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Title: Effect of single versus multistrain probiotic in extremely preterm infants: a randomised trial
Authors: Athalye-Jape, Gayatri
Esvaran, Meera
Patole, Sanjay
Simmer, Karen
Nathan, Elizabeth
Doherty, Dorota
Keil, Anthony
Rao, Shripada
Chen, Liwei
Chandrasekaran, Lakshmi
Kok, Chooi
Schuster, Stephan Christoph
Conway, Patricia Lynne
Keywords: Science::Biological sciences
Issue Date: 2022
Source: Athalye-Jape, G., Esvaran, M., Patole, S., Simmer, K., Nathan, E., Doherty, D., Keil, A., Rao, S., Chen, L., Chandrasekaran, L., Kok, C., Schuster, S. C. & Conway, P. L. (2022). Effect of single versus multistrain probiotic in extremely preterm infants: a randomised trial. BMJ Open Gastroenterology, 9(1), e000811-.
Journal: BMJ Open Gastroenterology 
Abstract: Objective: Evidence indicates that multistrain probiotics benefit preterm infants more than single-strain (SS) probiotics. We assessed the effects of SS versus triple-strain (TS) probiotic supplementation (PS) in extremely preterm (EP) infants. Design: EP infants (gestational age (GA) <28 weeks) were randomly allocated to TS or SS probiotic, assuring blinding. Reference (REF) group was EP infants in the placebo arm of our previous probiotic trial. PS was commenced with feeds and continued until 37 weeks' corrected GA. Primary outcome was time to full feed (TFF: 150 mL/kg/day). Secondary outcomes included short-chain fatty acids and faecal microbiota collected at T1 (first week) and T2 (after 3 weeks of PS) using 16S ribosomal RNA gene sequencing. Results: 173 EP (SS: 86, TS: 87) neonates with similar GA and birth weight (BW) were randomised. Median TFF was comparable (11 (IQR 8-16) vs 10 (IQR 8-16) days, p=0.92). Faecal propionate (SS, p[removed]0.05) between groups, whereas beta-diversity analysis revealed significant differences between PS and REF groups (both p=0.001). Actinobacteria were higher (both p<0.01), and Proteobacteria, Firmicutes and Bacteroidetes were lower in PS versus REF. Gammaproteobacteria, Clostridia and Negativicutes were lower in both PS versus REF. Conclusion: TFF in EP infants was similar between SS and TS probiotics. Both probiotics were effective in reducing dysbiosis (higher bifidobacteria and lower Gammaproteobacteria). Long-term significance of increased propionate and butyrate needs further studies. Trial registration number ACTRN 12615000940572.
ISSN: 2054-4774
DOI: 10.1136/bmjgast-2021-000811
Schools: School of Biological Sciences 
School of Chemical and Biomedical Engineering 
Research Centres: Singapore Centre for Environmental Life Sciences and Engineering (SCELSE) 
Rights: © Author(s) (or their employer(s)) 2022. Published by BMJ. Open access. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:SBS Journal Articles
SCBE Journal Articles
SCELSE Journal Articles

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