Acidification of formula reduces bacterial translocation and gut colonization in a neonatal rabbit model

John R. Mehall, Robert Northrop, Daniel A. Saltzman, Richard J. Jackson, Samuel D. Smith

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Background/Purpose: The authors hypothesized that gastric acidity is protective because it is bactericidal. They tested acidified formula for protection against gut colonization and bacterial translocation. Methods: In vitro: Formula was acidified to pH of 2, 3, 4, 5 and innoculated with Enterobacter. Growth over time was quantitatively assessed. In vivo: 442 premature rabbit pups were sorted randomly and fed formula of pH 2, 3, 4, or 7, with ranitidine. Two models were utilized: (1) with bacterial challenge using a known acid sensitive organism, (2) without bacterial challenge to simulate natural gut colonization and to test against organisms of unknown acid sensitivity. Normal acid animals received pH 7 formula, no ranitidine. On day 3, the mesenteric lymph nodes (MLN), spleen, liver, and cecum were harvested and cultured. Results: Bacterial growth was inhibited at pH 2 and 3, growth was logarithmic above pH 4 (P < .001). Total and organ-specific translocation was reduced at pH 3 and below in both models (P < .05). Translocation with formula pH 3 equaled normal acid animals. Quantitative cecal colonization was reduced in pups receiving pH 3 and below in both models (P < .05). Conclusion: Acidification of formula below pH 4 is bactericidal to enteric organisms. Acidified formula decreases bacterial translocation and gut colonization.

Original languageEnglish (US)
Pages (from-to)56-62
Number of pages7
JournalJournal of Pediatric Surgery
Volume36
Issue number1
DOIs
StatePublished - 2001

Keywords

  • Bacterial translocation
  • Bowel colonization
  • Gastric acidity

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