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A major new study has found that administering probiotics to very low birth weight, preterm babies can significantly reduce the levels of multidrug-resistant bacteria in their gut—a breakthrough with important implications for antimicrobial resistance in newborn care units.
Researchers from the University of Birmingham, led by Professor Lindsay Hall and Dr Raymond Kiu, published their findings in Nature Communications. The study tracked a group of 34 preterm babies, each weighing less than 1,500g at birth, and investigated their gut microbiome during the crucial first three weeks after delivery.
Babies who were given a probiotic containing a specific strain of Bifidobacterium alongside standard antibiotic treatment developed a gut microbiome remarkably similar to that of healthy, full-term babies. This not only reduced the presence of antibiotic resistance genes but also decreased the number of harmful, multidrug-resistant bacteria compared to those who did not receive probiotics.
One of the most significant findings was a drop in drug-resistant pathogens like Enterococcus, often linked to infections and longer hospital stays. At the same time, beneficial gut bacteria increased in abundance among babies who got the probiotic. Conversely, infants who did not receive probiotics showed a dominance of potentially harmful bacteria (pathobionts) associated with severe infections and chronic health problems later in life.
Professor Hall explained:
“We have already shown that probiotics are highly effective in protecting vulnerable preterm babies from serious infections, and this study now reveals that these probiotics also significantly reduce the presence of antibiotic resistance genes and multidrug-resistant bacteria in the infant gut. Crucially, they seem to do so selectively—targeting resistant strains without disrupting non-resistant strains that might be beneficial.”
The research team also explored how antibiotics, probiotics, and genetic exchange between bacteria interact in shaping the preterm infant’s microbiome. The rapid colonization of the gut by Bifidobacterium following probiotic treatment was linked to the maturation of a healthier microbiota and lower levels of resistant pathogens.
This work aligns with recommendations by the World Health Organization, which already advocates probiotic use in preterm infants. Many neonatal intensive care units in the UK have implemented such protocols, aiming to protect the most vulnerable newborns against infection and curb the spread of antimicrobial resistance.
Dr Kiu noted the broader implications:
“Our findings shed light on the complex interactions between antibiotics, probiotics, and horizontal gene transfer in shaping the early-life microbiome. We believe this research lays the groundwork for future studies exploring the role of probiotics in antimicrobial stewardship and infection control among preterm populations.”
Disclaimer
This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals for guidance on the care of preterm infants and before making changes to neonatal treatment protocols.
Reference: “Probiotics for preterm babies lowered antibiotic resistant bacteria in gut,” University of Birmingham News, August 2025.
