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The effect of early administration of combined multi-strain and multi-species probiotics on gastrointestinal morbidities and mortality in preterm infants: A randomized controlled trial in a tertiary care unit.

Abstract Güney-Varal İ, Köksal N, Özkan H, Bağcı O, Doğan P. The effect of early administration of combined multi-strain and multi-species probiotics on gastrointestinal morbidities and mortality in preterm infants: A randomized controlled trial in a tertiary care unit. Turk J Pediatr 2017; 59: 13-19. Necrotizing enterocolitis (NEC) is a gastrointestinal emergency of the neonatal period. The aim of this study was to demonstrate the use of multistrain and multispecies probiotic on gastrointestinal morbidities and mortality. The study was organized as a randomized controlled, prospective study in premature infants (≤32 week and ≤1500 gram). The ready commercial preparations which contain multi-combined probiotics of Lactobacillus rhamnosus (4.1x10⁸ cfu) + Lactobacillus casei (8.2x10⁸ cfu) + Lactobacillus plantorum (4.1x10⁸ cfu) + Bifidobacterium animalis (4.1x10⁸ cfu) together with 383 mg of fructooligosaccharides and 100 mg of galactooligosaccharides as the prebiotic content, was administered enterally to the probiotic group (n=70); control group constituted of 40 preterms. Primary outcomes of the present study were ≥ Stage 2 NEC and the mortality. Secondary outcomes were culture-proven sepsis and days to reach full enteral feeding. All cases of NEC were seen in group 2 as 3.6% (n=4) of all infants. The mortality was found to be 1.4% (n=1) in Group 1 and 22.5% (n=9) in Group 2. The incidence of NEC and the mortality rate were found to be significantly lower in Group 1 (p=0.016, p=0.001, respectively). In Group 1, the NEC-related mortality rate and sepsis-related mortality rate were significantly lower than that of the control group (p=0.046, p=0.023). In this study, we showed that using probiotic strains in combined multistrain and multispecies forms at higher doses and for prolonged duration had positive effects on gastrointestinal complications, sepsis and mortality in premature infants.
PMID
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Authors

Mayor MeshTerms
Keywords

feeding intolerance

necrotizing enterocolitis

newborn

probiotics

sepsis

Journal Title the turkish journal of pediatrics
Publication Year Start




PMID- 29168358
OWN - NLM
STAT- MEDLINE
DCOM- 20171204
LR  - 20171213
IS  - 0041-4301 (Print)
IS  - 0041-4301 (Linking)
VI  - 59
IP  - 1
DP  - 2017
TI  - The effect of early administration of combined multi-strain and multi-species
      probiotics on gastrointestinal morbidities and mortality in preterm infants: A
      randomized controlled trial in a tertiary care unit.
PG  - 13-19
LID - 10.24953/turkjped.2017.01.003 [doi]
LID - 1672 [pii]
AB  - Guney-Varal I, Koksal N, Ozkan H, Bagci O, Dogan P. The effect of early
      administration of combined multi-strain and multi-species probiotics on
      gastrointestinal morbidities and mortality in preterm infants: A randomized
      controlled trial in a tertiary care unit. Turk J Pediatr 2017; 59: 13-19.
      Necrotizing enterocolitis (NEC) is a gastrointestinal emergency of the neonatal
      period. The aim of this study was to demonstrate the use of multistrain and
      multispecies probiotic on gastrointestinal morbidities and mortality. The study
      was organized as a randomized controlled, prospective study in premature infants 
      (</=32 week and </=1500 gram). The ready commercial preparations which contain
      multi-combined probiotics of Lactobacillus rhamnosus (4.1x10(8) cfu) +
      Lactobacillus casei (8.2x10(8) cfu) + Lactobacillus plantorum (4.1x10(8) cfu) +
      Bifidobacterium animalis (4.1x10(8) cfu) together with 383 mg of
      fructooligosaccharides and 100 mg of galactooligosaccharides as the prebiotic
      content, was administered enterally to the probiotic group (n=70); control group 
      constituted of 40 preterms. Primary outcomes of the present study were >/= Stage 
      2 NEC and the mortality. Secondary outcomes were culture-proven sepsis and days
      to reach full enteral feeding. All cases of NEC were seen in group 2 as 3.6%
      (n=4) of all infants. The mortality was found to be 1.4% (n=1) in Group 1 and
      22.5% (n=9) in Group 2. The incidence of NEC and the mortality rate were found to
      be significantly lower in Group 1 (p=0.016, p=0.001, respectively). In Group 1,
      the NEC-related mortality rate and sepsis-related mortality rate were
      significantly lower than that of the control group (p=0.046, p=0.023). In this
      study, we showed that using probiotic strains in combined multistrain and
      multispecies forms at higher doses and for prolonged duration had positive
      effects on gastrointestinal complications, sepsis and mortality in premature
      infants.
FAU - Guney-Varal, Ipek
AU  - Guney-Varal I
AD  - Department of Pediatrics, Division of Neonatology, Uludag University Faculty of
      Medicine, Bursa, Turkey.
FAU - Koksal, Nilgun
AU  - Koksal N
AD  - Department of Pediatrics, Division of Neonatology, Uludag University Faculty of
      Medicine, Bursa, Turkey.
FAU - Ozkan, Hilal
AU  - Ozkan H
AD  - Department of Pediatrics, Division of Neonatology, Uludag University Faculty of
      Medicine, Bursa, Turkey.
FAU - Bagci, Onur
AU  - Bagci O
AD  - Department of Pediatrics, Division of Neonatology, Uludag University Faculty of
      Medicine, Bursa, Turkey.
FAU - Dogan, Pelin
AU  - Dogan P
AD  - Department of Pediatrics, Division of Neonatology, Uludag University Faculty of
      Medicine, Bursa, Turkey.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - Turkey
TA  - Turk J Pediatr
JT  - The Turkish journal of pediatrics
JID - 0417505
SB  - IM
MH  - Enteral Nutrition
MH  - Enterocolitis, Necrotizing/*drug therapy/epidemiology
MH  - Humans
MH  - Incidence
MH  - Infant
MH  - Infant Mortality
MH  - Infant, Newborn
MH  - Infant, Premature
MH  - Infant, Premature, Diseases/*drug therapy/epidemiology
MH  - Male
MH  - Probiotics/*therapeutic use
MH  - Prospective Studies
MH  - Sepsis/*drug therapy/epidemiology
MH  - Tertiary Healthcare
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - *feeding intolerance
OT  - *necrotizing enterocolitis
OT  - *newborn
OT  - *probiotics
OT  - *sepsis
EDAT- 2017/11/24 06:00
MHDA- 2017/12/05 06:00
CRDT- 2017/11/24 06:00
PHST- 2017/11/24 06:00 [entrez]
PHST- 2017/11/24 06:00 [pubmed]
PHST- 2017/12/05 06:00 [medline]
AID - 1672 [pii]
AID - 10.24953/turkjped.2017.01.003 [doi]
PST - ppublish
SO  - Turk J Pediatr. 2017;59(1):13-19. doi: 10.24953/turkjped.2017.01.003.