Gastrointestinal microecology in the critically ill neonate.

The fecal and gastric microflora of 178 critically ill neonates was compared with that of 30 normal full-term infants. Significant findings included increased frequency of single species retrieval and decreased frequency of mixed aerobic-anaerobic fecal cultures in the ill infants. Also noted were increased retrieval of pathogenic organisms, ie, staphylococcus aureus from gastric and fecal cultures of the ill infants, and decreased retrieval rates of Escherichia coli enterococcus, B fragilis, and other anaerobes in the feces of this group. Yeast retrieval was increased in the feces of the ill neonates. Statistical analysis showed that delivery route, birth weight, and antibiotic therapy were significantly related to the retrieval rates of certain organisms in the gastric and fecal flora of the ill neonate. Given the breast-fed and formula-fed infants have different normal floral patterns, this study suggests that the flora of the ill neonate conforms to a different pattern. Implications in the prevention and treatment of various neonatal septic processes may be drawn from this data.