D2 | Abstract 20

Annual NUTRIM Symposium 18 November 2020

APPLIED SCIENCE

Planting the seeds in preventing necrotizing enterocolitis

N. van Best1,2, S. Trepels-Kottek3, P. Savelkoul2, T. Orlikowsky 3, M. Hornef1, J. Penders2

1Institute of Medical Microbiology, RWTH University Hospital Aachen, Aachen, Germany
2Department of Medical Microbiology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
3Institute of Pediatrics, Neonatology, RWTH University Hospital Aachen, Aachen, Germany
Background:
 Oral administration of probiotic bacteria to preterm neonates has been recommended to prevent the development of necrotizing enterocolitis (NEC). The influence of probiotics on the endogenous microbiome, however, has remained incompletely understood.

Study design & methods:
Here, we performed an observational study including 80 preterm neonates born at a gestational age <32-weeks to characterize the persistence of probiotic bacteria after no treatment or oral administration of two different probiotic formula and their influence on the microbial ecosystem during and after the intervention and their association with the development of NEC. Weekly fecal samples were profiled by 16S rRNA sequencing and monitored the presence of the probiotic bacteria by quantitative PCR.

Results:
 Microbiota profiles differed significantly between the control group and both probiotic groups. Probiotic supplementation was associated with lower temporal variation as well as higher relative abundance of Bifidobacterium and Enterobacter combined with reduced abundance of Escherichia, Enterococcus and Klebsiella. Colonization by probiotic bifidobacteria was observed in approximately 50% of infants although it remained transient in the majority of cases. A significantly reduced monthly incidence of NEC was observed in neonates supplemented with probiotics.

Conclusion:
 Our results demonstrate successful transient colonization by probiotic bacteria and a significant influence on the endogenous microbiota with a reduced abundance of bacterial taxa associated with the development of NEC. These results emphasizes that probiotic supplementation may allow targeted manipulation of the microbiota and confer a clinical benefit.
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