A pilot study of Bifidobacterium breve in neonates undergoing surgery for congenital heart disease

Abstract

BackgroundProbiotics have currently been widely used in patients undergoing various types of surgeries and improved their clinical outcomes, while data in pediatric cardiac surgery have been lacking. We investigated the safety and effects on the intestinal microbiota of the probiotic Bifidobacterium breve in neonates undergoing surgery for congenital heart disease.MethodsThis pilot, randomized study was performed in a single-center, university hospital-based pediatric intensive care unit (PICU). Twenty-one neonates undergoing surgery for congenital heart disease at >7 days after birth were randomly allocated to two groups: group A received 3 × 109 colony-forming units (CFU)/day of enteral B. breve strain Yakult (BBG-01), which was started 1 week before and terminated 1 week after surgery (n = 10), and group B did not receive BBG-01 (n = 11).ResultsThe characteristics of the patients were similar in both groups. The postoperative days until fulfillment of the criteria for discharge from the PICU tended to be fewer in group A (8 [7–8] days) than in group B (9 [8–14] days) (p = 0.10). Likewise, the postoperative days to enteral nutrition or achievement of caloric goal tended to be fewer in group A than in group B. The Bifidobacterium in fecal samples after initiating BBG-01 in group A were significantly higher in number than that in group B. Enterobacteriaceae were significantly fewer in group A than in group B immediately (7.0 [3.9–7.7] vs. 8.5 [8.0–9.1] log10 cells/g) and 1 week (7.7 [7.0–8.1] vs. 9.3 [8.6–9.5] log10 cells/g) after surgery (p < 0.05 for both comparisons). The number of Pseudomonas after 1 week was significantly lower in group A than in group B (p = 0.04). The concentrations of total organic and acetic acids were also significantly higher in group A than in group B. The postoperative course was uncomplicated and all neonates were discharged alive from the PICU.ConclusionsThe perioperative administration of a probiotic to neonates undergoing surgery for congenital heart disease was safe and significantly improved their intestinal environment. The positive effects of this treatment on clinically significant outcomes remain to be investigated.

Therapeutic Microbiology: the Role of <em>Bifidobacterium Breve</em> as Food Supplement for the Prevention/Treatment of Pediatric Diseases

“…Higher concentrations of fecal acetate and lower fecal pH levels were detected in children who received the probiotic 2 weeks after surgery [155]. Improvement of intestinal environment resulting from a perioperative supplementation with the same strain was also observed in neonates undergoing surgery for congenital heart disease [156]. Daily dosage of 3 x 10 9 CFU of B. breve Yakult (BBG-01) was administered starting 1 week before surgery and ending 1 week after the operation; infants who received the probiotic supplement showed significantly higher bifidobacteria levels and lower Enterobacteriaceae, Staphylococcus and Pseudomonas levels in fecal microbiota compared to infants not receiving the supplement.…”

GUT microbiota change and time of restore in intensive care therapy: a case report

“…took longer to stabilize, starting to regrow at day 35, and reaching a normal abundance at day 38. This genus might exert an inhibitory activity against Enterobacteriaceae and Enterococcus spp., by producing acetate and lowering the intestinal pH [10].…”

The High Incidence of Bacteremia in Children Undergoing Surgery Can Be Prevented by Bifidobacterium Supplementation

“…Umenai et al [19] reported that perioperative administration of probiotics (BBG-01) in neonates undergoing surgery for congenital heart diseases improved their intestinal environment. Postoperative recovery, as reflected by the duration of admission to the pediatric intensive care unit, timing of recommencement of enteral feeding, and spontaneous defecation after surgery, tended to be faster in these patients compared to subjects who were not administered probiotics.…”

“…BBG-01 has proven capacity to modulate intestinal microbiota by eradicating pathogenic bacteria such as Campylobacter , Enterococcus , and Candida after oral administration [9,12,18,19] . In this study, we present the beneficial effects of BBG-01 in pediatric surgical cases, particularly focusing on the incidence of bacteremia, and review the relevant literature.…”