Boneti Cristiano, Habib Christine M, Keller Jennifer E, Diaz Jose A, Kokoska Evan R, Jackson Richard J, Smith Samuel D
Division of Pediatric Surgery, Department of Surgery, Arkansas Children Hospital, Little Rock, AR 72202, USA.
J Pediatr Surg. 2009 Mar;44(3):530-3. doi: 10.1016/j.jpedsurg.2008.06.004.
BACKGROUND/PURPOSE: We previously reported that a diet acidified with citric acid effectively reinforces gastric acid protection against bacterial colonization and translocation. In this study, our objective was to examine a biologically acidified formula hypothesized to be more physiologic than formula acidified with free acid. This study was Institutional Animal Care and Use Committee (IACUC) approved and designed to determine whether this diet is better tolerated and equally effective to acidification with citric acid against gut colonization and subsequent bacterial translocation in a premature infant rabbit model.
A total of 89 rabbit pups born via cesarean delivery 1 day preterm were randomly assigned to 3 feeding groups: Pelargon Nestle at pH 4.55; NAN Nestle, a control diet at pH 7.0 with similar composition; and NAN Nestle acidified in the laboratory with citric acid at pH 4.55. Pups were gavage fed every 12 hours with Enterobacter cloacae challenges of 10 colony-forming units per milliliter of diet per feed and killed on day 3 of life. Lungs, liver, spleen, mesenteric lymph nodes, stomach, and cecum were cultured and quantitatively analyzed for target organism growth and statistically analyzed using chi(2) and Kruskal-Wallis tests.
Pelargon, compared to acidified NAN and NAN, significantly reduced the incidence of gastric colonization (15/33 [45%], 21/27 [78%], and 25/29 [86%], respectively; P < .01) and pulmonary colonization (10/33 [30%], 19/27 [70%], 21/29 [72%]; P < .01). Comparing the bacterial logs of colonized groups, the same benefit is observed in the lungs (0.77 +/- 1.22, 1.89 +/- 1.41, 2.12 +/- 1.47; P < .01). Gut colonization and bacterial translocation were equivalent between treatment groups (mesenteric lymph nodes: 10/33 [30%], 11/27 [40%], 8/29 [27%]; spleen: 10/33 [30%], 7/27 [26%], 8/29 [27%]; liver: 10/33 [30%], 6/27 [22%], 9/29 [31%]; cecum: 33/33 [100%], 27/27 [100%], 29/29 [100%]).
Biologically acidified formula demonstrated superior protection against pulmonary and gastric colonization compared to normal pH and diets acidified with free acid. Its effects may potentially reduce clinical pulmonary infection.
背景/目的：我们之前报道过，用柠檬酸酸化的饮食能有效增强胃酸对细菌定植和易位的保护作用。在本研究中，我们的目标是检测一种生物酸化配方奶，该配方奶被假定比用游离酸酸化的配方奶更符合生理需求。本研究经机构动物护理和使用委员会（IACUC）批准，旨在确定这种饮食在早产兔模型中是否比用柠檬酸酸化的饮食更易于耐受，并且在预防肠道定植及随后的细菌易位方面同样有效。
总共89只早产1天经剖宫产出生的兔仔被随机分为3个喂养组：pH值为4.55的雀巢能恩金盾；pH值为7.0、成分相似的对照饮食雀巢能恩；以及在实验室用柠檬酸酸化至pH值为4.55的雀巢能恩。每12小时给兔仔灌胃一次，每次喂食的饮食中每毫升含10个菌落形成单位的阴沟肠杆菌，并在出生第3天处死。对肺、肝、脾、肠系膜淋巴结、胃和盲肠进行培养，并对目标生物体的生长进行定量分析，使用卡方检验和克鲁斯卡尔 - 沃利斯检验进行统计分析。
与酸化的雀巢能恩和雀巢能恩相比，雀巢能恩金盾显著降低了胃定植的发生率（分别为15/33 [45%]、21/27 [78%]和25/29 [86%]；P <.01）和肺定植的发生率（10/33 [30%]、19/27 [70%]、21/29 [72%]；P <.01）。比较定植组的细菌对数，在肺部也观察到了同样的益处（0.77 ± 1.22、1.89 ± 1.41、2.12 ± 1.47；P <.01）。各治疗组之间的肠道定植和细菌易位情况相当（肠系膜淋巴结：10/33 [30%]、11/27 [40%]、8/29 [27%]；脾：10/33 [30%]、7/27 [26%]、8/29 [27%]；肝：10/33 [30%]、6/27 [22%]、9/29 [31%]；盲肠：33/33 [100%]、27/27 [100%]、29/29 [100%]）。
与正常pH值的饮食和用游离酸酸化的饮食相比，生物酸化配方奶对肺部和胃部定植具有更好的保护作用。其作用可能会潜在地减少临床肺部感染。
