Influence of Family Integrated Care on the Intestinal Microbiome of Preterm Infants With Necrotizing Enterocolitis and Enterostomy: A Preliminary Study.

Mengyang Yang,Min Jiang,Juan Du,Wenyan Dou,Mingyan Hei,Qin Yang

doi:10.3389/fped.2021.678254

Abstract

The aim of this study was to investigate the influence of family integrated care (FICare) on the intestinal microbiome of preterm infants with necrotizing enterocolitis and enterostomy. This was a prospective pilot study at Beijing Children's Hospital. Premature infants with an enterostomy who met the enrollment criteria were divided into the 2-week FICare and non-FICare groups (non-randomly). We collected their fecal samples and subjected the intestinal microbiomes to 16S rRNA gene sequencing. Operational taxonomic units (OTU) were analyzed to assess the intestinal microbiome richness, and we then carried out α-diversity, β-diversity, and species clustering analyses and a linear discriminant analysis (LDA) effect size (LEfSe) analysis to identify the differences in the microbial communities between the two groups. There were 12 patients enrolled in the study (FICare, n = 7; non-FICare, n = 5). There were no significant between-group differences in demographic characteristics, or in the relative abundances of phyla and genera. The major bacterial phyla were Proteobacteria, Firmicutes, and Actinobacteria, and Serratia, Enterococcus, Cronobacter, and Bifidobacterium dominated at the genus level. The α-diversity analysis indicated that the intestinal flora was more diverse in the non-FICare group than the FICare group (p < 0.05). However, most of the other indicators did not suggest a difference between the two groups. There was a high proportion of shared OTUs between the two groups, and the PCoA and clustering analyses indicated that the two groups were difficult to distinguish, indicating that the intestinal microbiomes were relatively similar between the groups. In summary, short-term FICare had no significant positive effect on the establishment of intestinal flora diversity in premature infants with necrotizing enterocolitis and enterostomy. The trial was registered in the Chinese Clinical Trial Registry (ChiCTR-OPN-17011801).

Highlights

The gut microbiota is a major factor influencing both health and disease [1]
Premature infants who were diagnosed with necrotizing enterocolitis (NEC) and underwent enterostomy followed by a stay in the neonatal intensive care unit (NICU) at Beijing Children’s Hospital were divided into the family integrated care (FICare) group and the non-FICare group
The exclusion criteria were as follows: (a) need for invasive ventilation; (b) major congenital anomaly or metabolic disease; (c) family unwilling to commit to staying in the hospital for more than 6 hours per day;(d) lack of consent; (e) birth weight (BW) < 400 g; (f) parental social factors or language barriers, that affect the treatment of the infant; (g) possible discharge within 2 weeks; and (h) oral intestinal probiotics taken after birth

Summary

Introduction

The gut microbiota is a major factor influencing both health and disease [1]. The composition and development of the microbiota during early life affects health into adulthood [2]. Infants who need intensive care are usually nursed in highsanitary incubators, receive antibiotics, have restricted breastmilk intake, and have limited contact with the mother’s skin. These factors all affect the development of the gut microbiota [3]. FICare provides more mother-to-child contact and more breastfeeding opportunities for premature babies in their early lives, which could improve the intestinal microbiome of premature infants in the NICU

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