Abstract
Background: Feeding intolerance (FI) is a common condition in premature infants that results in growth retardation and even necrotizing enterocolitis. The gut microbiome is linked to FI occurrence; however, the outcome after FI recovery is unclear.Methods: Fecal samples were collected from 11 pairs of premature twins/triplets for 16S rRNA gene sequencing. Initial fecal samples were collected shortly after admission, and then every other week until 7 weeks or discharge.Results: After FI recovery, there was no significant difference in the β-diversity of the intestinal flora between the FI group and the feeding tolerance (FT) group. By contrast, there was a significant difference in the β-diversity. Proteobacteria was the predominant phylum in the microbiome of the FI group, whereas Firmicutes was the predominant phylum in the microbiome of the FT group. The predominant bacteria with LDA >4 between the two groups at 13–15 days after birth, 19–28 days after birth, and at discharge were different, with the proportions of Bacillus, Clostridium butyricum, and Clostridium being highest in the FT group and Firmicutes, unidentified_Clostridiales, and Proteobacteria being highest in the FI group. Similarly, there were significant differences in the relative abundances of KEGG pathways, such as fatty acid metabolism, DNA repair and recombination proteins, energy metabolism, and amino acid metabolism, between the two groups (P < 0.01).Conclusions: There was a significant difference in diversity of the intestinal flora after feeding intolerance recovery. Feeding intolerance may disturb the succession of the intestinal bacterial community.
Highlights
Feeding intolerance (FI), a common condition in premature infants, is caused by an underdeveloped gastrointestinal tract or a disruption in intestinal function
Our results indicate that the effects of FI on the intestinal flora in premature infants continues long after recovery
All premature infants were fed with preterm formula after birth due to lack of breast milk
Summary
Feeding intolerance (FI), a common condition in premature infants, is caused by an underdeveloped gastrointestinal tract or a disruption in intestinal function. Few studies have examined the composition of the gut microbial community in premature infants with FI. The composition of the intestinal microbiome after FI recovery remains unknown. The composition of the gut microbial community can be altered by various factors such as the delivery mode, antibiotic exposure, gestational age at birth, route of feeding, and gender [7, 8]. The search for the causative agent is complicated by differences in the gut microbiome across different infants [11]. Feeding intolerance (FI) is a common condition in premature infants that results in growth retardation and even necrotizing enterocolitis. The gut microbiome is linked to FI occurrence; the outcome after FI recovery is unclear
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