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Talactoferrin may reduce hospital-acquired infections in low birth weight infants

Very low birth weight infants experienced fewer hospital-acquired infections when treated with talactoferrin vs. controls, although this abatement was seen primarily in coagulase-negative staphylococci-related bloodstream and central line infections, according to research published in The Journal of Pediatrics.

Further, researchers found talactoferrin prophylaxis and neonatal intensive care unit practices (NICU) impacted the baby’s fecal microbiota makeup,

Researchers amassed 24-hour fecal samples from 21 infants weighing less than 1,500 g at birth that received two doses of talactoferrin (or its excipient) a day by gastric gavage from day 1 to 28 of life. The samples were collected on day 21 and compared with fecal operational taxonomy units (OTU) in controlled and treated infants in two separate NICUs.

According to Sherman and colleagues, fecal OTUs per infant were higher in NICU 1 vs. NICU 2 (P < .001), and consistent with fewer antibiotic days (P < .02) and a shorter time of parenteral nutrition (P < .007) in NICU 1. OTUs of staphylococci were barely noticeable in both NICUs among infants treated with talactoferrin. There were also reductions of Enterobacter and Klebsiella among those treated with talactoferrin, but an increase in Citrobacter. Citrobacter did not cause any neonatal infections.

Common care practices such as parenteral nutrition and prolonged antimicrobial therapy also modified the consistency and makeup of the gut microflora, researchers wrote.

“Although colonization by staphylococci is greater on neonatal skin, the oropharynx and the gastrointestinal tract, rotating antibiotic usage does not alter colonization,” Michael P. Sherman, MD, of the division of neonatology at the University of Missouri, and colleagues wrote.

According to researchers, because talactoferrin is no longer made in the United States, future studies that use bovine lactoferrin as a prophylactic agent to avoid hospital-acquired infections need to use Next Generation sequencing. – by Janel Miller

Disclosure: Researchers received an honorarium to serve as members of the Mead Johnson Pediatric Institute Bioactive Expert Panel to write a manuscript.