The development of bacterial flora of premature neonates

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Abstract
SUMMARY: The sequential acquisition of bacterial flora by premature neonates was studied during a 10 month period. Mean gestational age of the babies was 29·01 weeks and the mean birth weight was 1·728 kg.Escherichia coliand group B streptococci (GBS) colonized the umbilicus of 7 and 6 babies respectively, out of 23 studied, on the first day of life.E. coliand staphylococci were the predominant flora on the 6th day and they colonized 12 and 13 respectively. The oral flora was predominantly Gram-positive cocci, mainlyStreptoccocus salivariuswhich was isolated from 17 out of 22 babies on the 6th day, viridians streptococci were isolated from 14 babies,Staphylococcus albusfrom 16 babies and group D streptococci from 11 babies.Candidaspp. also colonized the oral cavities of 17 out of 22 babies on the 6th day. At the end of the first week of life, the faecal flora was predominantly anaerobic represented byBifidobacteriurnspp.,Bacterioidesspp. andClostridiumspp. The commonest facultative faecal flora wereE. coli, which was isolated from all the babies, andStrept. faecalisisolated from 20 babies. Early gut colonization by GBS,Bacteroidesspp. andClostridiumspp. was noticed in more babies delivered vaginally than by caesarean section where colonization by these bacteria was relatively delayed. The use of prophylactic penicillin plus gentamicin in the special neonatal unit probably prevented systemic spread of any of the potential opportunistic pathogens during the study.