Abstract
Background/Objective:
The identification of probiotic species involved in gut homeostasis and their potential therapeutic benefits have led to an interest in their use for preventing necrotizing enterocolitis (NEC). Although bifidobacterium and lactobacilli sp. have been used to reduce the incidence of NEC in clinical trials. Lactobacillus sporogenes has not been used in the prevention of NEC in very low-birth weight infants yet. The objective of this study was to evaluate the efficacy of orally administered L sporogenes in reducing the incidence and severity of NEC in very low-birth weight (VLBW) infants.
Subjects/Methods:
A prospective, blinded, randomized controlled trial was conducted in preterm infants with a gestational age of <33 weeks or birth weight of <1500 g. VLBW infants who survived to start enteral feeding were randomized into two groups The infants in the study group were given L. sporogenes with a dose of 350 000 000 c.f.u. added to breast milk or formula, once a day, starting with the first feed until discharged. The infants in the control group were fed without L. sporogenes supplementation. The primary outcome measurement was death or NEC (Bell's stage ⩾2).
Results:
A total of 221 infants were studied: 110 in the study group and 111 in the control group. There was no significant difference in the incidence of death or NEC between the groups. Feeding intolerance was significantly lower in the probiotics group than in the control group (44.5% (n: 49) vs 63.1% (n: 70), respectively; P=0.006).
Conclusions:
L. sporogenes supplementation at the dose of 350 000 000 c.f.u/day is not effective in reducing the incidence of death or NEC in VLBW infants, however, it could improve the feeding tolerance.
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References
Alfaleh K, Bassler D (2008). Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev 23, CD005496.
Bin-Nun A, Bromiker R, Wilschanski M, Kaplan M, Rudensky B, Caplan M et al. (2005). Oral probiotics prevent necrotizing enterocolitis in very low birth weight infants. J Pediatr 147, 192–196.
Claud EC, Walker WA (2001). Hypothesis: inappropriate colonization of the premature intestine can cause neonatal necrotizing enterocolitis. FASEB J 15, 1398–1403.
Dai D, Walker WA (1998). Role of bacterial colonization in neonatal necrotizing enterocolitis and its prevention. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 39, 357–365.
Dani C, Biadaioli R, Bertini G, Martelli E, Rubaltelli FF (2002). Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in preterm infants. A prospective double-blind study. Biol Neonate 82, 103–108.
De Vecchi E, Drago L (2006). Lactobacillus sporogenes or Bacillus coagulans: misidentification or mislabelling? Int J Probiotics Prebiotics 1, 3–10.
Deshpande G, Rao S, Patole S (2007). Probiotics for prevention of necrotizing enterocolitis in preterm neonates with very low birth weight: a systematic review of randomized controlled trials. Lancet 369, 1614–1620.
Embleton ND, Yates R (2008). Probiotics and other preventative strategies for necrotising enterocolitis. Semin Fetal Neonatal Med 13, 35–43.
Gupta V, Garg R (2009). Probiotics. Indian J Med Microbiol 27, 202–209.
Hall MA, Cole CB, Smith SL, Fuller R, Rolles CJ (1990). Factors influencing the presence of faecal lactobacilli in early infancy. Arch Dis Child 65, 185–188.
Hoyos AB (1999). Reduced incidence of necrotizing enterocolitis associated with enteral administration of Lactobacillus acidophilus and Bifidobacterium infantis to neonates in an intensive care unit. Int J Infect Dis 3, 197–202.
Hunter CJ, Upperman JS, Ford HR, Camerini V (2008). Understanding the susceptibility of the premature infant to necrotizing enterocolitis (NEC). Pediatr Res 63, 117–123.
Isolauri E (1999). Immune effects of probiotics. In: Hanson LA, Yorken RH (eds). Probiotics, Other Nutritional Factors, and Intestinal Microflora. Nestle Nutrition Workshop Series. Vevey/Lippincott-Raven: Philadelphia, pp 229–241.
Juven BJ, Meinersmann RJ, Stern NJ (1991). Antagonistic effects of lactobacilli and pediococci to control intestinal colonization by human enteropathogens in live poultry. J Appl Bacteriol 70, 95–103.
Kitajima H, Sumida Y, Tanaka R, Yuki N, Takayama H, Fujimura M (1997). Early administration of Bifidobacterium breve to preterm infants: randomized controlled trial. Arch Dis Child Fetal Neonatal Ed 76, 101–107.
Kunz AN, Noel JM, Fairchok MP (2004). Two cases of Lactobacillus bacteremia during probiotic treatment of short gut syndrome. J Pediatr Gastroenterol Nutr 38, 457–458.
La Rosa M, Bottaro G, Gulino N, Gambuzza F, Di Forti F, Inì G et al. (2003). Prevention of antibiotic-associated diarrhea with Lactobacillus sporogens and fructo-oligosaccharides in children. A multicentric double-blind vs placebo study. Minerva Pediatr 55, 447–452.
Land MH, Rouster-Stevens K, Woods CR, Cannon ML, Cnota J, Shetty AK (2005). Lactobacillus sepsis associated with probiotic therapy. Pediatrics 115, 178–181.
Lin HC, Hsu CH, Chen HL, Chung MY, Hsu JF, Lien RI et al. (2008). Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Pediatrics 122, 693–700.
Lin HC, Su BH, Chen AC, Lin TW, Tsai CH, Yeh TF et al. (2005). Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants. Pediatrics 115, 1–4.
Matsumoto T, Ishikawa H, Tateda K, Yaeshima T, Ishibashi N, Yamaguchi K (2008). Oral administration of Bifidobacterium longum prevents gut-derived Pseudomonas aeruginosa sepsis in mice. J Appl Microbiol 104, 672–680.
Orrhage K, Nord CE (1999). Factors controlling the bacterial colonization of the intestine in breastfed infants. Acta Paediatr 88(Suppl 430), 47–57.
Reid G, Bruce AW, McGroarty JA, Cheng KJ, Costerton JW (1990). Is there a role for lactobacilli in prevention of urogenital and intestinal infections? Clin Microbiol Rev 3, 335–344.
Schanler RJ (2006). Probiotics and necrotising enterocolitis in premature infants. Arch Dis Child Fetal Neonatal Ed 91, 395–397.
Stoll BJ, Hansen N (2008). Infections in VLBW infants: studies from the NICHD Neonatal Research Network. Semin Perinatol 27, 293–301.
Talarico TL, Casas IA, Chung TC, Dobrogosz WJ (1988). Production and isolation of reuterin, a growth inhibitor produced by Lactobacillus reuteri. Antimicrob Agents Chemother 32, 1854–1858.
Walsh MC, Kliegman RM, Fanaroff AA (1988). Necrotizing enterocolitis: a practitioner's perspective. Pediatr Rev 9, 219–226.
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Sari, F., Dizdar, E., Oguz, S. et al. Oral probiotics: Lactobacillus sporogenes for prevention of necrotizing enterocolitis in very low-birth weight infants: a randomized, controlled trial. Eur J Clin Nutr 65, 434–439 (2011). https://doi.org/10.1038/ejcn.2010.278
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DOI: https://doi.org/10.1038/ejcn.2010.278
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