The potential role of the gut microbiota in the pathogenesis
of feeding intolerance (FI) remains unclear. Understanding
the role of the gut microbiota could provide a new avenue for
microbiota-targeted therapeutics. This study aimed to explore
the associations between aberrant gut microbiota and FI in
very low or extremely low birth weight (VLBW/ELBW) preterm
infants. In this observational case-control study, VLBW/
ELBW infants were divided into two groups: FI group and
feeding tolerance (FT) group. 16S rRNA gene sequencing was
performed to analyze the gut microbial diversity and composition
of the infants. The differences in the gut microbiota of
the two groups were compared. In total, 165 stool samples
were obtained from 44 infants, among which, 31 developed
FI and 13 served as controls. Alpha diversity was the highest
in the meconium samples of the two groups. LEfSe analysis
revealed that the abundances of Peptostreptococcaceae, Clostridiales
and Clostridia in the FT group were significantly higher
than in the FI group. At the phylum level, the FI group was dominated
by Proteobacteria, and the FT group was dominated
by Firmicutes. The meconium samples of the FI group had
higher proportions of γ-proteobacteria and Escherichia-Shigella
and a lower proportion of Bacteroides compared with the FT
group. Kyoto Encyclopedia of Genes and Genomes (KEGG)
analysis demonstrated that aberrant gut bacteria in the FI group
were strongly associated with dysregulation of C5-Brancheddibasic-
acid-metabolism, protein kinases, and sporulation.
These findings reveal candidate microbial markers to prevent
FI. Increased relative abundances of γ-proteobacteria
and Escherichia-Shigella and decreased abundance of Bacteroides
in meconium were associated with an increased risk
of FI, while Peptostreptococcaceae, Clostridiales and Clostridia
reduced the risk of FI in VLBW/ELBW infants.
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