Intestinal microbiota in neonates requiring urgent surgery: assessing the role of probiotics using fecal DNA sequencing.

Purpose: To assess the impact of urgent surgery on neonates and the value of an orally administered probiotic preparation of Bifidobacterium animalis subsp. lactis LKM512 (LKM) using fecal DNA sequencing to analyze intestinal microbiota.

Methods: Subjects for this study were 13 neonates born at our institution. Surgical cases required surgery within 3 days of birth. Groups studied were surgical cases administered LKM (n = 4; LKM+), surgical cases not administered have surgery and were not administered LKM (n = 2; CS), and normal healthy neonates (n = 3; CN). Stool specimens (20 mg) were collected five times (after birth, and on days 3, 7, 10, and 14 after surgery in surgical cases, and after birth, and on days 4, 8, 11, and 15 of life in controls).

Results: Clinical data were similar for LKM+ and LKM-. Enterobacteriaceae, Streptococcaceae, Staphylococcaceae and Bifidobacteriaceae were identified in the descending order of abundance in CS stool. Streptococcaceae, Staphylococcaceae, Enterococcaceae and Bifidobacteriaceae were identified in the descending order of abundance in LKM+ stool. Bifidobacteriaceae, Enterobacteriaceae, Staphylococcaceae and Streptococcaceae were identified in the descending order of abundance in LKM- stool. Unexpectedly, Bifidobacteriaceae was significantly more abundant in LKM- than LKM+ (p < 0.05).

Conclusion: Surgical stress appears to affect intestinal microbiota considerably. Probiotic administration in neonates requires clarification.