Probiotics and Prebiotics: Role in Prevention of Nosocomial Sepsis in Preterm Infants

Abstract

Nosocomial sepsis is associated with increased mortality and morbidity including neurodevelopmental impairment and prolonged hospital stay. Prevention of sepsis especially in the preterm infants in the neonatal intensive care unit remains a major challenge. The gastrointestinal tract is an important source of potential pathogens causing nosocomial sepsis as the immature intestinal epithelium can permit translocation of bacteria and yeast. The intestinal tract and its microflora play an important role in the immunity. Altering the gut microflora has been extensively studied for immunomodulation in preterm infants. Probiotics are live microorganisms which when administered in adequate amounts confer a health benefit on the host. Probiotics have been used for prevention and treatment of various medical conditions in children and adults. Studies on probiotics in premature infants have focused on normalizing intestinal flora, improvement in feeding intolerance, prevention of necrotizing enterocolitis and sepsis. In this paper, we discuss the intestinal bacterial colonization pattern; the rational for probiotics and prebiotic therapy with special focus on the prevention of nosocomial sepsis in preterm infants.

High Proportion of Intestinal Colonization with Successful Epidemic Clones of ESBL-Producing Enterobacteriaceae in a Neonatal Intensive Care Unit in Ecuador

“…At birth, the gastrointestinal tract is virtually sterile. [19] There was therefore, no rectal swabs taken at admission. The mean time between admission and first surveillance swab was 6.4 days.…”

Bacterial Translocation from Intestine: Microbiological, Immunological and Pathophysiological Aspects

“…Показано, что смесь молочнокислых пробиотиков предотвращала нарушение эпителиального барьера, вызываемого ли-пополисахаридами, стрессом и другими факторами, и укрепляла ПМС [44]. Кроме того, в процессе реакции на микробные продукты в организме хозяина происходило усиление мукозного IgA-ответа и системного иммуни-тета [45].…”

“…По мнению Американской академии педиатрии, убеди-тельных доказательств в необходимости повседневного профилактического применения пробиотиков для всех новорожденных до сих пор нет, но ожидаемые результаты проводимой мультицентровой оценки безопасности и эффективности живых микроорганизмов для предотвра-щения нозокомиального сепсиса у критически недоно-шенных новорожденных вызывают интерес [45].…”

Bacterial translocation: gap in the shield

“…Számos humán és ál-latkísérletes vizsgálat támasztotta alá a különböző össze-tételű probiotikumok jótékony hatását több betegség kezelését illetően is (fertőzéses eredetű hasmenés, nekrotizáló enterocolitis, Crohn-betegség stb.) [7,8]. Ugyanakkor, a probiotikumok adagolása által kiváltott jótékony hatás elérhető az úgynevezett prebiotikumok alkalmazásával is.…”