Prophylactic Probiotics to Prevent Death and Nosocomial Infection in Preterm Infants
- 1 November 2012
- journal article
- research article
- Published by American Academy of Pediatrics (AAP) in Pediatrics
- Vol. 130 (5), e1113-e1120
- https://doi.org/10.1542/peds.2011-3584
Abstract
BACKGROUND AND OBJECTIVE: It has been suggested that probiotics may decrease infant mortality and nosocomial infections because of their ability to suppress colonization and translocation of bacterial pathogens in the gastrointestinal tract. We designed a large double-blinded placebo-controlled trial using Lactobacillus reuteri to test this hypothesis in preterm infants. METHODS: Eligible infants were randomly assigned during the first 48 hours of life to either daily probiotic administration or placebo. Infants in the intervention group were administered enterally 5 drops of a probiotic preparation containing 108 colony-forming units of L reuteri DSM 17938 until death or discharge from the NICU. RESULTS: A total of 750 infants ≤2000 g were enrolled. The frequency of the primary outcome, death, or nosocomial infection, was similar in the probiotic and placebo groups (relative risk 0.87; 95% confidence interval: 0.63–1.19; P = .376). There was a trend toward a lower rate of nosocomial pneumonia in the probiotic group (2.4% vs 5.0%; P = .06) and a nonsignificant 40% decrease in necrotizing enterocolitis (2.4% vs 4.0%; P = .23). Episodes of feeding intolerance and duration of hospitalization were lower in infants ≤ 1500 g (9.6% vs 16.8% [P = .04]; 32.5 days vs 37 days [P = .03]). CONCLUSIONS: Although L reuteri did not appear to decrease the rate of the composite outcome, the trends suggest a protective role consistent with what has been observed in the literature. Feeding intolerance and duration of hospitalization were decreased in premature infants ≤1500 g.Keywords
This publication has 40 references indexed in Scilit:
- Production of conjugated linoleic acids by Lactobacillus plantarum strains isolated from naturally fermented Chinese picklesJournal of Zhejiang University-SCIENCE B, 2011
- Lactic Acid Bacteria Enriched from Human Gastric BiopsiesISRN Gastroenterology, 2011
- Probiotics for Prevention of Necrotising Enterocolitis: An Updated Meta-analysisKlinische Padiatrie, 2010
- The Effects of Probiotics on Feeding Tolerance, Bowel Habits, and Gastrointestinal Motility in Preterm NewbornsThe Journal of Pediatrics, 2008
- Prevalence of nosocomial infections in neonatal intensive care unit patients: Results from the first national point-prevalence surveyThe Journal of Pediatrics, 2001
- Does probiotics administration decrease serum endotoxin levels in infants?Journal of Pediatric Surgery, 1999
- Bloodstream infections in neonatal intensive care unit patientsThe Pediatric Infectious Disease Journal, 1994
- Gastric colonization and pneumonia in intubated critically ill patients receiving stress ulcer prophylaxisCritical Care Medicine, 1992
- Neonatal meningitis due to LactobacillusThe Pediatric Infectious Disease Journal, 1983
- Bacterial colonization of neonates admitted to an intensive care environmentThe Journal of Pediatrics, 1978