Long-term colonization of a lactobacillus plantarum synbiotic preparation in the neonatal gut

Pinaki Panigrahi, Sailajanandan Parida, Lingaraj Pradhan, Shubhranshu S. Mohapatra, Pravas R. Misra, Judith A. Johnson, Rama Chaudhry, Sarah Taylor, Nellie I. Hansen, Ira H. Gewolb

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Background: Probiotic, prebiotic, and synbiotic (a combination of pro- and prebiotic) supplements increasingly are being used to prevent and treat a variety of health conditions. Although colonization is considered a key element in the success of such treatments, few clinical studies have addressed colonizing ability. Studies are even more limited in neonates and infants, who may benefit most from such treatment. The present study was conducted to determine the colonizing ability, tolerance, and impact on the stool flora of 7 days of administration of a synbiotic supplement to a neonatal cohort, in preparation for a larger hospital-based trial. Patients and Methods: In this randomized, double-masked, controlled trial, healthy inborn newborns >35 weeks of gestational age and >1800 g birth weight were randomized between 1 and 3 days after birth to receive an oral synbiotic preparation (Lactobacillus plantarum and fructooligosaccharides) or a dextrose saline placebo. Two babies were treated with the synbiotic preparation for every 1 baby treated with the placebo. Duration of therapy was 7 days. Comprehensive stool cultures were done at baseline and on days 3, 7, 14, 21, and 28. Results: Nineteen infants received the active study supplement and 12 infants received the placebo for 7 days. L plantarum was cultured from the stools of 84%of the treated infants after 3 days of treatment, and from95%of infants on day 28 after birth. Of the infants, 100%, 94%, 88%, 56%, and 32% remained colonized at months 2, 3, 4, 5, and 6, respectively. In both groups, the total mean number of species and the mean log colony counts increased over time. The number of bacterial species was significantly higher on days 21 and 28 in the synbiotic preparation group compared with placebo (P=0.002 and 0.03, respectively). There was a linear increase in the mean log gramnegative colony counts in the placebo group during the 4-week period that was significantly higher than that in the Lactobacillus group on days 14, 21, and 28 (P<0.001 for each). In contrast, the supplement group had significantly higher gram-positive colony counts on days 14 (P=0.002) and 28 (P=0.04). Only 1 infant in the placebo group was colonized with L fermentum during the first 28 days of life. No difference was found in the percent increase in weight between baseline and day 7, but on day 28 and months 2, 3, and 6, the percent increase from baseline was higher in the probiotic-treated group (P≥0.05). The supplement was tolerated well. Conclusions: The synbiotic preparation colonized quickly after 3 days of administration and the infants stayed colonized for several months after therapy was stopped. There was an increase in bacterial diversity and gram-positive organisms and a reduction of gram-negative bacterial load in the treatment group. Because a combination preparation was used, it is difficult to specifically attribute the colonization to either the probiotic or prebiotic component in this study. Larger efficacy trials are warranted to examine the mechanism of action and precise effects of these supplements.

Original languageEnglish (US)
Pages (from-to)45-53
Number of pages9
JournalJournal of pediatric gastroenterology and nutrition
Volume47
Issue number1
DOIs
StatePublished - Jul 1 2008

Fingerprint

Synbiotics
Lactobacillus plantarum
Placebos
Probiotics
Prebiotics
Therapeutics
Parturition
Newborn Infant
Bacterial Load
Lactobacillus
Birth Weight
Gestational Age
Weights and Measures
Glucose

Keywords

  • Gut microflora
  • L plantarum
  • Lactobacillus
  • Neonate
  • Prebiotics
  • Probiotics
  • Synbiotics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

Cite this

Panigrahi, P., Parida, S., Pradhan, L., Mohapatra, S. S., Misra, P. R., Johnson, J. A., ... Gewolb, I. H. (2008). Long-term colonization of a lactobacillus plantarum synbiotic preparation in the neonatal gut. Journal of pediatric gastroenterology and nutrition, 47(1), 45-53. https://doi.org/10.1097/MPG.0b013e31815a5f2c

Long-term colonization of a lactobacillus plantarum synbiotic preparation in the neonatal gut. / Panigrahi, Pinaki; Parida, Sailajanandan; Pradhan, Lingaraj; Mohapatra, Shubhranshu S.; Misra, Pravas R.; Johnson, Judith A.; Chaudhry, Rama; Taylor, Sarah; Hansen, Nellie I.; Gewolb, Ira H.

In: Journal of pediatric gastroenterology and nutrition, Vol. 47, No. 1, 01.07.2008, p. 45-53.

Research output: Contribution to journalArticle

Panigrahi, P, Parida, S, Pradhan, L, Mohapatra, SS, Misra, PR, Johnson, JA, Chaudhry, R, Taylor, S, Hansen, NI & Gewolb, IH 2008, 'Long-term colonization of a lactobacillus plantarum synbiotic preparation in the neonatal gut', Journal of pediatric gastroenterology and nutrition, vol. 47, no. 1, pp. 45-53. https://doi.org/10.1097/MPG.0b013e31815a5f2c
Panigrahi, Pinaki ; Parida, Sailajanandan ; Pradhan, Lingaraj ; Mohapatra, Shubhranshu S. ; Misra, Pravas R. ; Johnson, Judith A. ; Chaudhry, Rama ; Taylor, Sarah ; Hansen, Nellie I. ; Gewolb, Ira H. / Long-term colonization of a lactobacillus plantarum synbiotic preparation in the neonatal gut. In: Journal of pediatric gastroenterology and nutrition. 2008 ; Vol. 47, No. 1. pp. 45-53.
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TY - JOUR

T1 - Long-term colonization of a lactobacillus plantarum synbiotic preparation in the neonatal gut

AU - Panigrahi, Pinaki

AU - Parida, Sailajanandan

AU - Pradhan, Lingaraj

AU - Mohapatra, Shubhranshu S.

AU - Misra, Pravas R.

AU - Johnson, Judith A.

AU - Chaudhry, Rama

AU - Taylor, Sarah

AU - Hansen, Nellie I.

AU - Gewolb, Ira H.

PY - 2008/7/1

Y1 - 2008/7/1

N2 - Background: Probiotic, prebiotic, and synbiotic (a combination of pro- and prebiotic) supplements increasingly are being used to prevent and treat a variety of health conditions. Although colonization is considered a key element in the success of such treatments, few clinical studies have addressed colonizing ability. Studies are even more limited in neonates and infants, who may benefit most from such treatment. The present study was conducted to determine the colonizing ability, tolerance, and impact on the stool flora of 7 days of administration of a synbiotic supplement to a neonatal cohort, in preparation for a larger hospital-based trial. Patients and Methods: In this randomized, double-masked, controlled trial, healthy inborn newborns >35 weeks of gestational age and >1800 g birth weight were randomized between 1 and 3 days after birth to receive an oral synbiotic preparation (Lactobacillus plantarum and fructooligosaccharides) or a dextrose saline placebo. Two babies were treated with the synbiotic preparation for every 1 baby treated with the placebo. Duration of therapy was 7 days. Comprehensive stool cultures were done at baseline and on days 3, 7, 14, 21, and 28. Results: Nineteen infants received the active study supplement and 12 infants received the placebo for 7 days. L plantarum was cultured from the stools of 84%of the treated infants after 3 days of treatment, and from95%of infants on day 28 after birth. Of the infants, 100%, 94%, 88%, 56%, and 32% remained colonized at months 2, 3, 4, 5, and 6, respectively. In both groups, the total mean number of species and the mean log colony counts increased over time. The number of bacterial species was significantly higher on days 21 and 28 in the synbiotic preparation group compared with placebo (P=0.002 and 0.03, respectively). There was a linear increase in the mean log gramnegative colony counts in the placebo group during the 4-week period that was significantly higher than that in the Lactobacillus group on days 14, 21, and 28 (P<0.001 for each). In contrast, the supplement group had significantly higher gram-positive colony counts on days 14 (P=0.002) and 28 (P=0.04). Only 1 infant in the placebo group was colonized with L fermentum during the first 28 days of life. No difference was found in the percent increase in weight between baseline and day 7, but on day 28 and months 2, 3, and 6, the percent increase from baseline was higher in the probiotic-treated group (P≥0.05). The supplement was tolerated well. Conclusions: The synbiotic preparation colonized quickly after 3 days of administration and the infants stayed colonized for several months after therapy was stopped. There was an increase in bacterial diversity and gram-positive organisms and a reduction of gram-negative bacterial load in the treatment group. Because a combination preparation was used, it is difficult to specifically attribute the colonization to either the probiotic or prebiotic component in this study. Larger efficacy trials are warranted to examine the mechanism of action and precise effects of these supplements.

AB - Background: Probiotic, prebiotic, and synbiotic (a combination of pro- and prebiotic) supplements increasingly are being used to prevent and treat a variety of health conditions. Although colonization is considered a key element in the success of such treatments, few clinical studies have addressed colonizing ability. Studies are even more limited in neonates and infants, who may benefit most from such treatment. The present study was conducted to determine the colonizing ability, tolerance, and impact on the stool flora of 7 days of administration of a synbiotic supplement to a neonatal cohort, in preparation for a larger hospital-based trial. Patients and Methods: In this randomized, double-masked, controlled trial, healthy inborn newborns >35 weeks of gestational age and >1800 g birth weight were randomized between 1 and 3 days after birth to receive an oral synbiotic preparation (Lactobacillus plantarum and fructooligosaccharides) or a dextrose saline placebo. Two babies were treated with the synbiotic preparation for every 1 baby treated with the placebo. Duration of therapy was 7 days. Comprehensive stool cultures were done at baseline and on days 3, 7, 14, 21, and 28. Results: Nineteen infants received the active study supplement and 12 infants received the placebo for 7 days. L plantarum was cultured from the stools of 84%of the treated infants after 3 days of treatment, and from95%of infants on day 28 after birth. Of the infants, 100%, 94%, 88%, 56%, and 32% remained colonized at months 2, 3, 4, 5, and 6, respectively. In both groups, the total mean number of species and the mean log colony counts increased over time. The number of bacterial species was significantly higher on days 21 and 28 in the synbiotic preparation group compared with placebo (P=0.002 and 0.03, respectively). There was a linear increase in the mean log gramnegative colony counts in the placebo group during the 4-week period that was significantly higher than that in the Lactobacillus group on days 14, 21, and 28 (P<0.001 for each). In contrast, the supplement group had significantly higher gram-positive colony counts on days 14 (P=0.002) and 28 (P=0.04). Only 1 infant in the placebo group was colonized with L fermentum during the first 28 days of life. No difference was found in the percent increase in weight between baseline and day 7, but on day 28 and months 2, 3, and 6, the percent increase from baseline was higher in the probiotic-treated group (P≥0.05). The supplement was tolerated well. Conclusions: The synbiotic preparation colonized quickly after 3 days of administration and the infants stayed colonized for several months after therapy was stopped. There was an increase in bacterial diversity and gram-positive organisms and a reduction of gram-negative bacterial load in the treatment group. Because a combination preparation was used, it is difficult to specifically attribute the colonization to either the probiotic or prebiotic component in this study. Larger efficacy trials are warranted to examine the mechanism of action and precise effects of these supplements.

KW - Gut microflora

KW - L plantarum

KW - Lactobacillus

KW - Neonate

KW - Prebiotics

KW - Probiotics

KW - Synbiotics

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