Effectiveness of probiotics in the prophylaxis of necrotizing enterocolitis in preterm neonates: a systematic review and meta-analysis

Bernardo, Wanderley Marques; Aires, Felipe Toyama; Carneiro, Renata Mota; Sá, Fernando Pereira de; Rullo, Vera Esteves Vagnozzi; Burns, Dennis Alexander

doi:10.1016/j.jpedp.2012.09.001

Cited by 14 publications

(19 citation statements)

References 34 publications

(87 reference statements)

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“…In experiment 2, we made a preliminary study of effects beyond the initial 5 days of antibiotics and did not find any reappearance of NEC sensitivity when antibiotic treatment was discontinued and the gut was allowed to be fully colonized. All pigs were vital but suffered from degrees of diarrhea, which we speculate could have been solved by different types of medication or probiotics (4,16).…”

Section: Discussionmentioning

confidence: 99%

Antibiotics modulate intestinal immunity and prevent necrotizing enterocolitis in preterm neonatal piglets

Jensen

Thymann

Cilieborg

et al. 2014

American Journal of Physiology-Gastrointestinal and Liver Physi

103

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Preterm birth, bacterial colonization, and formula feeding predispose to necrotizing enterocolitis (NEC). Antibiotics are commonly administered to prevent sepsis in preterm infants, but it is not known whether this affects intestinal immunity and NEC resistance. We hypothesized that broad-spectrum antibiotic treatment improves NEC resistance and intestinal structure, function, and immunity in neonates. Caesarean-delivered preterm pigs were fed 3 days of parenteral nutrition followed by 2 days of enteral formula. Immediately after birth, they were assigned to receive either antibiotics (oral and parenteral doses of gentamycin, ampicillin, and metronidazole, ANTI, n ϭ 11) or saline in the control group (CON, n ϭ 13), given twice daily. NEC lesions and intestinal structure, function, microbiology, and immunity markers were recorded. None of the ANTI but 85% of the CON pigs developed NEC lesions by day 5 (0/11 vs. 11/13, P Ͻ 0.05). ANTI pigs had higher intestinal villi (ϩ60%), digestive enzyme activities (ϩ53-73%), and goblet cell densities (ϩ110%) and lower myeloperoxidase (Ϫ51%) and colonic microbial density (10 5 vs. 10 10 colony-forming units, all P Ͻ 0.05). Microarray transcriptomics showed strong downregulation of genes related to inflammation and innate immune response to microbiota and marked upregulation of genes related to amino acid metabolism, in particular threonine, glucose transport systems, and cell cycle in 5-day-old ANTI pigs. In a follow-up experiment, 5 days of antibiotics prevented NEC at least until day 10. Neonatal prophylactic antibiotics effectively reduced gut bacterial load, prevented NEC, intestinal atrophy, dysfunction, and inflammation and enhanced expression of genes related to gut metabolism and immunity in preterm pigs.

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Section: Discussionmentioning

confidence: 99%

Antibiotics modulate intestinal immunity and prevent necrotizing enterocolitis in preterm neonatal piglets

Jensen

Thymann

Cilieborg

et al. 2014

American Journal of Physiology-Gastrointestinal and Liver Physi

103

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“…110 Currently in the UK, a multicenter trial has recruited over 1,300 babies to evaluate the effect of a single bacterium (Bifidobacterium breve) on reducing NEC. 111 Based on the most recent evidence, 112 some neonatal units have introduced probiotics into routine management of preterm infants.…”

Section: Current Research Focus Probioticsmentioning

confidence: 99%

Necrotizing enterocolitis: current perspectives

Yajamanyam

Rasiah²,

Ewer³

2014

RRN

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Necrotizing enterocolitis is the most common gastrointestinal emergency in neonates, particularly in those born very preterm. It is a leading cause of morbidity and mortality, especially in extremely low birth weight infants. Despite extensive research, the pathophysiology of necrotizing enterocolitis remains unclear and therapeutic options are limited. Multiple risk factors have been reported, but most are associated with prematurity and its complications. This makes management very challenging in vulnerable preterm infants. In this review, we focus on the risk factors and some of the current research in this area, particularly studies aimed at early detection and potential preventive measures for this potentially lethal condition.

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“…There is also good evidence from a meta-analysis of intervention studies that probiotics can prevent necrotizing enterocolitis, prevent infant sepsis and decrease mortality in preterm neonates with low birth weights especially in Africa, where there is high infant mortality [17]. Fermented milk supplemented with probiotics has been established to improve intestinal health, humoral and cell-mediated immunity and salivary and fecal antibodies [18].…”

Section: Benefits Of Fermented Milksmentioning

confidence: 99%

“…Therefore, consumption of probiotic can help to reduce the load of pathogens that otherwise could cause infections; thus, use of drugs and especially antibiotics in children is likely to be reduced [17].…”

Section: Benefits Of Fermented Milk In Vulnerable Populationsmentioning

confidence: 99%

Factors that negatively influence consumption of traditionally fermented milk (mursik) among preschool children (1-5 years old) in Kapseret location -Uasin Gishu County, Kenya

Kirui¹,

Nguka²

2017

AJFAND

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Traditionally fermented milks are widely consumed in various countries of sub-Saharan Africa and a number of health benefits to human beings are attributed to them. However, available studies show that children less than 5 years old consume milk mainly as fresh milk or when added to tea or porridge. Therefore, information on consumption of traditionally fermented milk by children is scanty, yet factors hindering its consumption have rarely been studied. The objective of this study was, therefore, to establish factors, which negatively influence consumption of Mursik, a traditionally fermented milk product from the Kenyan Rift Valley, Uasin Gishu County. This will have a positive impact on its consumption and hence increased nutritional status and health among children. The study sought to determine average weekly household mursik production, quantity and the extent of consumption by children less than five years and their association with sociodemographic and economic characteristics of households. A cross-sectional descriptive study involving 383 Kalenjin households was conducted within Kapseret location in August 2013. Structured questionnaires and a focused group discussion (FGD) question guide were the main instruments of data collection. The baseline survey showed that only 32% of households fed their children mursik and they fed a mean quantity of 250 ml per week or 12 kg annually. Education level of respondents (χ 2 = 0.116, P= 0.025), household mursik production levels (χ 2 = 0.1311, P=0.001) and respondents' nutrition knowledge of mursik (χ 2 =0.154, P=0.005) negatively influenced mursik consumption among pre-school children. Results further indicated that although a majority (86.4%) of respondents had average nutrition knowledge of mursik, the application of these nutrition concepts was lacking. This might be due to socio-economic factors, cultural beliefs, attitudes and/or negative perceptions among respondents of mursik consumption by young children. There seems to be urgent need for a well-designed nutrition intervention program, sensitizing mothers and the population in general on the importance of traditionally fermented milk (mursik) for children and as a transition food that is locally available, affordable and culturally acceptable.

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Effectiveness of probiotics in the prophylaxis of necrotizing enterocolitis in preterm neonates: a systematic review and meta-analysis

Cited by 14 publications

References 34 publications

Antibiotics modulate intestinal immunity and prevent necrotizing enterocolitis in preterm neonatal piglets

Antibiotics modulate intestinal immunity and prevent necrotizing enterocolitis in preterm neonatal piglets

Necrotizing enterocolitis: current perspectives

Factors that negatively influence consumption of traditionally fermented milk (mursik) among preschool children (1-5 years old) in Kapseret location -Uasin Gishu County, Kenya

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