Infant
Culture-independent analysis of fecal microbiota in infants, with special reference to Bifidobacterium species
Sakata S., Tonooka T., Ishizeki S., Takada M., Sakamoto M., Fukuyama M., Benno Y.
Fecal microbiota of 31 breast-fed, 26 mix-fed, and 11 bottle-fed infants were analyzed by using terminal restriction fragment length polymorphism (T-RFLP), and culture method. We first determined the total and cultivated bacterial counts in infant fecal microbiota. Only approximately 30% of bacteria present in fecal microbiota were cultivable while the remainder was yet-to-be cultured bacteria. Sixty-eight fecal samples were divided into two clusters (I and II) by T-RFLP analysis, and then subdivided into five subclusters (Ia, Ib, IIa, IIb and IIc). There was no clear relationship between clusters and feeding method. A proportion of bifidobacteria was detected in the fecal material by PCR method using species-specific primers. The predominant Bifidobacterium spp. was Bifidobacterium longum longum type (43 samples (63.2%)), followed by B. longum infantis type (23 samples (33.8%)) and B. breve (16 samples (23.5%)). The distribution of Bifidobacterium spp. was similar in the three feeding groups. In contrast, the high incidence of B. breve in cluster I, especially subcluster Ia and B. longum longum type in cluster II, especially subcluster IIa and IIc were characterized by T-RFLP method. Our results showed that the colonization of Bifidobacterium spp. in infant feces correlated with the T-RFLP clusters.
FEMS Microbiol Lett. 2005 Feb 15;243(2):417-23
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Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants
Lin H.C., Su B.H., Chen A.C., Lin T.W., Tsai C.H., Yeh T.F., Oh W.
OBJECTIVE: We evaluated the efficacy of probiotics in reducing the incidence and severity of necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants.
PATIENTS AND METHODS: A prospective, masked, randomized control trial was conducted to evaluate the beneficial effects of probiotics in reducing the incidence and severity of NEC among VLBW (< 1500 g) infants. VLBW infants who started to fed enterally and survived beyond the seventh day after birth were eligible for the trial. They were randomized into 2 groups after parental informed consents were obtained. The infants in the study group were fed with Infloran (Lactobacillus acidophilus and Bifidobacterium infantis) with breast milk twice daily until discharged. Infants in the control group were fed with breast milk alone. The clinicians caring for the infants were blinded to the group assignment. The primary outcome was death or NEC ( >or= stage 2).
RESULTS: Three hundred sixty-seven infants were enrolled: 180 in the study group and 187 in the control group. The demographic and clinical variables were similar in both groups. The incidence of death or NEC (>or= stage 2) was significantly lower in the study group (9 of 180 vs 24 of 187). The incidence of NEC (>or= stage 2) was also significantly lower in the study when compared with the control group (2 of 180 vs 10 of 187). There were 6 cases of severe NEC (Bell stage 3) in the control group and none in the study group. None of the positive blood culture grew Lactobacillus or Bifidobacterium species.
CONCLUSION: Infloran as probiotics fed enterally with breast milk reduces the incidence and severity of NEC in VLBW infants.
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The delivery of probiotics and prebiotics to infants
Kullen M.J., Bettler J.
A number of studies involving the feeding of probiotics and prebiotics to infants have been published over the last decade. These studies have examined a wide range of health outcomes, including growth and safety, prophylaxis and alleviation of diarrheal disease, reduction in atopic disease, reduction in necrotizing enterocolitis, and reduction in infection of the preterm infant. In addition, these studies have described microbiological alterations observed in response to probiotic and prebiotic feeding. Collectively, the reports demonstrate that probiotics show considerable promise in addressing several health outcomes of significance to both formula-fed and breastfed infants. As quantitative and qualitative differences appear to exist between the microfloras of human-milk fed and formula-fed infants, recent innovations to infant formula have involved the inclusion of probiotics and prebiotics as a means of making the flora of the formula fed infant more similar to that of the breastfed infant. To date, only a few probiotic- and prebiotic-containing infant formulas have been marketed, but as new safety and efficacy data emerge and the regulatory climate becomes more favourable, the number of products is expected to grow.
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Similar bifidogenic effects of prebiotic-supplemented partially hydrolyzed infant formula and breastfeeding on infant gut microbiota
Rinne M.M., Gueimonde M., Kalliomaki M.A., Salminen S., Isolauri E., Hoppu U.
The aim of the study was to assess the quantitative and qualitative differences of the gut microbiota in infants. We evaluated gut microbiota at the age of 6 months in 32 infants who were either exclusively breast-fed, formula-fed, nursed by a formula supplemented with prebiotics (a mixture of fructo- and galacto-oligosaccharides) or breast-fed by mothers who had been given probiotics. The Bifidobacterium, Bacteroides, Clostridium and Lactobacillus/Enterococcus microbiota were assessed by the fluorescence in situ hybridization, and Bifidobacterium species were further characterized by PCR. Total number of bifidobacteria was lower among the formula-fed group than in other groups (P=0.044). Total amounts of the other bacteria were comparable between the groups. The specific Bifidobacterium microbiota composition of the breast-fed infants was achieved in infants receiving prebiotic supplemented formula. This would suggest that early gut Bifidobacterium microbiota can be modified by special diets up to the age of 6 months.
FEMS Immunol Med Microbiol. 2005 Jan 1;43(1):59-65.
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Probiotics for Mother and Child
Reid G., Devillard E.
For the survival of humankind, nothing can be as important as the health of a mother and a child. As the world's population grows to more than 6 billion, it might seem ridiculous to suggest that any real threat exists to the human species. Diseases have long ravaged populations, as have wars, poverty, and malnutrition. Life today is no different with new and emerging diseases such as SARS and Mad Cow Disease leaving a trail of concern around the planet.
All that being said, the AIDS crisis is threatening humans like no other. In countries such as Botswana, close to half the population of pregnant women is infected. Of great concern, the disease is now prevalent among women and teenage girls, threatening not only their lives but those of their offspring. Efforts to control this spread are quite abysmal, albeit well intentioned.
Likewise, the death of a child every 15 seconds from diarrheal disease is not being addressed with the same vigor as SARS, even though the risk of dying from the latter for most people is similar to being struck by lightning. In the end, it is the economy and politics that dictate health spending. Image and perception are everything. While deaths mount among women and children from AIDS and other infections, the potential to intervene with a low-risk natural concept of probiotics seemed all too distant. As evidence mounts of the attributes of certain probiotic strains to treat diarrhea and reduce the risk of urogenital and other diseases, the developing world has failed to embrace it, support its evaluation and implementation, and take it to where it is needed the most. In this review, the case for and against probiotics for urogenital and intestinal infections is presented based on current literature. The story is far from complete, but the potential for improving the health of the mother and child is significant. United Nations and World Health Organization guidelines have now been developed to vanquish the unproved marketing hype products that have given probiotics a bad name.
It is now up to science to deliver the remedies, and to society to make sure that only proven products reach the marketplace and the people in most need.
J Clin Gastroenterol. 2004 Jul;38:S94-S101.
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D(-)-lactic acid-producing probiotics, D(-)-lactic acidosis and infants
Mack D.R.
University of Ottawa and Children's Hospital of Eastern Ontario, Ottawa, Canada.
There is mounting evidence that ingestion of selected probiotics can modify disease morbidity for specific conditions affecting humans, and there is growing interest in the amelioration or prevention of disease with probiotics. Modulation in gene expression of the cellular elements of the intestinal mucosa and interbacterial interactions are leading theories as to the mechanism whereby probiotics can effect benefit for the host. Furthermore, gene-environmental interactions are considered to be important in the development of disease in those at genetic risk. With the intestinal tract harbouring large numbers of bacteria, alteration of the microbial environment with probiotic microbes is being considered as a controllable factor that may limit disease expression for those at genetic risk. This reasoning has led to interest in the administration of probiotics to infants. However, there are significant developmental changes occurring in many organ systems from the time of parturition and during the first months of life. Because there is little in the published scientific medical literature regarding the effects of long-term administration of probiotics to infants, potential problems must be considered; one such issue is that of administration of D(-)-lactate-producing probiotics. An appraisal of the current knowledge of this potential adverse effect is the subject of this communication.
Can J Gastroenterol. 2004 Nov;18(11):671-5.
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