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首页> 外文期刊>BMC Pediatrics >Effect of routine probiotic, Lactobacillus reuteri DSM 17938, use on rates of necrotizing enterocolitis in neonates with birthweight < 1000 grams: a sequential analysis
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Effect of routine probiotic, Lactobacillus reuteri DSM 17938, use on rates of necrotizing enterocolitis in neonates with birthweight < 1000 grams: a sequential analysis

机译：常规益生菌路透乳杆菌DSM 17938的使用对出生体重<1000克的新生儿坏死性小肠结肠炎发生率的影响：序贯分析

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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. Methods This is a retrospective cohort study comparing the rates of NEC in neonates with birth weight?≤?1000 grams. The groups are separated into those neonates born from January 2004 to June 30, 2009, before introduction of L. reuteri , and neonates born July 2009 through April 2011 who received routine L. reuteri prophylaxis. The chart review study was approved by our institutional review board and exempted from informed consent. Neonates were excluded if they died or were transferred within the first week of life. The remainder were categorized as having no NEC, medical NEC, surgical NEC, or NEC associated death. Since no major changes occurred in our NICU practice in recent years, and the introduction of L. reuteri as routine prophylaxis was abrupt, we attributed the post-probiotic changes to the introduction of this new therapy. Rates of NEC were compared using Chi square analysis with Fisher exact t-test. Results Medical records for 311 neonates were reviewed, 232 before- and 79 after-introduction of L. reuteri prophylaxis. The incidence of NEC was significantly lower in the neonates who received L. reuteri (2 of 79 neonates [2.5%] versus 35 of 232 untreated neonates [15.1%]). Rates of late-onset gram-negative or fungal infections (22.8 versus 31%) were not statistically different between treated and untreated groups. No adverse events related to use of L reuteri were noted. Conclusions Prophylactic initiation of L. reuteri as a probiotic for prevention of necrotizing enterocolitis resulted in a statistically significant benefit, with avoidance of 1 NEC case for every 8 patients given prophylaxis.
机译：背景坏死性小肠结肠炎（NEC）是新生儿中的一种疾病，通常会导致死亡或严重的医学或神经发育并发症。 NEC的发生率在最小的婴儿中最高，并且已经尝试了许多努力来降低NEC的发生率。在1500克以下的新生儿中，使用各种益生菌已大大降低了NEC的发生率。这项研究检查了常规使用益生菌路透乳杆菌DSM 17938（BioGaia？）对新生儿发生NEC风险最高的新生儿（出生体重≤1000克）NEC发生率的影响。方法这是一项回顾性队列研究，比较出生体重≤1000克的新生儿的NEC发生率。将这些组分为2004年1月至2009年6月30日出生的罗伊氏乳杆菌，以及2009年7月至2011年4月出生的接受常规罗伊氏乳杆菌预防的新生儿。图表审查研究已获得我们机构审查委员会的批准，并获得了知情同意。如果新生儿死亡或在生命的第一周内被转移，则排除新生儿。其余分类为无NEC，医学NEC，外科NEC或与NEC相关的死亡。由于近年来我们的重症监护病房（NICU）并未发生重大变化，而作为常规预防措施引入罗伊氏乳杆菌突然出现，我们将益生菌后的变化归因于这种新疗法的引入。使用卡氏分析和Fisher精确t检验比较NEC的发生率。结果回顾了311例新生儿的病历，采用罗伊氏乳杆菌预防前的232例和引入后79例的病历。在接受罗伊氏乳杆菌的新生儿中，NEC的发生率显着较低（79名新生儿中的2名[2.5％]，而232名未经治疗的新生儿中的35名[15.1％]）。治疗组和未治疗组之间的迟发性革兰阴性或真菌感染发生率（22.8比31％）在统计学上没有差异。没有发现与使用罗伊氏乳杆菌相关的不良事件。结论预防性启动罗伊氏乳杆菌作为预防坏死性小肠结肠炎的益生菌具有统计学上的显着意义，每预防8例患者可避免1例NEC病例。

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