Abstract
Background
There is limited information on gut microbiota of neonates with congenital gastrointestinal surgical conditions (CGISCs) available.
Methods
This study compared stool microbiota and short-chain fatty acids (SCFAs) of 37 term infants with CGISCs with 36 term healthy infants (HIs). Two stool samples were collected from each infant: as soon as possible after birth (week 1) and 10–14 days of life (week 2).
Results
Bacterial richness and alpha diversity were comparable between CGISCs and HIs at week 1 and week 2 (all p > 0.05). Beta diversity analysis revealed that at week 1, CGISCs had similar community structures to HIs (p = 0.415). However, by week 2, community structures of CGISCs were significantly different from HIs (p = 0.003). At week 1, there were no significant differences in the relative abundances of genera Bifidobacterium and Bacteroides between CGISCs and HIs. At week 2, the relative abundance of Bifidobacterium was significantly lower in CGISCs (mean percentage 7.21 ± 13.49 vs. 28.96 ± 19.6; p = 0.002). Bacteroides were also less abundant in the CGISC group (mean percentage 0.12 ± 0.49 vs. 6.59 ± 8.62; p = 0.039). Relative abundance of genera Pseudomonas and Escherichia–Shigella were higher in CGISCs. At week 2, stool concentrations of all SCFAs were lower in CGISCs (all p < 0.001).
Conclusions
During hospitalization, neonates with CGISCs develop gut dysbiosis and deficiency of SCFAs.
Impact
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During hospitalisation, neonates with congenital gastrointestinal surgical conditions develop gut dysbiosis with deficiency of Bifidobacteria and Bacteroides and increased abundance of Escherichia-Shigella and Pseudomonas. They also have low levels of short chain fatty acids in their stools compared to healthy infants.
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This is the first study evaluating the gut microbiota using 16S ribosomal RNA sequencing methods and stool short chain fatty acids in neonates with congenital gastrointestinal surgical conditions and comparing them to healthy infants.
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The findings of this study will pave the way for randomised trials of bifidobacterial supplementation in neonates with congenital gastrointestinal surgical conditions.
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Acknowledgements
We sincerely thank the midwives at KEMH for facilitating stool collections of healthy term infants from postnatal wards, nursing staff at PCH for collecting stool samples from surgical infants, Mr. Damber Shrestha for providing data from the neonatal database, Ms. Yen Kok, Ms. Annie Chang, and Ms. Julie Hibbert for processing the stool samples and storing them in deep freezer and Dr. Gayatri Jape and Dr. Abhijeet Rakshasbhuvankar for helping with patient recruitment at KEMH. This study was funded by the PCH Grant and grants from the Centre for Neonatal Research and Education, Neonatal Directorate, KEMH for Women, Western Australia.
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S.C.R.: Conception and design, acquisition of data, analysis and interpretation of data; drafting the article and revising it critically for important intellectual content; and final approval of the version to be published. M.E.: Analysis and interpretation of data; drafting the article and revising it critically for important intellectual content; and final approval of the version to be published. S.K.P.: Conception and design, interpretation of data; revising the article critically for important intellectual content; and final approval of the version to be published. K.N.S.: Conception and design, interpretation of data; revising the draft of the article critically for important intellectual content; and final approval of the version to be published. I.G.: Conception and design, interpretation of data; revising the draft critically for important intellectual content; and final approval of the version to be published. A.K.: Conception and design, interpretation of data; revising the draft critically for important intellectual content; and final approval of the version to be published. B.W.: Analysis and interpretation of data; revising the draft critically for important intellectual content; and final approval of the version to be published. L.C.: Analysis and interpretation of data, revising the draft for important intellectual content; and final approval of the version to be published. P.L.C.: Conception and design, analysis and interpretation of data; revising the draft critically for important intellectual content; and final approval of the version to be published.
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Rao, S.C., Esvaran, M., Patole, S.K. et al. Gut microbiota in neonates with congenital gastrointestinal surgical conditions: a prospective study. Pediatr Res 88, 878–886 (2020). https://doi.org/10.1038/s41390-020-0824-7
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DOI: https://doi.org/10.1038/s41390-020-0824-7
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