Researchers Identify Probiotics as Key in Combating Antibiotic Resistance in Preterm Infants

What's Happening?

A recent study published in Nature Communications highlights the role of probiotics in reducing antibiotic-resistant bacteria in very-low-birth-weight (VLBW) preterm infants. The study, part of the Baby-Associated Microbiota of the Intestine (BAMBI) cohort, examined the effects of early antibiotic exposure and routine probiotic supplementation on the gut microbiome and antibiotic resistance genes (ARGs) in these infants. Researchers found that probiotic supplementation led to a Bifidobacterium-rich gut environment, reducing the presence of ARGs and limiting multidrug-resistant features compared to non-supplemented infants. Despite these benefits, Enterococcus remained a key reservoir for resistance genes, and short antibiotic courses increased the likelihood of horizontal gene transfer, particularly plasmid-mediated movement of resistance genes.

Why It's Important?

The findings underscore the potential of probiotics in mitigating antibiotic resistance in NICUs, where VLBW preterm infants are vulnerable to multidrug-resistant infections. By fostering beneficial gut bacteria, probiotics can reduce the burden of ARGs, offering a safer alternative to broad-spectrum antibiotics that disrupt the gut microbiome. This research supports the World Health Organization's recommendation for probiotics in very preterm infants and highlights the need for antibiotic stewardship to prevent the spread of resistance genes. Hospitals and NICUs can benefit from integrating probiotics into care protocols, potentially improving outcomes for this fragile population.

What's Next?

Further research is needed to refine probiotic dosing, duration, and strain choice to maximize benefits while minimizing resistance risks. Longer follow-up and multi-site trials could provide more comprehensive data on the long-term effects of probiotics in preterm infants. Additionally, hospitals may need to align feeding, hygiene, and prescribing practices to optimize the use of probiotics and antibiotics in NICUs. The study suggests that pairing probiotics with antibiotic stewardship and infection control measures could enhance care for VLBW preterm infants.