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Gross blood in stools of premature neonates, a clinical and microbiological follow-up study



R Luoto, M.D., PhD, Department of Paediatrics, Satakunta Central Hospital, Sairaalantie 3, Pori 28500, Finland.

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To characterize the clinical course and the gut microecology of premature infants with macroscopic gross blood in stools.


We studied 14 premature infants receiving breast milk supplemented with probiotics, according to our units practice, with macroscopic blood in stools without signs of ileus or systemic infection upon occurrence of the symptom and 14 days later. Controls were matched prospectively by gestational and postnatal age and type of feeding. Gut microbiota composition was analysed by quantitative real-time polymerase chain reaction (qPCR), and the presence of enteric viruses in the stools was assayed by PCR and by reverse transcription reaction followed by PCR (RT-PCR).


The symptom was transient, benign and self-limiting and none of the background factors explained it. No enteric viruses were detected, and the bacterial analyses showed no statistically significant differences between the infants with or without gross blood in stools. The characterization of the gut microbiota revealed low bacterial diversity.


Gross blood in the stools of premature infants without other clinical signs of infection can be an innocuous and self-limiting symptom. This cohort of preterm infants receiving breast milk supplemented with probiotics showed no alterations in gut microecology to be associated with the symptom.