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Erschienen in: Wiener klinische Wochenschrift 5/2015

01.12.2015 | original article

Influence of a combination of probiotics on bacterial infections in very low birthweight newborns

verfasst von: MD Zlatka Kanic, MD Prof. Dusanka Micetic Turk, MD, PhD Asst. Prof. Silva Burja, MD Vojko Kanic, PhD Prof. Dejan Dinevski

Erschienen in: Wiener klinische Wochenschrift | Sonderheft 5/2015

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Summary

Background

Late-onset infections are an important cause of morbidity and mortality in preterm infants. The purpose of our prospective randomised study was to establish whether a combination of probiotics (Lactobacillus acidophilus, Enterococcus faecium and Bifidobacterium infantum) affects the incidence of late-onset sepsis and other infections in very low birthweight infants (birthweight under 1500 g, gestational age under 33 weeks).

Methods

From 80 included infants, one half received probiotics (L. acidophilus, E. faecium and B. infantum) in the ratio 1.5:1:1.5, at a dose of 0.6 × 107 colony-forming units twice daily, given with the first portions of milk until discharge, whereas the other half did not.

Results

In the group receiving probiotics, 16 children had late-onset sepsis compared with 29 in the group without probiotics; p = 0.006. The number of late-onset septic events was lower (30) in the group receiving probiotics than in the group that did not receive probiotics (69); p = 0.003. Furthermore, fewer children had at least one late-onset infection (20 infants in the group receiving probiotics compared with 32 in the group without them; p = 0.009). There were less episodes of late-onset infections in the group receiving probiotics (35) than in the group without probiotics (79); p = 0.002.

Conclusions

A combination of probiotics at a low dose (1.2 × 107 colony-forming units) decreased the frequency of late-onset sepsis and other infections, as described in previous studies. In addition, children were discharged at a lower postmenstrual age. There were no side effects of probiotics reported.
Literatur
1.
Zurück zum Zitat Awad H, Mokhtar H, Imam SS, Gad GI, Hafez H, Aboushady N. Comparison between killed and living probiotic usage versus placebo for the prevention of necrotizing enterocolitis and sepsis in neonates. Pak J Biol Sci. 2010;13(6):253–62. CrossRefPubMed Awad H, Mokhtar H, Imam SS, Gad GI, Hafez H, Aboushady N. Comparison between killed and living probiotic usage versus placebo for the prevention of necrotizing enterocolitis and sepsis in neonates. Pak J Biol Sci. 2010;13(6):253–62. CrossRefPubMed
2.
3.
Zurück zum Zitat Bezirtzoglou E, Tsiotsias A, Welling GW. Microbiota profile in feces of breast- and formula-fed newborns by using fluorescence in situ hybridization (FISH). Anaerobe. 2011;17(6):478–82. CrossRefPubMed Bezirtzoglou E, Tsiotsias A, Welling GW. Microbiota profile in feces of breast- and formula-fed newborns by using fluorescence in situ hybridization (FISH). Anaerobe. 2011;17(6):478–82. CrossRefPubMed
4.
Zurück zum Zitat Bianconi S, Gudavalli M, Sutija VG, Lopez AL, Barillas-Arias L, Ron N. Ranitidine and late-onset sepsis in the neonatal intensive care unit. J Perinat Med. 2007;35(2):147–50. CrossRefPubMed Bianconi S, Gudavalli M, Sutija VG, Lopez AL, Barillas-Arias L, Ron N. Ranitidine and late-onset sepsis in the neonatal intensive care unit. J Perinat Med. 2007;35(2):147–50. CrossRefPubMed
5.
Zurück zum Zitat Bradley JS. Considerations unique to pediatrics for clinical trial design in hospital acquired pneumonia and ventilator assiciated pneumonia. Clin Infect Dis. 2010;51(S1):136–43. CrossRef Bradley JS. Considerations unique to pediatrics for clinical trial design in hospital acquired pneumonia and ventilator assiciated pneumonia. Clin Infect Dis. 2010;51(S1):136–43. CrossRef
6.
Zurück zum Zitat Burja S, Treiber M, Tekauc-Golob A, et al. Neonatal mortality in the Maribor region (1997–2008). Acta medico-biotechnica. 2014;7(1):23–31. Burja S, Treiber M, Tekauc-Golob A, et al. Neonatal mortality in the Maribor region (1997–2008). Acta medico-biotechnica. 2014;7(1):23–31.
7.
Zurück zum Zitat Carl MA, Ndao IM, Springman AC, Manning SD, Johnson JR, Johnson BD, et al. Sepsis from the gut: the enteric habitat of bacteria that cause late-onset neonatal bloodstream infections. Clin Infect Dis. 2014;58(9):1211–8. CrossRefPubMedPubMedCentral Carl MA, Ndao IM, Springman AC, Manning SD, Johnson JR, Johnson BD, et al. Sepsis from the gut: the enteric habitat of bacteria that cause late-onset neonatal bloodstream infections. Clin Infect Dis. 2014;58(9):1211–8. CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Cheng YW, Wong SN. Diagnosing symptomatic urinary tract infections in infants by catheter urine culture. J Paediatr Child Health. 2005;41:437–40. CrossRefPubMed Cheng YW, Wong SN. Diagnosing symptomatic urinary tract infections in infants by catheter urine culture. J Paediatr Child Health. 2005;41:437–40. CrossRefPubMed
9.
Zurück zum Zitat Costalos C, Skouteri V, Gounaris A, Sevastiadou S, Triandafilidou A, Ekonomidou C, et al. Enteral feeding of premature infants with Saccharomyces boulardii. Early Hum Dev. 2003;74(2):89–96. CrossRefPubMed Costalos C, Skouteri V, Gounaris A, Sevastiadou S, Triandafilidou A, Ekonomidou C, et al. Enteral feeding of premature infants with Saccharomyces boulardii. Early Hum Dev. 2003;74(2):89–96. CrossRefPubMed
10.
Zurück zum Zitat Dani C, Biadaioli R, Bertini G, Martelli E, Rubaltelli FF. Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in preterm infants. A prospective double-blind study. Biol Neonate. 2002;82(2):103–8. CrossRefPubMed Dani C, Biadaioli R, Bertini G, Martelli E, Rubaltelli FF. Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in preterm infants. A prospective double-blind study. Biol Neonate. 2002;82(2):103–8. CrossRefPubMed
11.
Zurück zum Zitat Duffy LC. Interactions mediating bacterial translocation in the immature intestine. J Nutr. 2000;130(2S Suppl):432S–6S. PubMed Duffy LC. Interactions mediating bacterial translocation in the immature intestine. J Nutr. 2000;130(2S Suppl):432S–6S. PubMed
12.
Zurück zum Zitat Ehrenkrantz RA. Early, aggressive nutritional management for very low birth weight infants: what is the evidence? Semin Perinatol. 2007;31(2):48–55. CrossRef Ehrenkrantz RA. Early, aggressive nutritional management for very low birth weight infants: what is the evidence? Semin Perinatol. 2007;31(2):48–55. CrossRef
13.
Zurück zum Zitat Fernandez-Carrocera LA, Solis-Herrera A, Cabanillas-Ayon M, Gallardo-Sarmiento RB, Garcia-Perez CS, Montano-Rodriguez R, et al. Double-blind, randomised clinical assay to evaluate the efficacy of probiotics in preterm newborns weighing less than 1500 g in the prevention of necrotising enterocolitis. Arch Dis Child Fetal Neonatal Ed. 2013;98:F5–9. CrossRefPubMed Fernandez-Carrocera LA, Solis-Herrera A, Cabanillas-Ayon M, Gallardo-Sarmiento RB, Garcia-Perez CS, Montano-Rodriguez R, et al. Double-blind, randomised clinical assay to evaluate the efficacy of probiotics in preterm newborns weighing less than 1500 g in the prevention of necrotising enterocolitis. Arch Dis Child Fetal Neonatal Ed. 2013;98:F5–9. CrossRefPubMed
14.
Zurück zum Zitat Gill HS. Probiotics enhance anti-effective defences in the gastrointestinal tract. Best Pract Res Clin Gastroenterol. 2003;17(5):755–73. CrossRefPubMed Gill HS. Probiotics enhance anti-effective defences in the gastrointestinal tract. Best Pract Res Clin Gastroenterol. 2003;17(5):755–73. CrossRefPubMed
15.
Zurück zum Zitat Gray JW. Which factors predict hospital-acquired late-onset neonatal sepsis? Pediatr Health. 2008;2(4):477–84. CrossRef Gray JW. Which factors predict hospital-acquired late-onset neonatal sepsis? Pediatr Health. 2008;2(4):477–84. CrossRef
16.
Zurück zum Zitat Kaufman D, Fairchild KD. Clinical microbiology of bacterial and fungal sepsis in very-low-birth-weight infants. Clin Microbiol Rev. 2004;17(3):638–80. CrossRefPubMedPubMedCentral Kaufman D, Fairchild KD. Clinical microbiology of bacterial and fungal sepsis in very-low-birth-weight infants. Clin Microbiol Rev. 2004;17(3):638–80. CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Kolaček S. Imunost probavnog sustava. Paediatr Croat. 2005;49(Suppl. 1):89–93. Kolaček S. Imunost probavnog sustava. Paediatr Croat. 2005;49(Suppl. 1):89–93.
18.
Zurück zum Zitat Lin HC, Su BH, Chen AC, Lin TW, Tsai CH, Yeh TF, et al. Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants. Pediatrics. 2005;115(1):1–4. PubMed Lin HC, Su BH, Chen AC, Lin TW, Tsai CH, Yeh TF, et al. Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants. Pediatrics. 2005;115(1):1–4. PubMed
19.
Zurück zum Zitat Lin HC, Hsu CH, Chen HL, Chung MY, Hsu JF, Lien RI, et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Pediatrics. 2008;122(4):693–700. CrossRefPubMed Lin HC, Hsu CH, Chen HL, Chung MY, Hsu JF, Lien RI, et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Pediatrics. 2008;122(4):693–700. CrossRefPubMed
20.
21.
Zurück zum Zitat Mičetić-Turk D, Šikić-Pogačar M. Klinična uporaba probiotikov v pediatriji. Zdrav Vestn. 2011;80:933–43. Mičetić-Turk D, Šikić-Pogačar M. Klinična uporaba probiotikov v pediatriji. Zdrav Vestn. 2011;80:933–43.
22.
Zurück zum Zitat Mihatsch WA, von Schoenaich P, Fahnenstich H, et al. The significance of gastric residuals early enteral feeding advancement of extremely low birth weight infants. Pediatrics. 2002;109(3):457–9. CrossRefPubMed Mihatsch WA, von Schoenaich P, Fahnenstich H, et al. The significance of gastric residuals early enteral feeding advancement of extremely low birth weight infants. Pediatrics. 2002;109(3):457–9. CrossRefPubMed
23.
Zurück zum Zitat Mihatsch WA, Vossbeck S, Eikmanns B, Hoegel J, Pohlandt F. Effect of bifidobacterium lactis on the incidence of nosocomial infections in very-low-birthweight infants: a randomized controlled trial. Neonatology. 2010;98(2):156–63. CrossRefPubMed Mihatsch WA, Vossbeck S, Eikmanns B, Hoegel J, Pohlandt F. Effect of bifidobacterium lactis on the incidence of nosocomial infections in very-low-birthweight infants: a randomized controlled trial. Neonatology. 2010;98(2):156–63. CrossRefPubMed
24.
Zurück zum Zitat Millar MR, Bacon C, Smith SL, Walker V, Hall MA. Enteral feeding of premature infants with Lactobacillus GG. Arch Dis Child. 1993;69(5):483–7. CrossRefPubMedPubMedCentral Millar MR, Bacon C, Smith SL, Walker V, Hall MA. Enteral feeding of premature infants with Lactobacillus GG. Arch Dis Child. 1993;69(5):483–7. CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Mohan R, Koebnick C, Schildt J, Mueller M, Radke M, Blaut M. Effects of Bifidobacterium lactis Bb12 supplementation on body weight, fecal pH, acetate, lactate, calprotectin, and IgA in preterm infants. Pediatr Res. 2008;64(4):418–22. CrossRefPubMed Mohan R, Koebnick C, Schildt J, Mueller M, Radke M, Blaut M. Effects of Bifidobacterium lactis Bb12 supplementation on body weight, fecal pH, acetate, lactate, calprotectin, and IgA in preterm infants. Pediatr Res. 2008;64(4):418–22. CrossRefPubMed
26.
Zurück zum Zitat Neu J, Walker WA. Necrotising enterocolitis. N Engl J Med. 2011;354(3):255–64. CrossRef Neu J, Walker WA. Necrotising enterocolitis. N Engl J Med. 2011;354(3):255–64. CrossRef
27.
28.
Zurück zum Zitat Philip AG, Mills PC. Use of C-reactive protein in minimizing antibiotic exposure: experience with infants initially admitted to a well-baby nursery. Pediatrics. 2000;106(1):E4. CrossRefPubMed Philip AG, Mills PC. Use of C-reactive protein in minimizing antibiotic exposure: experience with infants initially admitted to a well-baby nursery. Pediatrics. 2000;106(1):E4. CrossRefPubMed
29.
Zurück zum Zitat Polin RA. Management of neonates with suspected or proven early-onset bacterial sepsis. Pediatrics. 2012;129(5):1006–15. CrossRefPubMed Polin RA. Management of neonates with suspected or proven early-onset bacterial sepsis. Pediatrics. 2012;129(5):1006–15. CrossRefPubMed
30.
Zurück zum Zitat Polin RA, Denson S, Brady MT, Committee on Fetus and Newborn, Committee on Infectious Diseases. Epidemiology and diagnosis of health care-associated infections in the NICU. Pediatrics. 2012;129:e1104–9. CrossRefPubMed Polin RA, Denson S, Brady MT, Committee on Fetus and Newborn, Committee on Infectious Diseases. Epidemiology and diagnosis of health care-associated infections in the NICU. Pediatrics. 2012;129:e1104–9. CrossRefPubMed
31.
Zurück zum Zitat Robertson J, Shilkofski N. Chap. 25, Blood chemistry and body fluid. In: Robertson J, Shilkofski N, editors. The Harriet Lane handbook. 17th ed. Philadelphia: Mosby; 2005. pp. 661–72. Robertson J, Shilkofski N. Chap. 25, Blood chemistry and body fluid. In: Robertson J, Shilkofski N, editors. The Harriet Lane handbook. 17th ed. Philadelphia: Mosby; 2005. pp. 661–72.
32.
Zurück zum Zitat Samanta M, Sarkar M, Ghosh P, Ghosh J, Sinha M, Chatterjee S. Prophylactic probiotics for prevention of necrotizing enterocolitis in very low birth weight newborns. J Trop Pediatr. 2009;55(2):128–31. CrossRefPubMed Samanta M, Sarkar M, Ghosh P, Ghosh J, Sinha M, Chatterjee S. Prophylactic probiotics for prevention of necrotizing enterocolitis in very low birth weight newborns. J Trop Pediatr. 2009;55(2):128–31. CrossRefPubMed
33.
Zurück zum Zitat Sawardekar KP. Changing spectrum of neonatal omphalitis. Pediatr Infect Dis J. 2004;23(1):22–6. CrossRefPubMed Sawardekar KP. Changing spectrum of neonatal omphalitis. Pediatr Infect Dis J. 2004;23(1):22–6. CrossRefPubMed
35.
Zurück zum Zitat Stoll BJ, Hansen NI, Higgins RD, Fanaroff AA, Duara S, Goldberg R, et al. Very low birth weight preterm infants with early onset neonatal sepsis: the predominance of gram-negative infections continues in the National Institute of Child Health and Human Development Neonatal Research Network, 2002–2003. Pediatr Infect Dis J. 2005;24(7):635–9. CrossRefPubMed Stoll BJ, Hansen NI, Higgins RD, Fanaroff AA, Duara S, Goldberg R, et al. Very low birth weight preterm infants with early onset neonatal sepsis: the predominance of gram-negative infections continues in the National Institute of Child Health and Human Development Neonatal Research Network, 2002–2003. Pediatr Infect Dis J. 2005;24(7):635–9. CrossRefPubMed
37.
Zurück zum Zitat Underwood MA, Salzman NH, Bennett SH, Barman M, Mills D, Marcobal A, et al. A randomized placebo-controlled comparison of two prebiotic/probiotic combinations in preterm infants: impact on weight gain, intestinal microbiota, and fecal short chain fatty acids. J Pediatr Gastroenterol Nutr. 2009;48(2):216–25. CrossRefPubMedPubMedCentral Underwood MA, Salzman NH, Bennett SH, Barman M, Mills D, Marcobal A, et al. A randomized placebo-controlled comparison of two prebiotic/probiotic combinations in preterm infants: impact on weight gain, intestinal microbiota, and fecal short chain fatty acids. J Pediatr Gastroenterol Nutr. 2009;48(2):216–25. CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Van der Zwet WC, Kaiser AM, van Elburg RM, Berkhof J, Fetterb WPF, Parlevlieta GA, Vandenbroucke-Graulsa CMJE. Nosocomial infections in a Dutch neonatal intensive care unit: surveillance study with definitions for infection specifically adapted for neonates. J Hosp Infect. 2005;61(4):300–11. CrossRefPubMed Van der Zwet WC, Kaiser AM, van Elburg RM, Berkhof J, Fetterb WPF, Parlevlieta GA, Vandenbroucke-Graulsa CMJE. Nosocomial infections in a Dutch neonatal intensive care unit: surveillance study with definitions for infection specifically adapted for neonates. J Hosp Infect. 2005;61(4):300–11. CrossRefPubMed
40.
Zurück zum Zitat Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am. 1986;33(1):179–201. PubMed Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am. 1986;33(1):179–201. PubMed
Metadaten
Titel
Influence of a combination of probiotics on bacterial infections in very low birthweight newborns
verfasst von
MD Zlatka Kanic
MD Prof. Dusanka Micetic Turk
MD, PhD Asst. Prof. Silva Burja
MD Vojko Kanic
PhD Prof. Dejan Dinevski
Publikationsdatum
01.12.2015
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe Sonderheft 5/2015
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-015-0845-0