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The bacterial flora of neonates with congenital abnormalities of the gastro-intestinal tract

Published online by Cambridge University Press:  25 March 2010

V. O. Rotimi
Affiliation:
Department of Medical Microbiology, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX
B. I. Duerden
Affiliation:
Department of Medical Microbiology, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX
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Summary

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The development of the bacterial flora of neonates with congenital abnormalities of the gastro-intestinal tract was studied in 31 infants during the first 10 days of life. Specimens were collected from the umbilicus, mouth and gastro-intestinal tract on the pre-operative day, at operation and on post-operative days 1, 2, 3, 5, 7 and 10. Bacteria were isolated semi-quantitatively on a variety of plain and selective media and identified by conventional methods.

Staphylococcus albus was the predominant species isolated from the umbilicus; it was recovered from 24 of the 31 babies. The viridans group of streptococci and Streptococcus salivarius were the commonest species isolated from the mouth; there were no differences between the babies with different abnormalities and treatment with antibiotics had no effect on the bacterial flora. Ten babies were colonized by each species on the pre-operative day, and 25 and 19 respectively by the tenth post-operative day. Anaerobic gram-positive cocci were the predominant oral anaerobes. Bacteria were not isolated from the rectal swabs of babies with tracheo-oesophageal fistula (TOF) or small bowel atresia on the pre-operative days. Post-operatively the predominant faecal isolates from babies with TOF were Str. faecalis, Escherichia coli and Clostridium perfringens. About 80% of the babies with small bowel atresia were colonized by Str. faecalis and Bacteroides vulgatus, 60% each by E. coli, Klebsiella aerogenes and Str. faecium. The five babies with necrotizing enterocolitis were colonized by Str. faecalis, E. coli, Cl. perfringens and Cl. difficile; Bacteroides spp. were not recovered from any of them. The commonest facultative species recovered from babies with large bowel obstruction were Str. faecalis and E. coli. B. vulgatus, Cl. perfringens and Bifidobacterium spp. were the commonest anaerobes and anaerobes outnumbered aerobes. No significant isolates were recovered from the wound swabs and none of the babies developed post-surgical sepsis.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1982

References

Amies, C. R. & Douglas, J. I. (1965). A modified formula for the preparation of Stuart's transport medium. Candian Journal of Public Health 58, 296300.Google Scholar
Aszodi, A. & Soper, R. T. (1978). Neonatal necrotising enterocolitis. American Journal of Proctology Gastroenterology and Rectal Surgery 29, 1321.Google Scholar
Cowan, S. T. (1974). Identification of Medical Bacteria, 2nd ed.London: Cambridge University Press.Google Scholar
Drasar, B. S. & Hill, M. J. (1974). Human Intestinal Flora. London. Academic Press.Google Scholar
Duerden, B. I., Coller, J. G., Brown, R., Dracon, A. G. & Holbrook, W. P. (1980). A scheme for the identification of clinical isolates of gram-negative anaerobic bacilli by conventional bacteriological tests. Journal of Medical Microbiology 13, 231245.CrossRefGoogle ScholarPubMed
Finegold, S. M., Sutter, V. L., Boyle, J. D. & Shimada, K. (1970). The normal flora of ileostomy and transverse colostomy effluents. Journal of Infectious Diseases 122, 376381.Google Scholar
Gillies, R. R. & Dodds, J. I. (1976). Bacteriology Illustrated. Edinburgh: Churchill Livingstone.Google Scholar
Gorbach, S. L., Nahas, L., Lerner, P. I. & Weinstein, L. (1967). Studies of intestinal microflora, I. Effects of diet, age and periodic sampling on numbers of faecal microorganisms in man. Gastroenterology 53, 845855.CrossRefGoogle ScholarPubMed
Hafiz, S. & Oakley, C. L. (1976). Clostridium difficile: Isolation and characteristics. Journal of Medical Microbiology 9, 129136.Google Scholar
Holbrook, W. P., Ogston, S. A. & Ross, R. W. (1978). A method for the isolation of Bacteroides melaninogenicus from the human mouth. Journal of Medical Microbiology 11, 203207.CrossRefGoogle ScholarPubMed
Howard, F. M., Flynn, D. M., Bradley, J. M., Noone, P. & Szawatkowski, M. (1977). Outbreak of necrotising enterocolitis caused by Clostridium butyricum. Lancet ii, 10991102.CrossRefGoogle Scholar
Kalser, M. H., Cohen, R., Arteaga, I., Yawn, E., Mayoral, I., Hoffert, W. R. & Frazier, D. (1966). Normal viral and bacterial flora of the human small and large intestine. New England Journal of Medicine 274, 500505.Google Scholar
Kosoloske, A. M., Ulrich, J. A. & Hoffman, H. (1978). Fulminant necrotising enterocolitis associated with clostridia. Lancet ii, 10141016.Google Scholar
Larson, H. E., Price, A. B., Honour, P. & Borriello, S. P. (1978). Clostridum difficile and the aetiology of pseudomembraneous colitis. Lancet i, 10631066.Google Scholar
Lay, K. M. & Russell, C. (1972). Longitudinal study of the prevalence of Candida species in the mouths of infants. Journal of Dental Research 51, 1237.Google Scholar
Mortimer, E. A., Wolinsky, E., Gonzaga, A. J. & Rammelkemp, C. H. (1966). Role of airborne transmission in staphylococcal infections. British Medical Journal 1, 319322.Google Scholar
Rotimi, V. O. & Duerden, B. I. (1981). The development of the bacterial flora in normal neonates. Journal of Medical Microbiology 14, 5162.CrossRefGoogle ScholarPubMed
Rotimi, V. O., Faulkner, J. & Duerden, B. I. (1980). Rapid methods for the identification of clinical isolates of gram-negative anaerobic bacilli. Medical Laboratory Sciences 37, 331339.Google Scholar
Smith, M. F., Borriello, S. P., Clayden, G. S. & Casewell, M. W. (1980). Clinical and bacteriological findings in necrotising enterocolitis. Journal of Infection 2, 2331.Google Scholar
Willis, A. T. (1977). Anaerobic Bacteriology, 3rd ed.London, Boston: Butterworths.Google Scholar
Willis, A. T., Bullen, C. L., William, K., Fagg, C. G., Bourne, A. & Vignon, M. (1973). Breast milk substitute: A bacteriological study. British Medical Journal 4, 6772.Google Scholar
Woodroffe, R. C. S. & Shaw, D. A. (1974). Microbial population on skin and hair. In The Normal Microbial Flora of Man (ed. Skinner, F. A. and Carr, J. G.), pp. 1334. London: Academic Press.Google Scholar