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probiotics, neonate, prophylaxis

A U Happel, S L Barnabas, R Froissart, J S Passmore
Probiotics are used in the prophylaxis and treatment of several conditions, including irritable bowel syndrome, diarrhoea, necrotising enterocolitis (NEC) and colic in infants. Despite the long history of probiotic use in humans, there is still significant debate about their efficacy and safety, particularly in HIV-infected and immunocompromised individuals. Here, we reviewed the safety and adverse event (AE) reporting from clinical trials that have tested probiotics in at risk populations, including HIV-infected individuals, the terminally ill and elderly, and neonates...
January 18, 2018: Beneficial Microbes
Mohan Pammi, Gautham Suresh
BACKGROUND: Lactoferrin, a normal component of human colostrum and milk, can enhance host defenses and may be effective for prevention of sepsis and necrotizing enterocolitis (NEC) in preterm neonates. OBJECTIVES: Primary objective 1. To assess the safety and effectiveness of lactoferrin supplementation to enteral feeds for prevention of sepsis and NEC in preterm neonates Secondary objectives 1. To determine the effects of lactoferrin supplementation to enteral feeds to prevent neonatal sepsis and/or NEC on duration of positive-pressure ventilation, development of chronic lung disease (CLD) or periventricular leukomalacia (PVL), length of hospital stay to discharge among survivors, and adverse neurological outcomes at two years of age or later2...
June 28, 2017: Cochrane Database of Systematic Reviews
George J Daskalakis, Alexis K Karambelas
OBJECTIVE: To examine the influence of vaginal probiotic administration as an adjunct to standard antibiotic treatment on perinatal outcome in women with preterm premature rupture of membranes (PPROM). MATERIALS AND METHODS: This was a prospective randomized trial of cases with PPROM (24-34 weeks) that were admitted to our department between 2011 and 2015. Forty-nine cases received vaginal probiotics for 10 days in combination with antibiotic prophylaxis and were compared to 57 others that received only antibiotics for the same time period...
October 15, 2016: Fetal Diagnosis and Therapy
Manuela Molinaro, Massimo Aiazzi, Antonio La Torre, Elisabetta Cini, Roberto Banfi
Preterm infants are at high risk of neonatal sepsis. We report a case of a preterm infant under prophylaxis with Lactobacillus Rhamnosus for necrotizing enterocolitis; the child develops neonatal sepsis by Lactobacillus Rhamnosus. The infection is improved after probiotic withdrawal and had complete remission after 20 days of specific antibiotic therapy.
September 2016: Recenti Progressi in Medicina
S Viswanathan, C Lau, H Akbari, C Hoyen, M C Walsh
OBJECTIVE: Data from multiple clinical trials, mostly conducted outside the US, indicate that probiotic prophylaxis is an effective intervention for prevention of necrotizing enterocolitis (NEC) in preterm infants. Probiotics are routinely used in many countries. However, in the US, probiotic use in preterm infants is limited (6.7% of very low birth weight (VLBW) infants in the US were exposed to probiotics in 2014, Vermont Oxford Network (VON)). Probiotic products are often considered in 'generic' terms, but considerable variation exists between commercially available probiotics in terms of their quantity and quality...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Luisa A Denkel, Frank Schwab, Lars Garten, Christine Geffers, Petra Gastmeier, Brar Piening
OBJECTIVE: To determine the effect of dual-strain probiotics on the development of necrotizing enterocolitis (NEC), mortality and nosocomial bloodstream infections (BSI) in preterm infants in German neonatal intensive care units (NICUs). DESIGN: A multi-center interrupted time series analysis. SETTING: 44 German NICUs with routine use of dual-strain probiotics on neonatal ward level. PATIENTS: Preterm infants documented by NEO-KISS, the German surveillance system for nosocomial infections in preterm infants with birth weights below 1,500 g, between 2004 and 2014...
2016: PloS One
Florian Guthmann, Romaine P Arlettaz Mieth, Hans Ulrich Bucher, Christoph Bührer
AIM: Prophylactic probiotics to reduce necrotising enterocolitis (NEC) are mostly given for at least 28 days or until discharge. We describe the effects of a shorter duration dosing strategy. METHODS: Retrospective cohort study of neonates (birthweight 400-1500 g) in three neonatal intensive care units in Switzerland and Germany that embarked on probiotic prophylaxis given for 10 or 14 days, employing a fixed combination (Lactobacillus acidophilus plus Bifidobacterium infantis, each 10(9) CFU/day) licensed as a drug in Switzerland...
March 2016: Acta Paediatrica
Y Yuan, W Zhou, X Rong, W N Lu, Z Zhang
OBJECTIVE: The study's aim was to assess incidence and epidemiologic profile of nosocomial infection (NI) in a NICU of China, and to identify main risk factors of NIs. MATERIALS AND METHODS: Chi square test for discrete variables and independent t-test for continuous variables to examine the association with NI. Univariate regression model was applied to the variables to predict the NI status. Finally the multivariate model was utilized with stepwise methods included all variables in the univariate model to extrapolate the independent variables to NI...
2015: Clinical and Experimental Obstetrics & Gynecology
Mohan Pammi, Steven A Abrams
BACKGROUND: Lactoferrin, a normal component of human colostrum and milk, can enhance host defense and may be effective in the prevention of sepsis and necrotizing enterocolitis (NEC) in preterm neonates. OBJECTIVES: Primary objective To assess the safety and effectiveness of oral lactoferrin in the prevention of sepsis and NEC in preterm neonates. Secondary objectives1. To determine the effects of oral lactoferrin used to prevent neonatal sepsis and/or NEC on duration of positive-pressure ventilation, development of chronic lung disease (CLD) or periventricular leukomalacia (PVL), length of hospital stay to discharge among survivors, and adverse neurological outcomes at two years of age or later...
February 20, 2015: Cochrane Database of Systematic Reviews
Andrea Zbinden, Reinhard Zbinden, Christoph Berger, Romaine Arlettaz
BACKGROUND: The use of probiotics as prophylaxis for necrotizing enterocolitis (NEC) in preterm infants is being increasingly practised. OBJECTIVE: We report, for the first time, a case series of 3 preterm, very-low-birth-weight (VLBW) infants who developed bacteremia with Bifidobacterium longum on probiotic therapy with Infloran® containing viable B. longum. METHODS: We retrospectively reviewed data of 3 infants (of gestational age <30 weeks and birth weight <1,230 g)...
2015: Neonatology
Robert E Click
A naturally occurring, gastrointestinal disorder of ruminants (Johne's disease) is a chronic, debilitating, lethal disease. The causative agent is Mycobacterium avium subspecies paratuberculosis (MAP). Exposure that leads to disease occurs primarily in utero and/or during the neonatal period. Outside a dietzia probiotic treatment, there are no preventive/curative therapies. Interestingly, MAP is at the center of a controversy as to its role (cause of, perpetuate of, innocent bystander) in Crohn's disease, ulcerative colitis, irritable bowel syndrome, diabetes, sarcoidosis, Blau syndrome, and multiple sclerosis-diseases in which the incidence of systemic MAP is higher than that in the general population...
May 31, 2012: Mycobacterial Diseases: Tuberculosis & Leprosy
N Ofek Shlomai, G Deshpande, S Rao, S Patole
Necrotizing enterocolitis (NEC) is a major cause of mortality (25%) and morbidity including recurrent sepsis, dependence on parenteral nutrition, need for surgery, and survival with short bowel syndrome in preterm very low birth weight infants. Mortality (45-100%) and morbidity including the risk of long-term neurodevelopmental impairment are higher in extremely preterm infants needing surgery for NEC. Systematic reviews of randomized controlled trials (RCT) indicate that probiotics significantly reduce the risk of NEC (RR 0...
2014: Neonatology
Wanderley Marques Bernardo, Felipe Toyama Aires, Renata Mota Carneiro, Fernando Pereira de Sá, Vera Esteves Vagnozzi Rullo, Dennis Alexander Burns
OBJECTIVE: To elucidate the benefits of using probiotics in the prevention of necrotizing enterocolitis (NEC) and its complications in preterm newborns. METHOD: This was a systematic review of randomized controlled trials, which included studies retrieved from three databases (MEDLINE, Embase, and LILACS), using a combination of the terms (necrotizing enterocolitis) AND (probiotics). RESULTS: 11 randomized trials were included, totaling 2,887 patients, 1,431 in the probiotic group and 1,456 in the control group...
January 2013: Jornal de Pediatria
Sherry A Luedtke, Jacob T Yang, Heather E Wild
Necrotizing enterocolitis (NEC) is one of the leading causes of death in the neonatal intensive care unit. Morbidity and mortality rates significantly increase with decreases in gestational age and birth weight. Strong evidence suggests probiotic prophylaxis may significantly decrease the incidence of NEC and should therefore be incorporated into the standard of care for preterm infants. However, debate still remains because of limitations of completed studies. The purpose of this review was to provide an overview of the controversies regarding probiotic use in preterm infants and to shed light on the practical considerations for implementation of probiotic supplementation...
October 2012: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Chelsea Hunter, Mary Ann V T Dimaguila, Peter Gal, John E Wimmer, James Laurence Ransom, Rita Q Carlos, McCrae Smith, Christie C Davanzo
BACKGROUND: Necrotizing enterocolitis (NEC) is a disease in neonates, often resulting in death or serious medical or neurodevelopmental complications. The rate of NEC is highest in the smallest babies and many efforts have been tried to reduce the rate of NEC. In neonates born below 1500 grams, the rate of NEC has been significantly reduced with the use of various probiotics. This study examines the impact of routine use of a probiotic, Lactobacillus reuteri DSM 17938 (BioGaia®), on the rate of NEC in neonates at highest risk for developing NEC, those with birth weight ≤1000 grams...
2012: BMC Pediatrics
Shoichi Ezaki, Kanako Itoh, Tetsuya Kunikata, Keiji Suzuki, Hisanori Sobajima, Masanori Tamura
BACKGROUND: To examine occurrence of cow's milk protein intolerance (CMPI) in newborns that underwent small intestine surgery and the clinical profiles of those newborns with postoperative CMPI, and to evaluate the preventive effects of probiotics on CMPI. METHODS: We retrospectively reviewed from 2000 to 2009, a total of 30 newborns required surgery on their small intestines. All of these patients had received antibiotics to prevent postoperative infection. Since 2005 we adopted a protocol of targeted probiotic therapy prophylaxis...
March 2012: Allergology International: Official Journal of the Japanese Society of Allergology
Paolo Manzoni, Lidia Decembrino, Elena Gallo, Stefano Rizzollo, Caterina Franco, Michael Mostert, Mauro Stronati, Daniele Farina
An episode of sepsis occurs in 20 to 40% of all preterm patients, and such figures have been reported constantly increasing in Neonatal Intensive Care Units. Neonatal sepsis include bloodstream, urine, cerebrospinal, peritoneal infections, infections starting from burns and wounds, or from any other usually sterile sites. Many specific risk factors account for the increased risk of sepsis, including employment of broad-spectrum antibiotics selecting resistant microflora, parenteral nutrition, acid inhibitors and steroids, as well as the systematic and long-lasting use of invasive management...
December 2010: Recenti Progressi in Medicina
Paolo Manzoni, Evelyne Jacqz-Aigrain, Stefano Rizzollo, Caterina Franco, Mauro Stronati, Michael Mostert, Daniele Farina
Fungal-related morbidity and mortality is a major concern for most neonatal intensive care units (NICUs) worldwide. Incidence rates are increasing and might be higher than reported due to the challenges associated with diagnosing fungal infections. As preterm neonates display clinical characteristics that make them prone to Candida spp infections, and there is a high frequency of severe neurodevelopmental sequelae in those who survive neonatal fungal infections, specific prevention--rather than empiric or pre-emptive treatment--should be the optimal strategy...
March 2011: Early Human Development
P Manzoni, S Rizzollo, L Decembrino, G Ruffinazzi, A Rossi Ricci, E Gallo, I Stolfi, M Mostert, M Stronati, D Farina
Sepsis-related morbidity and mortality are major problems in NICU. Preterm neonates display clinical characteristics that make them prone to infections. Due to the high frequency of severe neurodevelopmental sequelae in survivors, the best possible strategy to manage sepsis in NICU is to prevent them. Hygiene, cohorting, stewardship on use of H2-blockers, steroids and broad-spectrum antibiotic are mandatory, as well as proper management of central venous accesses and surgical devices. In addition, clinical research offers the opportunity of adopting pharmacological preventative strategies such as use of palivizumab to prevent RSV infection, use of fluconazole to prevent fungal sepsis, use of probiotics and lactoferrin to enhance the innate immunity, and use of pagibaximab to prevent staphylococcal sepsis...
March 2011: Early Human Development
P Rupa, J Schmied, B N Wilkie
Probiotic Lactococcus lactis (LL) is immunomodulatory and may prevent allergy by biasing from type-2 to a type-1 immune response. We hypothesized that newborn pigs pre-treated orally with LL are protected against allergy to ovomucoid (Ovm). Pigs were assigned to two treatment groups. Piglets were pretreated orally on days of age 1-7, 10, 12, 14, 21, 28 and 35 with LL (n=30) or medium (control, n=32) and sensitized to Ovm by intraperitoneal injection together with cholera toxin on days 14, 21 and 35. Pigs were orally challenged with egg white (day 46) and assigned scores for allergic signs...
March 15, 2011: Veterinary Immunology and Immunopathology
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