Key words: Neonate, Intestinal flora, Infection, Bifidobacterium

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1 Key words: Neonate, Intestinal flora, Infection, Bifidobacterium

2 Table 1 Media of aerobic culture (37 Ž 24 hrs) Table 2 Media of anaerobic culture (37 Ž 48 hrs ) Table 3 Methods for analysis of fecal flora 1) included VM. KM. each 1.0, 80 iig /ml 2) included SM. NM. each 3,000, 1,000,ttg/ml

3 Number of viable bacteria in the feces of mice after oral administration Number of viable bacteria in the feces of mice after oral administration Number of viable bacteria in the feces of mice after oral administration Number of viable S. typhimurium in the feces of SPFICR mice after oral administration of 109 S. typhimurium

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6 Fig. 13 Fig. 15 Number of viable bacter is in the feces of neonate Fig. 14 Fig. 16

7 Fig Comparison of total Bifidobacterium and dosed B. breve per gram wet feces Each neonate was dosed 109 B. breve Fig. 17 Subject MA Fig. 18 Subject SA Fig. 19 Subject KO Fig. 20 Subject IS Fig. 21 Subject AS Fig. 22 Subject IC

8 Fig. 23 Fig. 24 Subject KI Subject YO Fig. 25 Subject EG Fig. 26 Subject NA (Jaundice) Fig. 27 Case M.K. 26W 760g Number of viable bacteria per gram wet feces

9 Fig. 28 Case T.T. clinical course Fig. 29 Case T. T. Š 26W 795g Number of viable bacteria per gram wet feces Aci : Acinetobacter Ach : Achromobacter F : Flavobacterium

10 Number of bacteria per gram wet feces Fig. 31 2nd baby 1720g q- Number of bacteria per gram wet feces

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13 the newborn intestine. Am. J. Clin. Nutr., 33: , ) Tanaka, R.& Mutai, M.: Improved medium for selective isolation and enumeration of Bifidobacterium. Appl. Environ. Microbial., 40: , ) Jacomina, A. A., Van der Wiel-Korstanje & Winkler, K. C.: J. Med. Microbial., 8: 491 3) Miller, M. E.: Phagocytosis in the newborn infant: Humoral and cellular factors. J. Pediatr., 74: , ) McCracken, G. H.& Eichenwald, H. F.: Leukocyte function and the development of opsonic and complement activity in the neonate. Amer. J. Dis. Child., 121: , ) Hensens, C.& Klastersky, J.: Intestinal colonization with lactobacilli strains in neutropenic patients. Biomedicine, 25: 11-15, 5) Forman, M. L.& Stiehm, E. R.: Impaired opsonic activity but normal phagocytosis in lowbirth-weight infants. New Eng. J. Med., 281: , ) Gothefors, L.: Symbiosis between host and microorganismus: Neonatal colonization. Scand. J. Infect. Dis., 24: 68-73, ) Brook, I., et al.: Aerobic and anaerobic bacterial flora of the maternal cervix and newborn gastric fluid and conjunctiva. 9) Rotimi, V. O.& Duerden, B. I.: The development of the bacterial flora in normal neonates. Pediatrics, 63: , ) Agarwal, R. C., Ansari, Z., Ahmad, S. H., Dutta, A. K.& Kumar, R.: Gastric aspirate examination for early detection of neonatal septicemia. J. Med. Microbial., 14: 51-62, ) Beerens, H., Romond, C.& Neut, C.: Influence of breast-feeding on the bifid flora of Indian Pediatrics, 17: ,

14 Intestinal Flora and Infection of Neonates Masahiro HOTTA Department of Pediatrics, School of Medicine, Keio University Systemic bacterial infection during the neonatal period is often severe and difficult to treat. The intestinal bacterial flora is thought one of the major sources of the causative agents. Generally no bacteria can be found in the feces of newborn infants immediately after birth. This study was designed to clarify the relationship between bacterial infection and the process of intestinal flora formation. First the intestinal flora of twelve neonates was analyzed. Another ten neonates were administered Bifidobacterium breve, which is non-pathogenic and is found in the feces of many healthy nursing infants. Neonates with abnormal proliferation of specific pathogenic bacteria in the intestinal tract were administered B. breve orally. The following results were obtained. 1) The formation of the intestinal flora was divided into three types. One type is that in which only intestinal bacteria were detected from the beginning. Another type is that in which some bacteria, such as Acinetobacter or Bacillus, other than intestinal ones were detected transiently. The third type is that in which only certain specific bacteria, for example Pseudomonas aeruginosa or Serratia marcescens colonized continuously and abundantly, causing bacterial infection. 2) Orally administered B. breve could colonize in the gastrointestinal tract of newborn infants when given right after birth. 3) When the neonates with abnormal proliferation of specific bacteria were administered B. breve orally, the B. breve colonized and the specific bacteria disappeared from the digestive tract.

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