|Kansagra, Ketan - ST. PETER'S UNIV HOSPITAL|
|Stoll, Barbara - BAYLOR COLLEGE OF MEDICIN|
Submitted to: Current Issues in Intestinal Microbiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: July 1, 2005
Publication Date: May 20, 2006
Citation: Harvey, R.B., Andrews, K., Droleskey, R.E., Kansagra, K.V., Stoll, B., Burrin, D.G., Sheffield, C.L., Anderson, R.C., Nisbet, D.J. 2006. Qualitative and quantitative comparison of gut bacterial colonization in enterally and parenterally fed neonatal pigs. Current Issues in Intestinal Microbiology. 7:61-64. Interpretive Summary: Because pre-term human infants usually can't be orally fed, they must be fed intravenously. This often puts them at risk for infection and death. We used a baby pig model to determine what factors lead to bacterial infection and found that newborns need to get "good bacteria" in their gut as soon as possible. A suitable intervention could include the treating of premature babies with beneficial gut bacteria. If successful, this has the potential for application in assuring good nutritional health of pre-term human infants.
Technical Abstract: Total parenteral nutrition (TPN) has been associated with sepsis, translocation of gut luminal bacteria, gut mucosal atrophy, impaired gut barrier function, and increased gut permeability in preterm human infants. In this study, we sought to compare the composition of microbiota in the neonatal pig gut to translocation events and to examine the effects of TPN versus enteral (ENT) feeding on early gut colonization. Newborn, colostrum-deprived pigs (<24 h old) were fitted with intravenous catheters and divided into two groups. One group (n = 13) received total TPN through intravenous feeding and the second group (n = 13) (enteral-ENT) was fed a commercial milk replacer. After 7 d of treatment, pigs were euthanized and samples were collected for bacterial culture from the blood, intestinal tract and organs. ENT pigs had increased bacterial diversity (number of species isolated), higher concentrations of bacteria, and bacterial colonization of all segments of the intestinal tract compared to the TPN pigs. Translocation of bacteria from the intestinal tract to tissues or blood was similar for both groups. The ENT group had 1/13 positive for Clostrium difficile toxin A whereas the TPN group had 5/13. We concluded that TPN was not positively associated with translocation, that ENT favored increased bacterial concentrations comprised of more speciation in the gastrointestinal tract compared to TPN, and that TPN-treated neonates were at higher risk of colonization by toxin-expressing strains of C. difficile.