Abstract Objective To evaluate the effect of oral administration of probiotics on intestinal colonization with drug-resistant bacteria among preterm infants in the neonatal intensive care unit (NICU). Methods A doubleblind, randomized, placebo-controlled trial was carried out in the preterm infants who were transferred to the NICU immediately after birth. These infants were stratified by whether they were breastfed and then randomized into test group and control group. The test group was given probiotics from the day when enteral feeding began, while the control group was treated conventionally without probiotics. The two groups were compared in terms of the colonization with extended-spectrum beta-lactamase-producing bacteria, as assessed by rectal swabs on days 1, 3, 7, and 14 after birth, and the incidence of diseases. Results Rectal colonization with drug-resistant bacteria was found in the test group (n=119) and control group (n=138) on days 1, 3, 7, and 14 after birth. There were no significant differences in the incidence of late-onset sepsis and necrotizing enterocolitis between the two groups (P>0.05). Among non-breastfed infants, the test group had significantly decreased rectal colonization with drug-resistant bacteria compared with the control group on day 14 after birth (71.1% vs 88.9%; P=0.04). No probiotic-related adverse events were observed in the study. Conclusions Oral administration of probiotics may reduce rectal colonization with drug-resistant bacteria in preterm infants under certain conditions and shows good safety.
About author:: [1] 刘健慧, 王丹华. NICU 常见院内感染耐药菌的定植与感染[J].新生儿科杂志, 2004, 19(5): 233-236.[2] Kalliomaki M, Salminen S, Arvilommi H, et al. Probiotics in primary prevention of atopic disease: s randomised placebocontrolled trial[J].Lancet, 2001, 357(9262): 1076-1079.[3] Brand S, Reinecker HC, Sandborn WJ. An enhanced barrier is a better defense: Effects of probiotics on intestinal barrier function[J].Inflamm Bowel Dis, 2002, 8(1): 67-69.[4] Smith TJ, Anderson D, Margolis LM, et al. Persistence of Lactobacillus reuteri DSM 17938 in the human intestinal tract: response to consecutive and alternate-day supplementation[J].J Am Coll Nutr, 2011, 30(4): 259-264.[5] 乔立兴, 唐月华, 王伟, 等. NICU 内早产儿早期肠道内添 加益生菌的临床观察[J].中国微生态学杂志, 2012, 24(11): 1011-1013.[6] Nair V, Soraisham AS. Probiotics and prebiotics: role in prevention of nosocomial sepsis in preterm infants[J].Int J Pediatr, 2013, 2013: 874726.[7] Wang Q, Dong J, Zhu Y. Probiotic supplement reduces risk of necrotizing enterocolitis and mortality in preterm very low-birthweight infants: an updated meta-analysis of 20 randomized, controlled trials[J].J Pediatr Surg, 2012, 47(1): 241-248.[8] Deshpande G, Rao S, Patole S, et al. Updated Meta-analysis of Probiotics for Preventing Necrotizing Enterocolitis in Preterm Neonates[J].Pediatrics, 2010, 125(5): 921-930.[9] Indrio F, Riezzo G, Raimondi F, et al. The Effects of Probiotics on Feeding Tolerance, Bowel Habits, and Gastrointestinal Motility in Preterm Newborns[J].J Pediatr. 2008, 152(6): 801-806.[10] AlFaleh K, Anabrees J, Bassler D, et al. Cochrane Review: Probiotics for prevention of necrotizing enterocolitis in preterm infants[J].Evid Based Child Health, 2012,7(6): 1807-1854.[11] Lin HC, Hsu CH, Chen HL, et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial[J].Pediatrics, 2008, 122(4): 693-700.[12] Bin-Nun A, Bromiker R, Wilschanski M, et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight neonates[J].J Pediatr, 2005,147(2): 192-196.
Cite this article:
HUA Xin-Tian,TANG Jun,MU De-Zhi. Effect of oral administration of probiotics on intestinal colonization with drugresistant bacteria in preterm infants[J]. CJCP, 2014, 16(6): 606-609.
HUA Xin-Tian,TANG Jun,MU De-Zhi. Effect of oral administration of probiotics on intestinal colonization with drugresistant bacteria in preterm infants[J]. CJCP, 2014, 16(6): 606-609.
刘健慧, 王丹华. NICU 常见院内感染耐药菌的定植与感染[J].新生儿科杂志, 2004, 19(5): 233-236.
[2]
Kalliomaki M, Salminen S, Arvilommi H, et al. Probiotics in primary prevention of atopic disease: s randomised placebocontrolled trial[J].Lancet, 2001, 357(9262): 1076-1079.
[3]
Brand S, Reinecker HC, Sandborn WJ. An enhanced barrier is a better defense: Effects of probiotics on intestinal barrier function[J].Inflamm Bowel Dis, 2002, 8(1): 67-69.
[4]
Smith TJ, Anderson D, Margolis LM, et al. Persistence of Lactobacillus reuteri DSM 17938 in the human intestinal tract: response to consecutive and alternate-day supplementation[J].J Am Coll Nutr, 2011, 30(4): 259-264.
[5]
乔立兴, 唐月华, 王伟, 等. NICU 内早产儿早期肠道内添 加益生菌的临床观察[J].中国微生态学杂志, 2012, 24(11): 1011-1013.
[6]
Nair V, Soraisham AS. Probiotics and prebiotics: role in prevention of nosocomial sepsis in preterm infants[J].Int J Pediatr, 2013, 2013: 874726.
[7]
Wang Q, Dong J, Zhu Y. Probiotic supplement reduces risk of necrotizing enterocolitis and mortality in preterm very low-birthweight infants: an updated meta-analysis of 20 randomized, controlled trials[J].J Pediatr Surg, 2012, 47(1): 241-248.
[8]
Deshpande G, Rao S, Patole S, et al. Updated Meta-analysis of Probiotics for Preventing Necrotizing Enterocolitis in Preterm Neonates[J].Pediatrics, 2010, 125(5): 921-930.
[9]
Indrio F, Riezzo G, Raimondi F, et al. The Effects of Probiotics on Feeding Tolerance, Bowel Habits, and Gastrointestinal Motility in Preterm Newborns[J].J Pediatr. 2008, 152(6): 801-806.
[10]
AlFaleh K, Anabrees J, Bassler D, et al. Cochrane Review: Probiotics for prevention of necrotizing enterocolitis in preterm infants[J].Evid Based Child Health, 2012,7(6): 1807-1854.
[11]
Lin HC, Hsu CH, Chen HL, et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial[J].Pediatrics, 2008, 122(4): 693-700.
[12]
Bin-Nun A, Bromiker R, Wilschanski M, et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight neonates[J].J Pediatr, 2005,147(2): 192-196.
