Survey and evidence based review of probiotics used in very low birth weight preterm infants within the United States

Viswanathan, S.; Lau, Christine; Akbari, Heba; Hoyen, Claudia K.; Walsh, Michele C.

doi:10.1038/jp.2016.144

Cited by 48 publications

(30 citation statements)

References 43 publications

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“…Despite over a decade of clinical trials 44,45 , the lack of a standardized approach to the organism(s), dosage or regimen used has limited probiotic use in neonatal sepsis 17,46 . We found that in vitro growth inhibition of pathobionts did not predict in vivo efficacy.…”

Section: Discussionmentioning

confidence: 99%

Preventing dysbiosis of the neonatal mouse intestinal microbiome protects against late-onset sepsis

Singer

Blosser

Zindl

et al. 2019

Nat Med

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C. helped to perform and analyze metagenomics sequencing and strain-tracking experiments. Some immunofluorescence experiments were performed by C.L.Z. Some bioluminescence experiments were performed by D.J.S. D.D. helped prepare figures for the initial submission. V.A.L. fit the statistical models for the analysis of bioluminescence data. 16S rRNA microbiome sequencing and initial analysis were performed by C.

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Section: Discussionmentioning

confidence: 99%

Preventing dysbiosis of the neonatal mouse intestinal microbiome protects against late-onset sepsis

Singer

Blosser

Zindl

et al. 2019

Nat Med

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“…Still, based on recent evidence ( 4 , 10 ) and expert opinion ( 11 ), many NICUs in Europe, Australia, and Canada have implemented routine probiotic-supplementation to preterm infants. Probiotics are infrequently used in preterm infants in the USA ( 12 ). Risks of probiotic sepsis and contaminations of probiotic products may explain skepticism ( 13 – 16 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of Probiotic Supplementation on the Gut Microbiota and Antibiotic Resistome Development in Preterm Infants

et al. 2018

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Objectives: In 2014 probiotic supplementation (Lactobacillus acidophilus and Bifidobacterium longum subspecies infantis; InfloranⓇ) was introduced as standard of care to prevent necrotizing enterocolitis (NEC) in extremely preterm infants in Norway. We aimed to evaluate the influence of probiotics and antibiotic therapy on the developing gut microbiota and antibiotic resistome in extremely preterm infants, and to compare with very preterm infants and term infants not given probiotics.Study design: A prospective, observational multicenter study in six tertiary-care neonatal units. We enrolled 76 infants; 31 probiotic-supplemented extremely preterm infants <28 weeks gestation, 35 very preterm infants 28–31 weeks gestation not given probiotics and 10 healthy full-term control infants. Taxonomic composition and collection of antibiotic resistance genes (resistome) in fecal samples, collected at 7 and 28 days and 4 months age, were analyzed using shotgun-metagenome sequencing.Results: Median (IQR) birth weight was 835 (680–945) g and 1,290 (1,150–1,445) g in preterm infants exposed and not exposed to probiotics, respectively. Two extremely preterm infants receiving probiotic developed NEC requiring surgery. At 7 days of age we found higher median relative abundance of Bifidobacterium in probiotic supplemented infants (64.7%) compared to non-supplemented preterm infants (0.0%) and term control infants (43.9%). Lactobacillus was only detected in small amounts in all groups, but the relative abundance increased up to 4 months. Extremely preterm infants receiving probiotics had also much higher antibiotic exposure, still overall microbial diversity and resistome was not different than in more mature infants at 4 weeks and 4 months.Conclusion: Probiotic supplementation may induce colonization resistance and alleviate harmful effects of antibiotics on the gut microbiota and antibiotic resistome.Clinical Trial Registration: Clinicaltrials.gov: NCT02197468. https://clinicaltrials.gov/ct2/show/NCT02197468

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“…10 Although probiotics do not reduce LOS, they do reduce necrotising enterocolitis and mortality, 11 and are being introduced into clinical practice. 12 There is good evidence for hand hygiene as part of a package of care designed to reduce LOS. 13 The key to reducing LOS is likely to be in decreasing the number and duration of procedures, such as assisted breathing technologies and parenteral nutrition, that involve foreign bodies, which are potential conduits for the low virulence culprits of LOS.…”

Section: Does Bovine Lactoferrin Prevent Late-onset Neonatal Sepsis?mentioning

confidence: 99%

Does bovine lactoferrin prevent late-onset neonatal sepsis?

Doyle

Cheong

2019

The Lancet

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Survey and evidence based review of probiotics used in very low birth weight preterm infants within the United States

Abstract: The probiotics use in VLBW infants within the US is increasing, but is still limited. There was no evidence for safety or efficacy of 90% of the probiotics currently used in US NICUs, and therefore, caution is warranted.

Cited by 48 publications

References 43 publications

Preventing dysbiosis of the neonatal mouse intestinal microbiome protects against late-onset sepsis

Preventing dysbiosis of the neonatal mouse intestinal microbiome protects against late-onset sepsis

Effects of Probiotic Supplementation on the Gut Microbiota and Antibiotic Resistome Development in Preterm Infants

Does bovine lactoferrin prevent late-onset neonatal sepsis?

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