Probiotics to prevent necrotising enterocolitis and nosocomial infection in very low birth weight preterm infants

Br J Nutr. 2017 Apr;117(7):994-1000. doi: 10.1017/S0007114517000769. Epub 2017 Apr 26.

Abstract

The aim of the study was to determine whether routine probiotic supplementation (RPS) with Lactobacillus rhamnosus GG (LGG) or Lactobacillus acidophilus +Lactobacillus bifidum is associated with reduced risk of necrotising enterocolitis (NEC)≥Stage II in preterm neonates born at ≤32 weeks' gestation. We conducted a retrospective cohort study on the effect of probiotic supplementation in very low birth weight infants in our neonatal unit by comparing two periods: before and after supplementation. The incidence of NEC≥Stage II, late-onset sepsis and all-cause mortality was compared for an equal period 'before' (Period I) and 'after' (Period II) RPS with LGG or L. acidophillus+L. bifidum. Multivariate logistic regression analysis was conducted to adjust for relevant confounders. The study population was composed of 261 neonates (Period I v. II: 134 v. 127) with comparable gestation duration and birth weights. In <32 weeks, we observed a significant reduction in NEC≥Stage II (11·3 v. 4·8 %), late-onset sepsis (16 v. 10·5 %) and mortality (19·4 v. 2·3 %). The benefits in neonates aged ≤27 weeks did not reach statistical significance. RPS with LGG or L. acidophillus+L. bifidum is associated with a reduced risk of NEC≥Stage II, late-onset sepsis and mortality in preterm neonates born at ≤32 weeks' gestation.

Keywords: Lactobacillus; Lactobacillus acidophillus; Lactobacillus bifidum; rhamnosus GG; LGG Lactobacillus rhamnosus GG; NEC necrotising enterocolitis; VLBW very low birth weight; Late-onset sepsis; Necrotising enterocolitis; Probiotics; Very low birth weight infants.

Publication types

  • Comparative Study

MeSH terms

  • Cohort Studies
  • Combined Modality Therapy
  • Cross Infection / epidemiology
  • Cross Infection / immunology
  • Cross Infection / microbiology
  • Cross Infection / prevention & control*
  • Enterocolitis, Necrotizing / epidemiology
  • Enterocolitis, Necrotizing / immunology
  • Enterocolitis, Necrotizing / microbiology
  • Enterocolitis, Necrotizing / prevention & control*
  • Gastrointestinal Microbiome* / immunology
  • Humans
  • Incidence
  • Infant
  • Infant Mortality
  • Infant Nutritional Physiological Phenomena*
  • Infant, Newborn
  • Infant, Premature, Diseases / epidemiology
  • Infant, Premature, Diseases / immunology
  • Infant, Premature, Diseases / microbiology
  • Infant, Premature, Diseases / prevention & control*
  • Infant, Very Low Birth Weight
  • Intensive Care Units, Neonatal
  • Lacticaseibacillus rhamnosus / immunology
  • Lactobacillus acidophilus / immunology
  • Levilactobacillus brevis / immunology
  • Practice Guidelines as Topic
  • Premature Birth / immunology
  • Premature Birth / microbiology
  • Premature Birth / physiopathology
  • Premature Birth / therapy*
  • Probiotics / adverse effects
  • Probiotics / therapeutic use*
  • Retrospective Studies
  • Risk
  • Sepsis / epidemiology
  • Sepsis / immunology
  • Sepsis / microbiology
  • Sepsis / prevention & control
  • Spain / epidemiology