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PLoS One. 2016 Jun 22;11(6):e0158136. doi: 10.1371/journal.pone.0158136. eCollection 2016.

Protective Effect of Dual-Strain Probiotics in Preterm Infants: A Multi-Center Time Series Analysis.

Author information

1
Institute of Hygiene and Environmental Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.
2
Department of Neonatology, Charité Universitätsmedizin Berlin, Berlin, Germany.

Abstract

OBJECTIVE:

To determine the effect of dual-strain probiotics on the development of necrotizing enterocolitis (NEC), mortality and nosocomial bloodstream infections (BSI) in preterm infants in German neonatal intensive care units (NICUs).

DESIGN:

A multi-center interrupted time series analysis.

SETTING:

44 German NICUs with routine use of dual-strain probiotics on neonatal ward level.

PATIENTS:

Preterm infants documented by NEO-KISS, the German surveillance system for nosocomial infections in preterm infants with birth weights below 1,500 g, between 2004 and 2014.

INTERVENTION:

Routine use of dual-strain probiotics containing Lactobacillus acidophilus and Bifidobacterium spp. (Infloran) on the neonatal ward level.

MAIN OUTCOME MEASURES:

Incidences of NEC, overall mortality, mortality following NEC and nosocomial BSI.

RESULTS:

Data from 10,890 preterm infants in 44 neonatal wards was included in this study. Incidences of NEC and BSI were 2.5% (n = 274) and 15.0%, (n = 1631), respectively. Mortality rate was 6.1% (n = 665). The use of dual-strain probiotics significantly reduced the risk of NEC (HR = 0.48; 95% CI = 0.38-0.62), overall mortality (HR = 0.60, 95% CI = 0.44-0.83), mortality after NEC (HR = 0.51, 95% CI = 0.26-0.999) and nosocomial BSI (HR = 0.89, 95% CI = 0.81-0.98). These effects were even more pronounced in the subgroup analysis of preterm infants with birth weights below 1,000 g.

CONCLUSION:

In order to reduce NEC and mortality in preterm infants, it is advisable to add routine prophylaxis with dual-strain probiotics to clinical practice in neonatal wards.

PMID:
27332554
PMCID:
PMC4917100
DOI:
10.1371/journal.pone.0158136
[Indexed for MEDLINE]
Free PMC Article

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