Quantitative and Qualitative Study of Intestinal Flora in Neonates

BACKGROUND: In the neonatal period the developing intestinal barrier function provides a sub-optimal mucosal defense against infection. Establishment of the normal commensal micro-flora plays a vital role in this process. AIMS: To determine aerobic and anaerobic bacteria by quantitative and qualitative methods from faecal samples of neonates. SETTINGS AND DESIGN: A prospective study was carried out in two groups in a tertiary care hospital, Group A-comprised preterm infant and in group B-full term infants. MATERIALS AND METHODS: Sixty two preterm infants with the weight < 1500 gm and gestation age < 34 weeks and twenty nine full term infants with 4 weeks of age were included. Quantitation of bacterial load was done by ten-fold serial dilutions on respective media. STATISTICAL ANALYSIS: The data were analyzed by using EPIINFO-Ver 6.04. RESULTS AND CONCLUSIONS: The predominant aerobic bacterium was Klebsiella pneumoniae. In pre term infants aerobic bacteria were colonized with an average of 2.1 and anaerobic bacteria 0.1. Quantitation showed faecal bacterial colony count ranging from 10(4)-10(13) CFU/gms. Gram negative and gram positive bacteria increased gradually over an interval of 2 to 3 weeks. Mean log CFU of gram negative bacteria and gram positive bacteria were statistically insignificant from day 3 to day 14 (P > 0.05). On day 21 there was a significant change in colonization of both bacterial sp (P < 0.05). Potential pathogenic aerobic bacteria dominate the intestinal flora of premature babies nursed in neonatal unit. There is a need to investigate interventions to offset this imbalance in gut micro-ecology of premature babies.