12137
document
Effects of oral Lactobacillus GG on enteric microflora in low-birth-weight neonates . BACKGROUND Colonization patterns , especially by anaerobic flora , may play an important role in neonatal gut function . Probiotics could affect disease risk either directly through colonization or indirectly by promoting changes in gut microbial ecology . METHODS To study the ability of Lactobacillus GG ( LGG ) to colonize the neonatal gut and modify its microbial ecology , a prospective , randomized study was performed in 71 preterm infants of less than 2000 g birth weight . Infants less than 1500 g ( 24 treated , 15 control ) received 10 ( 9 ) LGG orally twice daily for 21 days . Those infants weighing 1500 to 1999 g ( 23 treated , 9 control ) were treated for 8 days . Stools were collected before treatment and on day 7 to 8 ( and day 14 and 21 , in the infants weighing less than 1500 g ) for quantitative aerobic and anaerobic cultures . RESULTS Colonization with LGG occurred in 5 of 24 ( 21 % ) infants who weighed less than 1500 g versus 11 of 23 ( 47 % ) in larger infants . Colonization was limited to infants who were not on antibiotics within 7 days of treatment with LGG . There was a paucity of bacterial species at baseline , although larger infants had more bacterial species ( 1.59 +/- 0.13 ( SEM ) vs 1.11 +/- 0.12 ; P < 0.03 ) and higher mean log colony forming units ( CFU ) ( 8.79 +/- 0.43 vs 7.22 +/- 0.63 ; P < 0.05 ) compared with infants weighing less than 1500 g LGG . Treatment in infants weighing less than 1500 g resulted in a significant increase in species number by day 7 , with further increases by day 21 . This increase was mainly the result of increased Gram ( + ) and anaerobic species . No difference in species number was noted in controls . Mean log CFU of Gram ( - ) bacteria did not change in treated infants weighing less than 1500 g. However , Gram ( + ) mean log CFU showed a significant increase on day 21 ( 6.1 +/- 0.9 ) compared with day 0 ( 3.5 +/- 0.9 ) ( P < 0.05 ) . No significant changes in species number or quantitative counts were noted after LGG treatment in the infants weighing 1500 to 1999 g LGG was well tolerated in all infants . CONCLUSION The neonatal response to a probiotic preparation is dependent on gestational and post-natal age and prior antibiotic exposure . Although LGG is a relatively poor colonizer in infants , especially those infants weighing less than 1500 g at birth , it does appear to affect neonatal intestinal colonization patterns .
12138
Intervention_Pharmacological
oral Lactobacillus GG
12139
Intervention_Pharmacological
Lactobacillus GG ( LGG )
12140
Intervention_Pharmacological
LGG
12141
Intervention_Pharmacological
antibiotics
12142
Outcome_Physical
enteric microflora
12143
Outcome_Physical
disease risk
12144
Outcome_Physical
colonize the neonatal gut and modify its microbial ecology
12145
Outcome_Physical
quantitative aerobic and anaerobic cultures
12146
Outcome_Physical
Colonization with LGG occurred
12147
Outcome_Physical
Colonization
12148
Outcome_Physical
bacterial species
12149
Outcome_Physical
mean log colony forming units ( CFU )
12150
Outcome_Physical
increase in species number by day 7 , with further increases by day 21 .
12151
Outcome_Physical
increased Gram ( + ) and anaerobic species
12152
Outcome_Physical
species number
12153
Outcome_Physical
Mean log CFU of Gram ( - ) bacteria
12154
Outcome_Physical
Gram ( + ) mean log CFU
12155
Outcome_Physical
species number or quantitative counts
12156
Outcome_Other
LGG was well tolerated
12157
Outcome_Physical
neonatal response to a probiotic preparation
12158
Outcome_Physical
neonatal intestinal colonization patterns
12159
Participant_Condition
enteric microflora in low-birth-weight neonates .
12160
Participant_Condition
Infants less than 1500 g
12161
Participant_Condition
infants weighing less than 1500 g