This paper is only available as a PDF. To read, Please Download here.
Objectives: Necrotizing enterocolitis (NEC) has been associated with a wide variety of bacteria and their cytotoxins. The content and the nature of gut bacterial colonization in newborns that require intensive care hospitalization has been demonstrated to be abnormal. In the 25-bed neonatal intensive care unit in Hospital Simon Bolivar, in Bogotá, Colombia, cases of NEC are common causes of morbidity and mortality. This article examines the hypothesis that oral administration of prophylactic Lactobacillus acidophilus and Bifidobacterium infantis to all neonates in an intensive care unit, would decrease the incidence of NEC.
Methods: Daily doses of 250 million live L. acidophilus and 250 million B. infantis were given to all 1237 newborns (both inpatients and transfer patients) admitted to the unit during 1 year, until they were discharged from the hospital. In this study, 1282 patients hospitalized during the previous year were used as controls.
Results: There were no complications attributed to the daily administration of L. acidophilus and B. infantis. The study groups were compared for place of origin, clinical, and demographic variables, and there was no statistically significant difference in those variables. In the historic control group, there were 85 NEC cases compared to 34 cases in the group that received probiotic prophylaxis (P < 0.0002). In the historic control group, there were 35 NEC-associated fatalities compared to 14 fatalities in the group that received probiotic prophylaxis (P < 0.005).
Conclusions: The positive results in this study support the need for further investigation of bacterial colonization and its role in NEC.
- Necrotizing enterocolitis.N Engl J Med. 1984; 310: 1093-1103
- Feeding practices for infants weighing less than 1500 g at birth and the pathogenesis of necrotizing enterocolitis.Clin Perinatol. 1994; 21: 271-306
- A unifying hypothesis for pathogenesis and prevention of necrotizing enterocolitis.J Pediatr. 1990; 117 (Suppl): S68-S74
- Pathogenesis and prevention of necrotizing enterocolitis: hypothesis based on personal observation and a review of the literature.Pediatrics. 1984; 74: 1086-1092
- Comparative effect of ischemia, bacteremia, and substrate on the pathogenesis of intestinal necrosis.J Pediatr Surg. 1986; 21: 536-537
- Fecal bacterial microflora of newborn infants during intensive care management and treatment with five antibiotics regimens.Pediatr Infect Dis. 1986; 5: 533-539
- Acute necrotizing enterocolitis in infancy: a review of 64 cases.Pediatrics. 1975; 55: 376-387
- A controlled trial in intensive care units of selective decontamination of the digestive tract with nonabsorbable antibiotics. The French study group on selective decontamination of the digestive tract.N Engl J Med. 1992; 326: 594-599
- Gastrointestinal host defense and necrotizing enterocolitis.J Pediatr. 1990; 117 (Suppl): S33-S43
- Selective bowel decontamination results in gram-positive translocation.J Surg Res. 1990; 48: 444-447
- Molecular cross-talk between epithelial cells and pathogenic microorganisms.Cell. 1991; 67: 651-659
- Biotherapeutic agents.JAMA. 1996; 275: 870-876
- Adhering heat-killed human Lactobacillus acidophilus, strain LB, inhibits the process of pathogenicity of diarrhoeagenic bacteria in cultured human intestinal cells.J Diarrhoeal Dis Res. 1993; 11: 235-243
- Lactobacillus acidophilus LA 1 binds to cultured human intestinal cell lines and inhibits cell attachment and cell invasion by enterovirulent bacteria.Gut. 1994; 35: 483-489
- Inhibition of adhesion of entero-invasive pathogens to human intestinal Caco-2 cells by Lactobacillus acidophilus strain LB decreases bacterial invasion.FEMS Microbiol Lett. 1993; 110: 299-305
- Protective effect of Lactobacillus acidophilus on development of infection, caused by Klebsiella pneumoniae.Fiziol Zh. 1993; 39: 62-68
- Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxis for candida vaginitis.Ann Intern Med. 1992; 116: 353-357
- Bifidobacteria supplementation reduces the incidence and severity of neonatal necrotizing enterocolitis (NEC) in newborn rats.Pediatr Res. 1995; 37 ([Abstract]): A198
- Lack of effect of Lactobacillus on gastrointestinal bacterial colonization in premature infants.Pediatr Infect Dis J. 1986; 5: 663-668
- Co-infection with gram (+) bacteria blocks transcytosis of E. Coli in Caco-2 cells: possible relationship to necrotizing enterocolitis (NEC).Pediatr Res. 1995; 37 ([Abstract]): A297
Accepted: April 6, 1999
Received: November 2, 1998
© 1999 Published by Elsevier Inc.
User licenseElsevier user license |
How you can reuse
Elsevier's open access license policy
Elsevier user license
For non-commercial purposes:
- Read, print & download
- Text & data mine
- Translate the article
- Reuse portions or extracts from the article in other works
- Redistribute or republish the final article
- Sell or re-use for commercial purposes
Elsevier's open access license policy