708 - Bifidobacterium longum subsp infantis (EVC001) is Associated with Reduced Incidence of Necrotizing Enterocolitis Stage ≥2 and Bloody Stools in Premature Babies

Publication Number: 708.3603

Victoria Palacios, Stanford University School of Medicine, Mountain View, NV, United States; Kristin Sohn, University of Nevada, Reno School of Medicine, Reno, NV, United States; Reese H.. Clark, Duke University School of Medicine, Marietta, SC, United States

Background: The premature gut microbiome exhibits delayed colonization and decreased biodiversity, and premature babies are at high risk for dysbiosis due to multiple factors. Dysbiosis is associated with chronic, life-long diseases, including diabetes, inflammatory bowel disease, and even cancer. More immediately, dysbiosis is associated with distal colon inflammation, hematochezia, and is known to precede the development of necrotizing enterocolitis. The dysbiosis in premature babies offers a unique time point to affect life-long health with the use of probiotics. In fact, human milk oligosaccharides (HMOs), the third largest component of human milk, are only digestible with the help of glycosidases possessed by specific bacteria. EVC001 specifically has the unique ability to consume HMO as its sole carbon source, secreting a protective anti-inflammatory metabolite, indole-3-lactic acid, as a by-product of catabolism. Probiotics containing B.infantis offer protection, anti-inflammatory properties, and decrease intestinal permeability.

Objective: To utilize an evidence-based probiotic protocol to reduce feeding intolerance and achieve a 50% reduction in necrotizing enterocolitis (NEC) ≥ stage 2 within two years of protocol implementation.

Design/Methods: From January 2022 through September 2023, we administered daily enteral Bifidobacterium longum ssp. infantis EVC001 (B. infantis EVC001) to babies ≤ 33 6/7 weeks gestation until 36 weeks post menstrual age. We compared feeding tolerance and complications to babies admitted during the prior two-year period. Fisher’s Exact test was used to analyze proportional data and t-test was used for continuous variables.

Results: 265 babies received EVC001. 277 babies formed the pre-probiotic cohort. Probiotic use was associated with decreased NEC ≥ stage 2 (p=0.0058), reduced bloody stools (p < 0.0001), decreased time to full enteral feeds (p < 0.0001), and decreased total parenteral nutrition (TPN) days (p < 0.0001).

Conclusion(s): Supplementation with B. infantis EVC001 was associated with a decrease in NEC, a decrease in bloody stools, and improvement in feeding tolerance in premature babies.

Table 1. Characteristics of babies in probiotic and control cohorts


Table 2. Clinical outcomes of babies in probiotic cohort vs. control cohort


Table 3. Clinical outcomes by gestational age


Table 1. Characteristics of babies in probiotic and control cohorts


Table 2. Clinical outcomes of babies in probiotic cohort vs. control cohort


Table 3. Clinical outcomes by gestational age