Abstract
Background
Preterm infants are generally fed through nasogastric enteral feeding tubes (NEFTs). The aim of this work was to evaluate the role of NEFTs in the initial colonization of the preterm gut and its evolution within the first 2 weeks after birth.
Methods
For this purpose, fecal and NEFT-derived samples from 30 preterm infants hospitalized in a neonatal intensive care unit (NICU) were collected from birth to the second week of life. Samples were cultivated in ten culture media, including three for the isolation of antibiotic-resistant microorganisms.
Results
Isolates (561) were identified by 16S ribosomal RNA gene sequencing. Although the first NEFTs inserted into the neonates after birth were rarely colonized, analysis of NEFTs and fecal samples over time revealed a significant increase in bacterial abundance, diversity, and detection frequency. Results showed a parallel colonization between time-matched NEFTs and fecal samples, suggesting an ongoing bidirectional transfer of bacteria from the neonatal gut to the NEFTs and vice versa.
Conclusions
In short-term hospitalization, length is by far the determinant factor for the early colonization of preterm infants. As NEFT populations reflect the bacterial populations that are colonizing the preterm in a precise moment, their knowledge could be useful to prevent the dissemination of antibiotic-resistant strains.
Impact
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The hospital environment modulates preterm colonization immediately after birth.
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The colonization of preterm feces and NEFTs occurs in parallel.
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There is an ongoing bidirectional transfer of microorganisms from the neonatal gut to the NEFTs and vice versa.
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Bacterial communities inside NEFTs could act as reservoirs of antibiotic resistance genes.
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NEFT populations reflect the bacteria that are colonizing the preterm at a precise moment.
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Acknowledgements
We thank the nursing team of the Neonatology Unit of La Paz University Hospital in Madrid (Spain) for their assistance and the Spanish Ministry of Economy and Competitiveness and the Spanish Pediatric Association Grant (2015) for their funding.
Funding information
This work has been funded by the Spanish Ministry of Economy and Competitiveness (project ref. PID2019-105606RB-I00) and by the Spanish Pediatric Association Grant (AEP, 2015).
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J.J.P. and I.C.N carried out the microbiological analysis of the samples and wrote the first draft of the manuscript. C.A.R. and L.F.A carried out the statistical analysis. B.M.- S. coordinated the clinical part of the study. B.M.-S, B.C.J., E.E.P., and M.S.P. enrolled infants and collected the clinical data. M.S.P., B.O.M., and J.M.R. conceived and designed the study. L.F.A. contributed to the study design. All authors contributed to the analysis, and/or interpretation of data. All authors revised the article critically and approved the final version to be published.
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The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of La Paz University Hospital of Madrid, Spain (protocol code PI-3199 and date of approval, 27 June 2018). Parents or guardians provided written informed consent prior to enrollment.
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Jara Pérez, J., Moreno-Sanz, B., Castro Navarro, I. et al. Nasogastric enteral feeding tubes modulate preterm colonization in early life. Pediatr Res 92, 838–847 (2022). https://doi.org/10.1038/s41390-021-01852-5
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DOI: https://doi.org/10.1038/s41390-021-01852-5
