Probiotic associations in the prevention of necrotising enterocolitis and the reduction of late-onset sepsis and neonatal mortality in preterm infants under 1500g. A systematic review

Baucells, Benjamin J.; Hally, Maria Mercadal; Sánchez, Airam Tenesor Álvarez; Aloy, J. Figueras

doi:10.1016/j.anpede.2015.07.021

Cited by 18 publications

(20 citation statements)

References 24 publications

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“…In the analysis of the different strains, the combination of 2 probiotics (L. acidophilus with B. bifidum) seemed to produce the greatest benefits. 11 This is concordant with a recent meta-analysis reporting that multiple strain probiotics seemed to be the most effective way to prevent NEC and reduce mortality in preterm infants of 34 weeks' gestation or of a birth weight 1500 g. 12 However, in another meta-analysis, the incidence of severe NEC was significantly reduced in infants receiving Lactobacillus (8 trials) -RR 0.61 95% CI [0.40e0.95], Bifidobacterium (6 trials) -RR 0.37 95% CI [0.14e0.97], or multispecies (two or more) supplement (18 trials) -RR 0.41 95% CI [0.29e0.56] without mentioning any difference between strains. 20 We also observed an increase in faecal sIgA levels in both groups.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the combination of 2 probiotics (Lactobacillus acidophilus with Bifidobacterium bifidum) seemed to produce the greatest benefits. 11 This has been reinforced by a recent meta-analysis reporting that multiple strains of probiotics seemed to be the most effective way to prevent NEC and reduce mortality in preterm infants of 34 weeks' gestation or of a birth weight 1500 g. 12 However, due to the differences in probiotic components and administration, it would be necessary to perform randomized controlled trials comparing different probiotic mixtures. Therefore, the purpose of this study was to compare L. acidophilus boucardii strain versus multispecies probiotic on NEC incidence and faecal secretory IgA levels in very low birth weight preterm neonates.…”

Section: Introductionmentioning

confidence: 99%

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Single strain versus multispecies probiotic on necrotizing enterocolitis and faecal IgA levels in very low birth weight preterm neonates: A randomized clinical trial

Gómez-Rodríguez

Amador-Licona

Daza-Benítez

et al. 2019

Pediatrics & Neonatology

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Pediatrics and Neonatology (2019) 60, 564e569 than neonates with a faecal sIgA level increment 0.45 mg/dl. No adverse effects were found after probiotics use. Conclusions: No difference between strains of probiotics used was found on NEC incidence or in the increase of faecal sIgA levels. Faecal sIgA levels were positively related to gestational age and body weight in very low preterm infants. ClinicalTrials.gov/NCT02245815.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Single strain versus multispecies probiotic on necrotizing enterocolitis and faecal IgA levels in very low birth weight preterm neonates: A randomized clinical trial

Gómez-Rodríguez

Amador-Licona

Daza-Benítez

et al. 2019

Pediatrics & Neonatology

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“…In our study, the same combination of probiotics was observed to have a protective effect against NEC and death, although here too the rate of use of breast-feeding was much lower than is desirable and below that reported elsewhere (21) . In a systematic review, Baucells et al (22) reported that the best protective effects against NEC and death were obtained with the use of the combination of L. acidophilus and B. bifidum. A systematic review by Bernardo et al (8) , of eleven clinical trials involving 2887 patients, evaluated the benefits of using probiotics as a preventive against NEC and other morbidities associated with prematurity.…”

Section: Necrotising Enterocolitis and Deathmentioning

confidence: 99%

Probiotics to prevent necrotising enterocolitis and nosocomial infection in very low birth weight preterm infants

et al. 2017

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The aim of the study was to determine whether routine probiotic supplementation (RPS) with Lactobacillus rhamnosus GG (LGG) or Lactobacillus acidophilus +Lactobacillus bifidum is associated with reduced risk of necrotising enterocolitis (NEC)≥Stage II in preterm neonates born at ≤32 weeks' gestation. We conducted a retrospective cohort study on the effect of probiotic supplementation in very low birth weight infants in our neonatal unit by comparing two periods: before and after supplementation. The incidence of NEC≥Stage II, late-onset sepsis and all-cause mortality was compared for an equal period 'before' (Period I) and 'after' (Period II) RPS with LGG or L. acidophillus+L. bifidum. Multivariate logistic regression analysis was conducted to adjust for relevant confounders. The study population was composed of 261 neonates (Period I v. II: 134 v. 127) with comparable gestation duration and birth weights. In <32 weeks, we observed a significant reduction in NEC≥Stage II (11·3 v. 4·8 %), late-onset sepsis (16 v. 10·5 %) and mortality (19·4 v. 2·3 %). The benefits in neonates aged ≤27 weeks did not reach statistical significance. RPS with LGG or L. acidophillus+L. bifidum is associated with a reduced risk of NEC≥Stage II, late-onset sepsis and mortality in preterm neonates born at ≤32 weeks' gestation.

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“…7,[15][16][17][18][19] A combination of L. acidophilus and B. bifidum was reported to be more effective than either probiotic alone or a multistrain combination. 20) Therefore, the meta-analyses tried to identify strains with great efficacy. 14) The results showed reduction in mortality and morbidity only in a minority of the studied strains or combinations.…”

Section: Discussionmentioning

confidence: 99%

Synbiotics use for preventing sepsis and necrotizing enterocolitis in very low birth weight neonates: a randomized controlled trial

et al. 2020

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Background: Probiotics and prebiotics have strain-specific effects on the host. Synbiotics, a mixture of probiotics and prebiotics, are proposed to have more beneficial effects on the host than either agent has alone.Purpose: We performed a randomized controlled trial to investigate the effect of Lactobacillus and Bifidobacterium together with oligosaccharides and lactoferrin on the development of necrotizing enterocolitis (NEC) or sepsis in very low birth weight neonates.Methods: Neonates with a gestational age ≤32 weeks and birth weight ≤1,500 g were enrolled. The study group received a combination of synbiotics and lactoferrin, whereas the control group received 1 mL of distilled water as placebo starting with the first feed until discharge. The outcome measures were the incidence of NEC stage ≥2 or late-onset cultureproven sepsis and NEC stage ≥2 or death.Results: Mean birth weight and gestational age of the study (n=104) and the control (n=104) groups were 1,197±235 g vs. 1,151±269 g and 29±1.9 vs. 28±2.2 weeks, respectively (P>0.05). Neither the incidence of NEC stage ≥2 or death, nor the incidence of NEC stage ≥2 or late-onset culture-proven sepsis differed between the study and control groups (5.8% vs. 5.9%, P=1; 26% vs. 21.2%, P=0.51). The only significant difference was the incidence of all stages of NEC (1.9% vs. 10.6%, P=0.019).Conclusion: The combination of synbiotics and lactoferrin did not reduce NEC severity, sepsis, or mortality.

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Probiotic associations in the prevention of necrotising enterocolitis and the reduction of late-onset sepsis and neonatal mortality in preterm infants under 1500g. A systematic review

Cited by 18 publications

References 24 publications

Single strain versus multispecies probiotic on necrotizing enterocolitis and faecal IgA levels in very low birth weight preterm neonates: A randomized clinical trial

Single strain versus multispecies probiotic on necrotizing enterocolitis and faecal IgA levels in very low birth weight preterm neonates: A randomized clinical trial

Probiotics to prevent necrotising enterocolitis and nosocomial infection in very low birth weight preterm infants

Synbiotics use for preventing sepsis and necrotizing enterocolitis in very low birth weight neonates: a randomized controlled trial

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