Investigators Take a Look at Gut Microbiota of Preterm Newborns

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Clostridium difficile and Clostridium perfringens were found in 83% of newborns nursed by formula milk in the second week of life, but all infants by the end of the third week of life.

New insight show how gut microbiota differs in preterm newborns during the first few weeks of life.1

A team, led by Kenza Hattoufiv, University Hospital Centre Ibn Sin, identified different phyla in the gut microbiota of preterm newborns.

“Breast milk has great effects on barrier integrity and mucosal defenses of the intestinal tract compared to formula milk,” the authors wrote. “Through this study, we focused on the microbiota, detected by molecular biology, which colonizes the intestine of the newborn during the first three weeks of life depending on the type of feeding.”

The Study

In the prospective, cohort study, the investigators examined data from the National Reference Center for Neonatology and Nutrition, CHU IBN SINA Children's Hospital in Rabat, with the collaboration of the CHIS research laboratory.

They collected stool samples from 29 preterm infants whose gestational age was between 28-36 weeks of amenorrhea and analyzed microbial compositions of the samples by real-time polymerase chain reaction (PCR), screening for Firmicutes, Bacteroidetes, Actinobacteria, Proteobacteria.

The investigators initiated enteral nutrition between the second and sixth day, with a median of 2 days. There were no infants breastfed directly following birth and no infant was directly breastfed during hospitalization.


However, 79% of the mothers collected breast milk at home to ultimately feed to their hospitalized children. This group received more than 50% of their mother’s milk.

The results show Lactobacillus spp was detected only in infants nursed by both breast and formula milk during the first 2 weeks of life. On the other hand, enterococcus spp was present in all breastfed infants.

Finally, clostridium difficile and Clostridium perfringens were found in 83% of newborns nursed by formula milk in the second week of life, but all infants by the end of the third week of life.

“When breastfeeding is possible, it should be encouraged. Otherwise, infant formulas supplemented with probiotics and/or prebiotics allow the establishment of a microbiota similar to that of the breastfed child,” the authors wrote. “Other preventive approaches should be introduced, including vaginal or fecal microbiota transplantation in case of cesarean delivery.”

Gut Bacteria

Earlier this year, investigators found clear difference in gut bacteria between pediatric patients with autism spectrum disorder (ASD) and pediatric patients without ASD.

A team, led by Xinyan Xie, Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, identified the taxonomic composition and evaluate the changes in the fecal microbiota in Chinese children with ASD.

Patients with ASD had significantly higher relative abundance of Enterobacteriaceae (FDR-P <0.001) at the family level, but a significant reduction of the taxa Monoglobaceae (FDR-= 0.009).

For the genera level, BifidobacteriumBacteroidesBlautiaFaecalibacterium, and Anaerostipes made up the main part of the gut microbiota in both groups.

However, after correcting for multiple comparisons, the relative abundances at the phylum level of Actinobacteria and Proteobacteria in the study group was significantly higher than those in the control group.


Hattoufi, kenza and Raji, Fatiha and Tligui, Houssain and Aguenaou, Hassan and Barkat, Amina, Association of Gut Microbiota and Type of Feeding: Molecular Analysis of a Cohort of Preterm Moroccan Newborns. Available at SSRN: or