Background and aims The effects of lactoferrin [LF] on neonatal gut bacteria is unknown. We theorised LF has a greater impact on gut microbiota than the NICU environment.
Methods Ten very preterm infants received enteral recombinant human lactoferrin [rhLF], while 11 infants received placebo for the first 28 days of life. We collected a faecal sample on day 21. We sequenced amplicons made from the V1 – V3 region of bacterial 16 S rRNA in faeces. QIIME and mothur processed filtered reads to classify operational taxonomy units [OTUs] with >97% sequence similarity. Statistical analyses used SPSS.
Results Mean faecal OTUs per infant were higher in NICU1 (mean = 63,284) versus NICU2 (48,080, p < 0.001). Reasons for higher OTUs in NICU1 were less antibiotics versus NICU2 (mean = 4.7 vs. 9.5 d, p < 0.002); NICU1 used early enteral nutrition in NICU1, while infants in NICU2 received more parenteral nutrition (p < 0.007). Veillonella as a marker of gut microbiome maturity was higher in NICU1 (mean OTUs = 13,146 versus NICU2 = 1909, p < 0.04). A placebo-treated infant with necrotizing enterocolitis had 58,071 OTUs of Enterobacter hormaechei in the faeces. Infants given placebo had more E. hormaechei (mean OTUs = 23,661) versus rhLF-treated babies (mean = 2330, p < 0.03). Two neonatal pathogens, S. aureus and Pseudomonas, were lower in the faeces of rhLF-treated infants (p < 0.03 and p < 0.01, respectively).
Conclusions rhLF modulates gut bacteria of preterm infants. The NICU habitat also significantly affects the intestinal microbiome. Research must show if bovine LF also reduces faecal pathogens in very preterm infants.
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