Review Article

Development and Functions of the Infant Gut Microflora: Western vs. Indian Infants

Table 2

Summary of studies investigating the gut microflora in Indian infants.

AuthorsYearStudy populationLocationMain findings

Albert et al. [59]1977South Indian infants aged 1-20 monthsVellore, Tamil Nadu(i) The normal gut microflora was predominantly anaerobic; bifidobacteria were the most abundant microbes
(ii) Aerobic bacteria mainly comprised enterobacteria and enterococci

Balamurugan et al. [61]2008South Indian children aged 2-3 yearsVellore, Tamil Nadu(i) Bifidobacteria were the most abundant gut bacteria
(ii) Lactobacillus acidophilus was also detected
(iii) Both bacteria decreased in abundance after the age of 2-3 years

Balamurugan et al. [60]2010Term-born neonates in a tertiary care hospital in southern IndiaVellore, Tamil NaduEnterobacteria (Escherichia coli) and bifidobacteria (Bifidobacterium longum subspecies infantis) were the predominant gut bacteria

Pandey et al. [63]2012Full-term, breastfed infantsPune, Maharashtra(i) Gut microflora of vaginally born infants on postnatal day 7 was dominated by Acinetobacter sp. (44%), followed by Bifidobacterium sp. and Staphylococcus sp.
(ii) In cesarean-born infants, Citrobacter sp., E. coli, and Clostridium difficile were the dominant microbes; bifidobacteria were absent

Sharma et al. [70]2012Full-term infants around 4 weeks of ageNew Delhi(i) Predominant aerobic organisms: Micrococcus sp. (3.4%)
(ii) Predominant facultative anaerobes: Klebsiella pneumoniae (41.3%), Enterococcus faecium (34.4%), E. coli (24.1%), Proteus sp. (10.3%), and Staphylococcus epidermidis (6.8%)
(iii) Predominant anaerobic organisms: Bifidobacterium sp. (13.4%) and Clostridium bifermentans (3.4%)

Kabeerdoss et al. [62]2013Term-born infants in a south Indian hospital followed up from birth till 6 months of ageVellore, Tamil Nadu(i) Enterobacteria and lactobacilli were the predominant gut bacteria in the first 2 days of life
(ii) Bifidobacteria and staphylococci increased by the fourth day
(iii) Bacteroides-Prevotella group increased by around 6 months of age
(iv) Enterococci were less abundant

Dinh et al. [64]2016Persistently stunted (cases) and normal children (controls) from a birth cohort in a south Indian slum community followed up from birth till 2 years of ageVellore, Tamil Nadu(i) Firmicutes (38.6%) and Proteobacteria (25.89%) were the most abundant bacteria in the overall cohort, followed by Actinobacteria (17.5%), Bacteroidetes (13.8%), and Verrucomicrobia
(ii) Microflora of control children was enriched in the probiotic species Bifidobacterium longum and Lactobacillus mucosae

Chandel et al. [67]2017Full-term, cesarean-born infantsOdisha(i) Firmicutes (28%; Enterococcus, Clostridium, and Staphylococcus) and Proteobacteria (64%; Escherichia, Shigella) were the predominant phyla on postnatal day 7
(ii) By postnatal day 60, the proportion of Proteobacteria reduced to 13%, and Firmicutes (49%; e.g., Streptococcus), Bacteroidetes (36%), and Actinobacteria (Bifidobacterium) increased

Attri et al. [68]2018Vaginally born, exclusively breastfed, full-term infantsSolan and Shimla, Himachal Pradesh(i) First and second months of life: facultative anaerobic bacteria (Firmicutes and Proteobacteria) predominated
(ii) Third and fourth months: Obligate anaerobes (Bacteroidetes and Actinobacteria) increased
(iii) Clostridia were predominant throughout months 1-4 (20-30%)
(iv) Bifidobacterium adolescentis, B. bifidum, B. longum, B. pseudolongum, and B. breve were also detected

Attri et al. [69]2018Full-term, vaginally born, exclusively breastfed infantsSolan, Himachal Pradesh(i) In the first 4 months of life, Enterococcus, Streptococcus, and Lactobacillus were the predominant lactic acid-producing bacteria
(ii) B. breve was the predominant species of bifidobacteria
(iii) The diversity of lactic acid-producing bacteria and bifidobacteria increased over 4 months