Bifidobacteriumlongum subsp. infantis EVC001 Administration Is Associated with a Significant Reduction in the Incidence of Necrotizing Enterocolitis in Very Low Birth Weight Infants.
Bifidobacteriumlongum subsp. infantis EVC001 Administration Is Associated with a Significant Reduction in the Incidence of Necrotizing Enterocolitis in Very Low Birth Weight Infants.
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DOI：
10.1016/j.jpeds.2021.12.070
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发表时间：
2022-05
影响因子：
5.1
通讯作者：
Scottoline, Brian
中科院分区：
文献类型：
--
作者：
Tobias, Joseph;Olyaei, Amy;Laraway, Bryan;Jordan, Brian K.;Dickinson, Stephanie L.;Golzarri-Arroyo, Lilian;Fialkowski, Elizabeth;Owora, Arthur;Scottoline, Brian
目的：评价长双歧杆菌亚种的作用。婴儿EVC001 （B型婴儿EVC001）给药对单级新生儿重症监护病房（NICU）早产儿坏死性小肠结肠炎（NEC）发生率的影响2014年至2020年俄勒冈健康与科学大学两组极低出生体重（VLBW）婴儿未接触和接触B型婴儿EVC001益生菌的非同期回顾性分析。结果包括NEC发病率和NEC相关死亡率，包括极低出生体重（ELBW）婴儿的亚组分析。使用对数二项回归模型比较未暴露组和暴露组之间nec相关结果的发生率和风险。NEC诊断的累积发病率从未接触EVC001组的11.0% （n = 301）下降到EVC001组的2.7% (n = 182) （P < 0.01）。与没有EVC001队列相比，EVC001队列的NEC风险降低了73%（校正风险比为0.27；95% CI为0.094-0.614;P < 0.01），导致B型婴儿EVC001需要治疗的校正人数为13人（95% CI为10.0-23.5）。nec相关死亡率从无EVC001组的2.7%下降到EVC001组的0% （P = 0.03）。在两个队列中，ELBW婴儿的NEC发病率和风险（19.2% vs 5.3% [P < 0.01]；校正风险比为0.28；95% CI为0.085-0.698 [P = 0.02]）和死亡率（5.6% vs 0%, P < 0.05）均有相似的降低。在这项对483名VLBW婴儿的观察性研究中，B型婴儿EVC001治疗与NEC和NEC相关死亡风险的显著降低相关。B型婴儿补充EVC001可被认为安全有效地降低新生儿重症监护室的发病率和死亡率。
To assess the effects of Bifidobacterium longum subsp. infantis EVC001 (B infantis EVC001) administration on the incidence of necrotizing enterocolitis (NEC) in preterm infants in a single level IV neonatal intensive care unit (NICU). Nonconcurrent retrospective analysis of 2 cohorts of very low birth weight (VLBW) infants not exposed and exposed to B infantis EVC001 probiotic at Oregon Health & Science University from 2014 to 2020. Outcomes included NEC incidence and NEC-associated mortality, including subgroup analysis of extremely low birth weight (ELBW) infants. Log-binomial regression models were used to compare the incidence and risk of NEC-associated outcomes between the unexposed and exposed cohorts. The cumulative incidence of NEC diagnoses decreased from 11.0% (n = 301) in the no EVC001 (unexposed) cohort to 2.7% (n = 182) in the EVC001 (exposed) cohort (P < .01). The EVC001 cohort had a 73% risk reduction of NEC compared with the no EVC001 cohort (adjusted risk ratio, 0.27; 95% CI, 0.094–0.614; P < .01) resulting in an adjusted number needed to treat of 13 (95% CI, 10.0–23.5) for B infantis EVC001. NEC-associated mortality decreased from 2.7% in the no EVC001 cohort to 0% in the EVC001 cohort (P = .03). There were similar reductions in NEC incidence and risk for ELBW infants (19.2% vs 5.3% [P < .01]; adjusted risk ratio, 0.28; 95% CI, 0.085–0.698 [P = .02]) and mortality (5.6% vs 0%; P < .05) in the 2 cohorts. In this observational study of 483 VLBW infants, B infantis EVC001 administration was associated with significant reductions in the risk of NEC and NEC-related mortality. B infantis EVC001 supplementation may be considered safe and effective for reducing morbidity and mortality in the NICU.
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