Iron-containing micronutrient powders modify the effect of oral antibiotics on the infant gut microbiome

Together with scientists of ETH Zurich (Switzerland) and the Jomo Kenyatta University of Agriculture and Technology (Kenya), NIZO published a third article regarding better insights in the effects of iron fortification and novel dietary treatments on the gut microbiome in Kenyan infants in the journal Gut.

Previous studies: Prebiotic galacto-oligosaccharides (GOS) counteract the adverse effects on the infant gut microbiome

Worldwide, about a quarter of billion children are anaemic. At least half of childhood anaemia is partly caused by a lack of iron. Currently, iron replenishment therapies in underdeveloped tropical countries show minimal effect with severe advents, such as infections, intestinal inflammation and diarrhea. In the first study in 2014, it was shown that iron-containing micronutrient powders (MNPs) can favour the outgrowth of harmful enteropathogens at the expense of beneficial microbes such as Bifidobacteriaceae and Lactobacillaceae. It also caused intestinal inflammation and diarrhoea in some children. In the study of 2017, a new formulation of iron-containing MNPs with GOS was engineered to counteract the adverse effect of iron on the infant gut microbiome while maintaining efficacy against anaemia at a relatively low dose of iron. GOS has the potential to selectively enhance growth of the beneficial Bifidobacteriaceae and Lactobacillaceae. The conclusion of this study was indeed that GOS was able to counteract  the adverse effects of iron on the gut microbiome by stimulating beneficial Bifidobacteriaceae, while reducing the abundance of enteric pathogens. At the same time the MNP was effective in restoring iron deficiency anaemia of the infants.

Newest study: Iron-containing micronutrient powders modify the effect of oral antibiotics on the infant gut microbiome and increase post-antibiotic diarrhoea risk

The aim of the newest study was to determine the effects of antibiotics on the gut microbiome of Kenyan infants when given with or without iron-containing MNPs, as antibiotics are one of the most commonly prescribed medications to infants. Antibiotic treatment can be life-saving for children with bacterial infections. However, it is well-known that antibiotics can modify the gut microbiome composition and may increase colonization by enteric pathogens. The general finding of this newest study was that large differences were found in the gut microbiome composition comparing Kenyan infants receiving antibiotics with iron, with those receiving antibiotics without iron. Specifically, the relative abundance of beneficial Bifidobacterium was decreased and enteropathogens were increased. In addition, the prevalence of diarrhoea was higher in infants receiving antibiotics with iron compared with those receiving antibiotics without iron. Larger intervention trials to confirm these results are needed. However, if these findings are confirmed, health-care practitioners should consider temporarily discontinuing iron-containing MNPs during antibiotics treatment. NIZO contributed to this study by performing 16S microbiota profiling with in-depth bioinformatics analyses on the effects of iron and antibiotics on the gut microbiome of the Kenyan infants.

For more information about our microbiome expertise, contact our Division Manager Health, Sabina Lukovac.