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Changes in the intestinal microbiome of the preterm baby associated with stopping non-invasive pressure support: a prospective cohort study. | LitMetric

AI Article Synopsis

  • Intestinal dysbiosis in preterm babies is linked to conditions like necrotising enterocolitis and late-onset sepsis, and non-invasive positive pressure ventilation may negatively influence gut bacterial growth.
  • A study using high-throughput 16S rRNA gene sequencing found that transitioning from respiratory support to spontaneous breathing in preterm infants led to increased bacterial diversity and changes in specific gut bacteria.
  • The findings suggest that non-invasive positive pressure ventilation may suppress gut microbiome diversity and anaerobic bacteria, highlighting the need for strategies to promote a healthy gut microbiome in preterm infants.

Article Abstract

Background: Intestinal dysbiosis is implicated in the pathogenesis of necrotising enterocolitis and late-onset sepsis in preterm babies. The provision of non-invasive positive pressure ventilation is a common clinical intervention in preterm babies, and may be hypothesised to adversely affect intestinal bacterial growth, through increased aerophagia and induction of a hyperoxic intestinal environment; however this relationship has not been previously well characterised.

Methodology: In this prospectively recruited cohort study, high-throughput 16S rRNA gene sequencing was combined with contemporaneous clinical data collection, to assess within-subject changes in microbiome development around the time of transitioning from non-invasive positive pressure respiratory support to unsupported spontaneous breathing.

Results: In a group of 14 preterm infants, bacterial diversity was seen to increase by 0.34 units/week (inverse Simpson index) at the point of transitioning off non-invasive positive pressure respiratory support. Correspondingly, a significant increase in anaerobic genera ( spp, spp), and a non-significant fall in Enterobacteriaceae was also seen at this time.

Conclusions: Provision of non-invasive positive pressure ventilation is associated with suppression of both diversity accrual and obligate anaerobic growth in the preterm intestine. This has clinical implications in view of the widespread use of non-invasive positive pressure ventilation in preterm neonatal care (and wider adult use), and demonstrates the need for potential strategies (eg, probiotic support; reduced aerophagia) to support the development of a healthy gut microbiome during this time.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459353PMC
http://dx.doi.org/10.1136/bmjpo-2024-002675DOI Listing

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