Dynamics and clinical evolution of bacterial gut microflora in extremely premature patients.
OBJECTIVE
To determine baseline clinical characteristics that influence bacterial gut flora dynamics in very preterm infants and the relationship between gut flora dynamics and clinical evolution.


METHODS
Prospective, monocentric study enrolling 29 consecutive very preterm infants. We collected data about growth, digestive tolerance, nutrition, and antibiotic use. Microflora in stool samples, collected between 3 and 56 days of life, was identified with direct molecular fingerprinting.


RESULTS
Median (interquartile range) body weight and gestational age at birth were 950 g (760-1060 g) and 27 weeks (27-29 weeks), respectively. The diversity score (number of operational taxonomic units) increased 0.45 units/week (P < .0001), with staphylococci as the major group. Bifidobacterium was poorly represented. Gestational age (≥ 28 weeks) and caesarean delivery independently correlated with better diversity scores during follow-up (P < .05). The 6-week diversity score inversely correlated with the duration of antibiotherapy (P = .0184) and parenteral feeding (P = .013). The microflora dynamics was associated with the digestive tolerance profile. Weight gain increased with increasing diversity score (P = .0428).


CONCLUSIONS
Microflora diversity settled progressively in very preterm infants. Staphylococci were the major group, and few infants were colonized with Bifidobacterium spp. Measures that may improve microflora could have beneficial effects on digestive tolerance and growth.
Centre Hospitalier Universitaire de Montpellier, Hopital Arnaud de Villeneuve, Service de neonatalogie, Montpellier, France.
Aurelien
A
Jacquot
Dorine
D
Neveu
Fabien
F
Aujoulat
Gregoire
G
Mercier
Hélène
H
Marchandin
Estelle
E
Jumas-Bilak
Jean-Charles
JC
Picaud
D001419:Bacteria / Q000254:growth & development*; D044822:Biodiversity; D016172:DNA Fingerprinting; D004063:Digestion; D005243:Feces / Q000382:microbiology; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007422:Intestines / Q000382:microbiology*; D054892:Metagenome; D011446:Prospective Studies