Enteral supplementation of probiotics prevents severe NEC and all cause mortality in preterm infants .
There is insufficient data with regard to the benefits and potential adverse effects in the most at risk infants weighing less than 1000 grams at birth
BACKGROUND Necrotizing enterocolitis ( NEC ) and nosocomial sepsis are associated with increased morbidity and mortality in preterm infants .
Through prevention of bacterial migration across the mucosa , competitive exclusion of pathogenic bacteria , and enhancing the immune responses of the host , prophylactic enteral probiotics ( live microbial supplements ) may play a role in reducing NEC and the associated morbidity .
OBJECTIVES To compare the efficacy and safety of prophylactic enteral probiotics administration versus placebo or no treatment in the prevention of severe NEC or sepsis , or both , in preterm infants .
PLAIN LANGUAGE SUMMARY Probiotics for prevention of necrotizing enterocolitis in preterm infants Necrotizing enterocolitis ( NEC ) is a serious disease that affects the bowel of premature infants in the first few weeks of life .
Although the cause of NEC is not entirely known , milk feeding and bacterial growth play a role .
Probiotics ( dietary supplements containing potentially beneficial bacteria or yeast ) have been used to prevent NEC .
Early-onset sepsis in very low birth weight neonates: a report from the National Institute of Child Health and Human Development Neonatal Research Network.
OBJECTIVE Early-onset sepsis ( occurring within 72 hours of birth ) is included in the differential diagnosis of most very low birth weight ( VLBW ) neonates . To determine the current incidence of early-onset sepsis , risk factors for disease , and the impact of early-onset sepsis on subsequent hospital course , we studied a cohort of 7861 VLBW neonates ( 401 to 1500 gm ) admitted to the 12 National Institute of Child Health and Human Development ( NICHD ) Neonatal Research Network centers during a 32-month period ( 1991 - 1993 ) . METHODS The NICHD Neonatal Research Network maintains a prospect ively collected registry on all VLBW neonates born or cared for at participating centers . Data from this registry were analyzed retrospectively . RESULTS Blood culture-proven early-onset sepsis was uncommon , occurring in only 1.9 % of VLBW neonates . Group B streptococcus was the most frequent pathogen associated with early-onset sepsis ( 31 % ) , followed by Escherichia coli ( 16 % ) and Haemophilus influenzae ( 12 % ) . Decreasing gestational age was associated with increased rates of infection . Antibiotic therapy for suspected sepsis is frequently initiated at birth in VLBW neonates . Almost half of the infants in this cohort were considered to have clinical sepsis and continued to receive antibiotics for 5 or more days , despite a negative blood culture result in 98 % of cases . These findings underscore the difficulty of ruling out sepsis in the symptomatic immature neonate and the special concern for culture-negative clinical sepsis in the face of maternal antibiotic use . Neonates with early-onset sepsis were significantly more likely to have subsequent comorbidities , including severe intraventricular hemorrhage , patent ductus arteriosus , and prolonged assisted ventilation . Although 26 % of VLBW neonates with early-onset sepsis died , only 4 % of the 950 deaths that occurred in the first 72 hours of life were attributed to infection . For those infants discharged alive , early-onset sepsis was associated with a significantly prolonged hospital stay ( 86 vs 69 days ; p < 0.02 ) . CONCLUSIONS Early-onset sepsis remains an important but uncommon problem among VLBW preterm infants . Improved diagnostic strategies are needed to enable the clinician to distinguish between the infected and the uninfected VLBW neonate with symptoms and to target continued antibiotic therapy to those who are truly infected
Enteral supplementation of probiotics prevents severe NEC and all cause mortality in preterm infants .
There is insufficient data with regard to the benefits and potential adverse effects in the most at risk infants weighing less than 1000 grams at birth
BACKGROUND Necrotizing enterocolitis ( NEC ) and nosocomial sepsis are associated with increased morbidity and mortality in preterm infants .
Through prevention of bacterial migration across the mucosa , competitive exclusion of pathogenic bacteria , and enhancing the immune responses of the host , prophylactic enteral probiotics ( live microbial supplements ) may play a role in reducing NEC and the associated morbidity .
OBJECTIVES To compare the efficacy and safety of prophylactic enteral probiotics administration versus placebo or no treatment in the prevention of severe NEC or sepsis , or both , in preterm infants .
PLAIN LANGUAGE SUMMARY Probiotics for prevention of necrotizing enterocolitis in preterm infants Necrotizing enterocolitis ( NEC ) is a serious disease that affects the bowel of premature infants in the first few weeks of life .
Although the cause of NEC is not entirely known , milk feeding and bacterial growth play a role .
Probiotics ( dietary supplements containing potentially beneficial bacteria or yeast ) have been used to prevent NEC .