Hua Xin-Tian, Tang Jun, Mu De-Zhi
Department of Neonatology, West China Second University Hospital, Sichuan University. Chengdu 610041, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2014 Jun;16(6):606-9.
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).
A double-blind, 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.
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.
Oral administration of probiotics may reduce rectal colonization with drug-resistant bacteria in preterm infants under certain conditions and shows good safety.
评估口服益生菌对新生儿重症监护病房(NICU)早产儿肠道耐药菌定植的影响。
对出生后立即转入NICU的早产儿进行双盲、随机、安慰剂对照试验。这些婴儿按是否母乳喂养进行分层,然后随机分为试验组和对照组。试验组从开始肠内喂养之日起给予益生菌,而对照组采用不含益生菌的常规治疗。通过出生后第1、3、7和14天的直肠拭子评估两组产超广谱β-内酰胺酶细菌的定植情况以及疾病发生率,并进行比较。
出生后第1、3、7和14天,试验组(n = 119)和对照组(n = 138)均发现有耐药菌的直肠定植。两组晚发性败血症和坏死性小肠结肠炎的发生率无显著差异(P>0.05)。在非母乳喂养婴儿中,出生后第14天试验组的耐药菌直肠定植率显著低于对照组(71.1%对88.9%;P = 0.04)。研究中未观察到与益生菌相关的不良事件。
在某些情况下,口服益生菌可能会降低早产儿的耐药菌直肠定植率,且安全性良好。