Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
Department of Pediatrics, The University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
Adv Exp Med Biol. 2019;1125:25-36. doi: 10.1007/5584_2018_313.
Bacterial colonization patterns in preterm infants differ from those of their term counterparts due to maternal microbial diversity, delivery mode, feeding methods, antibiotic use, and exposure to commensal microbiota and pathogens in the neonatal intensive care unit (NICU). Early gut microbiome dysbiosis predisposes neonates to necrotizing enterocolitis (NEC), a devastating intestinal disease with high morbidity and mortality. Though mechanisms of NEC pathogenesis are not fully understood, the microbiome is a promising therapy target for prevention and treatment. Direct administration of probiotics to preterm infants has been shown to reduce the incidence of NEC, but is not without risk. The immature immune systems of preterm infants leave them vulnerable to even beneficial bacteria. Further research is required to investigate both short-term and long-term effects of probiotic administration to preterm infants. Other methods of altering the preterm infant microbiome must also be considered, including breastfeeding, prebiotics, and targeting the maternal microbiome.
早产儿的细菌定植模式与足月儿不同，这是由于母体微生物多样性、分娩方式、喂养方式、抗生素使用以及在新生儿重症监护病房（NICU）中接触共生菌群和病原体等因素导致的。早期肠道微生物组失调使新生儿易患坏死性小肠结肠炎（NEC），这是一种具有高发病率和死亡率的毁灭性肠道疾病。尽管 NEC 的发病机制尚未完全阐明，但微生物组是预防和治疗的有希望的治疗靶点。向早产儿直接给予益生菌已被证明可降低 NEC 的发病率，但并非没有风险。早产儿不成熟的免疫系统使他们容易受到即使是有益细菌的侵害。需要进一步研究益生菌对早产儿的短期和长期影响。还必须考虑改变早产儿微生物组的其他方法，包括母乳喂养、益生元和靶向母体微生物组。
