500 - Growth failure in preterm infants is associated with a decrease in Enterococcus and Clostridiae

Poster Number: 500
Publication Number: 500.425

Katherine A. Stumpf, University of Texas, Southwestern Medical Center, Dallas, Dallas, TX, United States; Maricel N. Maxey, Parkland Hospital, DeSoto, TX, United States; Monica L. Boren, Parkland Health & Hospital System, Valley View, TX, United States; Xinying niu, Children's Hospital & Medical Center, Dallas, TX, United States; Julie Mirpuri, University of Texas Southwestern Medical School, Dallas, TX, United States

Background: Preterm infants often require increased caloric intake to maintain appropriate growth while in the neonatal intensive care unit (NICU). Emerging evidence suggests that alterations of the gut microbiome may play a role in infant and childhood growth patterns. We hypothesized that specific gut microbial colonization patterns in preterm infants would be associated with poor growth or need for increased caloric intake.

Objective: The objective of this study is to determine if preterm infants with growth failure have a unique microbiome when compared to infants with normal growth.

Design/Methods: This is a prospective cohort study of infants < 29 weeks gestation that were enrolled at Parkland Hospital. Fecal samples were collected weekly from infants once on full enteral feeds. For analysis, enrolled infants’ samples were divided into cohorts defined as controls (adequate weight gain on appropriate calories of 120-130 kcal/kg/day) or poor growth (poor weight gain on increased calories of >130 kcal/kg/day). Information was obtained by chart review on maternal demographics, infant characteristics, diagnoses, dietician recommendations, type of diet received, and growth velocity. Fecal samples were blindly analyzed for microbiome composition by qRT-PCR and next generation sequencing.

Results: We conducted an interim analysis of 87 stool samples from 35 infants (mean gestational age 26 weeks, range 23-28 weeks). 28 samples were from the control cohort and 59 were from the poor growth cohort. The phyla Enterobacteriaceae, Bacteroidetes, and Firmicutes showed no difference between the two groups. There was statistically significant decreases in the genera Enterococcus (p < 0.01) and Clostridiae (p < 0.05) in the poor growth cohort. Next generation sequencing analysis is ongoing. Conclusion(s): There was a significant decrease in representation of Enterococcus and Clostridiae in the poor growth cohort. Our study adds to the growing body of evidence that alteration of the microbiome is associated with poor growth in preterm infants. This may ultimately represent a therapeutic target for growth failure in preterm infants.