Neonatal Intensive Care Unit, Ningbo Women and Children's Hospital, Ningbo, China.
Department of Neonatology, Dong'e Hospital of Traditional Chinese Medicine, Liaocheng, Shandong, China.
Medicine (Baltimore). 2023 Aug 11;102(32):e34787. doi: 10.1097/MD.0000000000034787.
Previous some systematic reviews reported that probiotics may benefit the prevention of NEC in preterm infants. But dissimilar bacterial strains and taxa used in included studies possibly result in bias. There is not a rounded systematic review which has estimated the benefit and safety of Enterococcus faecium to prevent NEC in preterm infants to date before we conducted.
This systematic review of randomized controlled trials and retrospective studies analyzing the benefit of Enterococcus faecium to prevent NEC in preterm infants was performed using PubMed, Web of Science, Cochrane Library, EMBASE, Wanfang data and China National Knowledge Infrastructure databases from inception to April 14, 2023. The search terms were "preterm" AND "necrotizing enterocolitis" AND "Enterococcus faecium OR probiotics." Studies reporting NEC involving preterm infants who were given Enterococcus faecium were included in this systematic review. A sensitivity analysis was conducted to assess the stability of results. A funnel plot was generated to identify publication bias. Two authors appraised studies quality and extracted data independently. This work has been reported according with preferred reporting items for systematic reviews and meta-analyses and assessing the methodological quality of systematic reviews. Statistical analysis was conducted using Review Manager 5.3 software. Risk ratio (RR) with 95% confidence intervals (CI) was calculated and analyzed.
Seven studies (N = 1487 participants) were included in this systematic review, and 6 randomized, controlled trials (N = 1237 participants) were included in the meta-analysis. Comparing with the control groups, the Enterococcus faecium groups had a significant decline in the incidence of NEC Bell stage II or higher (RR: 0.3138, 95% CI: 0.1983-0.4965; P < .00001; 6 studies, n = 1237) and infection (RR: 0.4818, 95% CI: 0.2950-0.7869; P = .004; 3 studies, n = 710).
Enterococcus faecium is effective and safe in preventing NEC (Bell stage II or higher) in preterm infants. But all studies included came from China. The dosages and durations of taking Enterococcus faecium were various.
之前的一些系统评价报告称，益生菌可能有益于预防早产儿坏死性小肠结肠炎（NEC）。但纳入研究中使用的不同细菌菌株和分类可能导致偏倚。在我们进行研究之前，尚无全面的系统评价评估屎肠球菌预防早产儿 NEC 的益处和安全性。
本系统评价纳入了使用 PubMed、Web of Science、Cochrane 图书馆、EMBASE、万方数据和中国知网数据库，检索时间从建库至 2023 年 4 月 14 日，对分析屎肠球菌预防早产儿 NEC 的益处的随机对照试验和回顾性研究进行了检索。检索词为“早产儿”和“坏死性小肠结肠炎”和“屎肠球菌或益生菌”。本系统评价纳入了报道屎肠球菌预防早产儿 NEC 的研究。进行了敏感性分析以评估结果的稳定性。生成漏斗图以识别发表偏倚。两名作者独立评估研究质量并提取数据。本研究根据系统评价和荟萃分析的首选报告项目以及系统评价方法学质量评估进行报告。使用 Review Manager 5.3 软件进行统计分析。计算并分析风险比（RR）及其 95%置信区间（CI）。
本系统评价纳入了 7 项研究（N = 1487 名参与者），其中 6 项随机对照试验（N = 1237 名参与者）纳入荟萃分析。与对照组相比，屎肠球菌组 NEC Bell Ⅱ期或更高级别的发生率显著降低（RR：0.3138，95%CI：0.1983-0.4965；P <.00001；6 项研究，n = 1237）和感染发生率（RR：0.4818，95%CI：0.2950-0.7869；P =.004；3 项研究，n = 710）。
屎肠球菌预防早产儿 NEC（Bell Ⅱ期或更高级别）有效且安全。但所有纳入的研究均来自中国。屎肠球菌的剂量和服用时间各不相同。
