The primary outcome was to evaluate the change of gut microbiota in VLBW infants after combined probiotic supplement. The secondary outcome was to analyze the correlation gut microbial composition and levels of cytokines. We found that probiotic treatment, but not placebo, decreased the α-diversity of gut microbiota in VLBW infants. At the phylum level, probiotic treatment strongly increased the abundance of Firmicutes, whereas that of Proteobacteria was significantly reduced. At the family level, Streptococcaceae and Lactobacillaceae became prevalent after probiotic treatment, while the relative abundance of Enterobacteriaceae was reduced in the meantime. Most notably, significant correlations were observed between Lactobacillaceae abundance and serum cytokine levels. Further studies are required to shed more light on the characteristics of gut microbiota of VLBW neonates. And the modulation of microbiota should be considered to improve the survival rate of VLBW infants.
Highlights
Due to recent advances in the neonatal intensive care, the survival rates of extremely preterm infants were significantly increased over the last 20 years [1]
A total of 72 fecal specimens collected from 36 very low birth weight (VLBW) infants on days 14 and 28 of life were collected
50 fecal specimens extracted from 30 preterm VLBW infants were qualified and underwent 16S rRNA gene sequencing
Summary
Due to recent advances in the neonatal intensive care, the survival rates of extremely preterm infants were significantly increased over the last 20 years [1]. Many meta-analyses of RCTs had shown that oral probiotics effectively reduce NEC and death [3, 4]. An update meta-analyses study showed that multiple strain probiotics could be more effective in preventing NEC and death in extremely preterm infants [5], but it is still unclear which probiotic combinations are most effective [6]. The study about correlation of intestinal microbiome and inflammatory factors is still lacking, especially the coeffect of probiotic supplement on gut microbiome and inflammatory factors. We conducted a randomized, double-blind controlled trial in VLBW infants with a probiotic supplement in order to elucidate the effects of combined probiotics on gut microbial community and inflammatory factors
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