益生菌预防机械通气儿童呼吸机相关性肺炎：一项随机双盲临床试验。
Probiotic prophylaxis to prevent ventilator-associated pneumonia in children on mechanical ventilation: A randomized double-blind clinical trial.
作者信息
Roshanzamiri Soheil, Alemzadeh Maryam, Ahmadizadeh Seyyedeh Narjes, Behzad Azita, Hashemi Seyyedeh Masumeh, Salamzadeh Jamshid, Mirrahimi Bahador
机构信息
Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Pediatric Intensive Care, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Front Pediatr. 2022 Nov 15;10:1045941. doi: 10.3389/fped.2022.1045941. eCollection 2022.
PURPOSE
Ventilator-Associated Pneumonia (VAP) is one of the most common nosocomial infections in the Pediatric Intensive Care Unit (PICU). Using new strategies to prevent nosocomial infections is crucial to avoid antibiotic resistance. One of these strategies is the utilization of probiotics. This study aims to investigate the efficacy of probiotic prophylaxis in preventing VAP in mechanically ventilated children.
METHOD
This study was a randomized, double-blind clinical trial. The study included 72 children under 12 years of age under mechanical ventilation for more than 48 h in the Mofid Children's Hospital. Patients were randomly divided into Limosilactobacillus reuteri probiotic recipients ( = 38) and placebo groups ( = 34). In addition to the standard treatment, both groups received a sachet containing probiotics or a placebo twice a day. Children were screened for VAP based on clinical and laboratory evidence.
RESULTS
The mean age of children in the intervention and placebo groups was 4.60 ± 4.84 and 3.38 ± 3.49 years, respectively. After adjusting the other variables, it was observed that chance of VAP among probiotics compared to the placebo group was significantly decreased (OR adjusted = 0.29; 95% CI: 0.09-0.95). Also, probiotic was associated with a significantly lower chance of diarrhea than the placebo group (OR adjusted = 0.09; 95% CI: 0.01-0.96).
CONCLUSION
Probiotic utilization is effective in preventing the incidence of VAP and diarrhea in children under mechanical ventilation in the PICU.
目的
呼吸机相关性肺炎（VAP）是儿科重症监护病房（PICU）中最常见的医院感染之一。采用新策略预防医院感染对于避免抗生素耐药性至关重要。其中一种策略是使用益生菌。本研究旨在探讨益生菌预防在预防机械通气儿童VAP中的疗效。
方法
本研究为随机双盲临床试验。研究纳入了莫菲德儿童医院72名12岁以下接受机械通气超过48小时的儿童。患者被随机分为罗伊氏乳杆菌益生菌接受组（n = 38）和安慰剂组（n = 34）。除标准治疗外，两组均每天两次接受包含益生菌或安慰剂的小包装。根据临床和实验室证据对儿童进行VAP筛查。
结果
干预组和安慰剂组儿童的平均年龄分别为4.60±4.84岁和3.38±3.49岁。在调整其他变量后，观察到与安慰剂组相比，益生菌组发生VAP的几率显著降低（调整后的OR = 0.29；95%CI：0.09 - 0.95）。此外，与安慰剂组相比，益生菌组腹泻的几率显著更低（调整后的OR = 0.09；95%CI：0.01 - 0.96）。
结论
在PICU中，使用益生菌可有效预防机械通气儿童发生VAP和腹泻。
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