Issue link: https://viewer.e-digitaledition.com/i/712302
Reducing Late-onset Sepsis BY VALERIE LAUER Probiotics Show Promise for in Preterm Infants USING A COMBINATION OF PROBIOTICS, RESE ARCHERS IN SLOVENIA WERE ABLE TO SIGNIFICANTLY REDUCE THE INCIDENCE OF L ATEONSE T SEPSIS IN A GROUP OF PRE TERM INFANTS BORN WITH VERY LOW BIRTH WEIGHTS. THE STUDY, PART of a growing body of research seeking to better understand and standardize the role probiotics can play in the well-being of pediatric patients, appeared in the December 2015 issue of The Central European Journal of Medicine's publication Wiener klinische Wochenschrift. The study followed the progress of 80 infants who were born preterm with birth weights of less than 3 pounds, 4 ounces. "The main problems with these patients after birth are lung immaturity and immune deficiency," says the lead author of the study, Zlatka Kanic, MD, PhD, pediatrician, neonatologist and intensivist in a multidisciplinary ICU at University Medical Centre, Maribor. "Despite better knowledge and technical improvement, nosocomial infec- tions and sepsis are still significant problems in very low birth weight infants. We wanted to find out whether oral supplementation with probiotics lowers the incidence of late-onset infections." FOCUSING IN In the study, 40 preterm infants with very low birth weights had their diets supplemented twice a day with a probiotic cocktail of Lactobacillus acidophylus, Enterococcus faecium and Bifidobacterium infantum, at a ratio of 1.5-to-1-to-1.5. Dr. Kanic and his colleagues used a reduced dosage for their study — 10 7 colony-forming units (CFUs) compared with the standard 10 9 CFU to 10 11 CFU usually used in children and adults. Supplementation continued from their first feedings until the patients were discharged. A control group of 40 preterm infants with similar birth weights were fed as usual without any probiotics. By the end of the study, 29 infants in the control group had developed late-onset sepsis, compared with 16 such cases in the experimental group. Though the sample size is small, the statistical diƒerence is significant. "Unfortunately, there are no international guidelines about the usage of probiotics in premature [infants]," Dr. Kanic says. "In our research, we established a lower number of late-onset sepsis and late-onset infections in very low birth weight infants by using a low dose of probiotics. Since this research, the probiotic combination and dosage is used regularly in these infants at our ICU." UNDERSTANDING THE MECHANISM At the University of Nebraska Medical Center, Ann Anderson Berry, MD, PhD, Associate Professor of the Division of Newborn Medicine, helped develop a standardized protocol for using probiotics in preterm infants cared for in the 1 0