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The effect of enteral supplementation of specific neutral and acidic oligosaccharides on the faecal microbiota and intestinal microenvironment in preterm infants

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Abstract

We aimed to determine the effects of enteral supplementation of a prebiotic mixture of neutral and acidic oligosaccharides (scGOS/lcFOS/pAOS) on the faecal microbiota and microenvironment in preterm infants. Furthermore, we determined the influence of perinatal factors on the development of the faecal microbiota. In a randomised controlled trial, preterm infants with gestational age <32 weeks and/or birth weight <1,500 g received enteral supplementation of scGOS/lcFOS/pAOS or placebo (maltodextrin) between days 3 and 30 of life. Faecal microbiota, as measured with fluorescent in situ hybridisation (FISH), and microenvironment [short-chain fatty acids (SCFAs), pH, sIgA] were measured at four time points: before the start of the study and at days 7, 14 and 30 of life. In total, 113 preterm infants were included. Enteral supplementation of the prebiotic mixture increased the total bacteria count at day 14 (Exp 3.92; 95 % confidence interval [CI] 1.18–13.04, p = 0.03), but not at day 30 (Exp 1.73; 95 % CI 0.60–5.03, p = 0.31). There was a trend toward increased bifidobacteria counts. There was a delayed intestinal colonisation of all bacteria. Enteral supplementation of the prebiotic mixture decreased the faecal pH (Exp 0.71; 95 % CI 0.54–0.93, p = 0.01) and there was a trend toward increased acetic acid compared to the placebo group (Exp 1.09; 95 % CI 0.99–1.20, p = 0.10). There was no effect on sIgA (Exp 1.94; 95 % CI 0.28–13.27, p = 0.50). Antibiotics decreased the total bacteria count (Exp 0.13; 95 % CI 0.08–0.22, p < 0.001). Enteral supplementation of a prebiotic mixture of neutral and acidic oligosaccharides increases the postnatal intestinal colonisation. However, the extensive use of broad-spectrum antibiotics in preterm infants decreased the growth of all intestinal microbiota, thereby, delaying the normal microbiota development.

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Acknowledgements

We are indebted to the parents for allowing their infants to participate in the study. Furthermore, we thank the medical and nursing staff of the neonatal intensive care unit of the VU University Medical Center and all the participating hospitals and Danone Research for the financial support and for providing the preterm formula (Nenatal Start®, Nenatal 1®) and study supplementation (acidic and neutral oligosaccharides and placebo [Maltodextrin]).

Financial disclosure

This study was supported by an unrestricted research grant from Danone®, Friedrichsdorf, Germany. Danone® also supported the manufacture of the prebiotic mixtures used in this study, but had no involvement in the analysis of the data or the interpretation of the results of this investigation. All authors approved the final version of the manuscript.

Conflict of interest

None of the authors have a conflict of interest.

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Authors and Affiliations

  1. Department of Paediatrics, Division of Neonatology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands

    E. A. M. Westerbeek, H. N. Lafeber, W. P. F. Fetter & R. M. van Elburg

  2. Danone Research—Centre for Specialised Nutrition, Bosrandweg 20, 6704 PH, Wageningen, The Netherlands

    R. A. Slump, J. Knol & R. M. van Elburg

  3. Danone Research—Centre for Specialised Nutrition, Friedrichsdorf, Germany

    G. Georgi

Authors
  1. E. A. M. Westerbeek
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  2. R. A. Slump
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  3. H. N. Lafeber
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  4. J. Knol
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  5. G. Georgi
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  6. W. P. F. Fetter
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  7. R. M. van Elburg
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Correspondence to R. M. van Elburg.

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Westerbeek, E.A.M., Slump, R.A., Lafeber, H.N. et al. The effect of enteral supplementation of specific neutral and acidic oligosaccharides on the faecal microbiota and intestinal microenvironment in preterm infants. Eur J Clin Microbiol Infect Dis 32, 269–276 (2013). https://doi.org/10.1007/s10096-012-1739-y

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  • DOI: https://doi.org/10.1007/s10096-012-1739-y

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