Parra-Llorca Anna, Gormaz María, Alcántara Cristina, Cernada María, Nuñez-Ramiro Antonio, Vento Máximo, Collado Maria C
Neonatal Research Group, Health Research Institute La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain.
Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain.
Front Microbiol. 2018 Jun 27;9:1376. doi: 10.3389/fmicb.2018.01376. eCollection 2018.
Preterm microbial colonization is affected by gestational age, antibiotic treatment, type of birth, but also by type of feeding. Breast milk has been acknowledged as the gold standard for human nutrition. In preterm infants breast milk has been associated with improved growth and cognitive development and a reduced risk of necrotizing enterocolitis and late onset sepsis. In the absence of their mother's own milk (MOM), pasteurized donor human milk (DHM) could be the best available alternative due to its similarity to the former. However, little is known about the effect of DHM upon preterm microbiota and potential biological implications. Our objective was to determine the impact of DHM upon preterm gut microbiota admitted in a referral neonatal intensive care unit (NICU). A prospective observational cohort study in NICU of 69 neonates <32 weeks of gestation and with a birth weight ≤1,500 g was conducted. Neonates were classified in three groups according to feeding practices consisting in their MOM, DHM, or formula. Fecal samples were collected when full enteral feeding (defined as ≥150 cc/kg/day) was achieved. Gut microbiota composition was analyzed by 16S rRNA gene sequencing. Despite the higher variability, no differences in microbial diversity and richness were found, although feeding type significantly influenced the preterm microbiota composition and predictive functional profiles. Preterm infants fed MOM showed a significant greater presence of Bifidobacteriaceae and lower of Staphylococcaceae, Clostridiaceae, and Pasteurellaceae compared to preterm fed DHM. Formula fed microbial profile was different to those observed in preterm fed MOM. Remarkably, preterm infants fed DHM showed closer microbial profiles to preterm fed their MOM. Inferred metagenomic analyses showed higher presence of genus in mother's milk group was related to enrichment in the Glycan biosynthesis and metabolism pathway that was not identified in the DHM or in the formula fed groups. In conclusion, DHM favors an intestinal microbiome more similar to MOM than formula despite the differences between MOM and DHM. This may have potential beneficial long-term effects on intestinal functionality, immune system, and metabolic activities.
早产微生物定植受胎龄、抗生素治疗、分娩方式影响，也受喂养方式影响。母乳一直被公认为人类营养的黄金标准。在早产儿中，母乳与生长改善、认知发育以及坏死性小肠结肠炎和晚发性败血症风险降低有关。在没有母亲自身母乳（MOM）的情况下，巴氏杀菌捐赠人乳（DHM）因其与前者相似，可能是最佳替代选择。然而，关于DHM对早产微生物群的影响及其潜在生物学意义知之甚少。我们的目的是确定DHM对转诊新生儿重症监护病房（NICU）收治的早产肠道微生物群的影响。在一个NICU对69名胎龄<32周、出生体重≤1500g的新生儿进行了一项前瞻性观察队列研究。根据喂养方式将新生儿分为三组，分别为接受MOM、DHM或配方奶喂养。当达到完全肠内喂养（定义为≥150cc/kg/天）时采集粪便样本。通过16S rRNA基因测序分析肠道微生物群组成。尽管变异性较高，但未发现微生物多样性和丰富度存在差异，不过喂养方式显著影响早产微生物群组成和预测功能谱。与接受DHM喂养的早产儿相比，接受MOM喂养的早产儿双歧杆菌科的存在显著更多，而葡萄球菌科、梭菌科和巴斯德菌科的存在更少。配方奶喂养的微生物谱与接受MOM喂养早产儿中观察到的不同。值得注意的是，接受DHM喂养的早产儿的微生物谱与接受MOM喂养的早产儿更接近。推断宏基因组分析显示，母乳组中属的存在更高与聚糖生物合成和代谢途径的富集有关，而在DHM组或配方奶喂养组中未发现这种情况。总之，尽管MOM和DHM之间存在差异，但DHM有利于形成比配方奶更类似于MOM的肠道微生物群。这可能对肠道功能、免疫系统和代谢活动具有潜在的长期有益影响。
