Impact of a multi-strain probiotic administration on peri-rectal colonization with drug-resistant Gram-negative bacteria in preterm neonates

Abstract

BackgroundInfections caused by drug resistant Gram-negative bacteria (DR-GNB) are a major health concern for hospitalized preterm neonates, globally. The aim of this study was to investigate the effect of a multi-strain probiotic on the incidence of rectal colonization with DR-GNB in preterm neonates.MethodsA double-blind, placebo-controlled, randomized clinical trial was conducted including 200 neonates, randomly allocated to a multi-strain probiotic (n = 100) or placebo (n = 100).ResultsFifteen percent of the neonates showed peri-rectal colonization with DR-GNB on the day of enrolment indicating probable maternal-to-neonate (vertical) bacterial transmission or environmental acquisition at time of delivery, with no difference between groups. Acquisition of further DR-GNB colonization was rapid, with an increase from 15% on the day enrolment to 77% by day 7 and 83% by day 14 of life. By day 7 (corresponding to early gut colonization), neonates in the probiotic group were 57% less likely to have peri-rectal DR-GNB colonization [OR: 0.43 (0.20–0.95); p = 0.04] and by day 14 (corresponding to late gut colonization), neonates in the probiotic group were 93% less likely to have peri-rectal DR-GNB colonization [OR: 0.07 (0.02–0.23); p < 0.001].ConclusionHospitalized neonates showed substantial peri-rectal colonization with DR-GNB at enrolment and further rapid acquisition of DR-GNB in the first 2 weeks of life. The use of a multi-strain probiotic was effective in reducing early and late neonatal gut colonization with DR-GNB.Clinical Trial RegistrationThe trial was registered at the Pan African Clinical Trial Registry (PACTR202011513390736).

Effect of a Multi-Strain Probiotic on Growth and Time to Reach Full Feeds in Preterm Neonates

“…We here present the results of a double-blind, placebo-controlled, randomized clinical trial investigating the effect of a multi strain probiotic on the time to reach full feeds and on growth in preterm neonates. This was one of the aims of a larger study, with the main aim of investigating the effect of probiotics on the carriage rate of DR-ESBL in preterm neonates [ 9 ].…”

Journey of the Probiotic Bacteria: Survival of the Fittest

“…The search for new probiotic strains has been stimulated in recent decades due the interest in healthier and functional foods [ 23 , 24 ]. Additionally, the concern of synthetic drugs in allopathic medicine and the rise of bacterial resistance, has increased the pursuit for non-pharmacological treatments such as the administration of probiotics [ 25 , 26 , 27 , 28 , 29 ]. Currently, the use of those microorganisms is considered a suitable alternative for the treatment of various infectious and non-infectious diseases and even metabolic disorders [ 17 , 18 , 22 ].…”