Enteral supplementation with Bifidobacterium animalis Bb-12 modulates gut microbiome and improves intestinal barrier in very preterm infants: a randomized, controlled trial

Purpose How probiotic supplementation initiates an effective prophylactic measure for modulating the colonization and development of gut microbiota and preventing necrotizing enterocolitis and late-onset sepsis in very preterm infants remains unclear. Therefore, we aimed to investigate the effects of early enteral supplementation with Bifidobacterium animalis Bb-12 on the gut microbiome and intestinal barrier function in very preterm infants. Methods Seventy-one very premature infants were randomized into observation and control groups. After enteral feeding, the observation and control groups received oral B. animalis BB-12 and 5% glucose (injection), respectively. On days 14 and 28 after birth, the gut microbiome, serum Zonulin protein, and fecal calprotectin (FC) levels were compared between both groups. Results The relative abundance of Actinomycetes and Bifidobacterium in the observation group was significantly higher than that in the control group on day 14 after birth (14.38% vs. 1.78%, P = 0.001; 13.95% vs. 1.24%, P = 0.000). Diversity analysis showed that the Chao value of the observation group was higher than that of the control group on day 28 (P = 0.038). The weighted UniFrac values of beta-diversity analysis on days 14 and 28 were significantly higher in the observation group than in the control group (P = 0.000). Furthermore, serum Zonulin and FC levels were significantly lower in the observation group than in the control group on days 14 and 28 (P = 0.000). Conclusion Enteral supplementation with B. animalis Bb-12 can modulate the gut microbiome, affect serum Zonulin and FC levels, and improve the intestinal barrier in very preterm infants.