Impact of a multi-strain probiotic administration on peri-rectal colonization with drug-resistant Gram-negative bacteria in preterm neonates.
Impact of a multi-strain probiotic administration on peri-rectal colonization with drug-resistant Gram-negative bacteria in preterm neonates.
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DOI：
10.3389/fped.2022.1002762
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发表时间：
2022
影响因子：
2.6
通讯作者：
中科院分区：
文献类型：
--
作者：
耐药革兰氏阴性菌 (DR-GNB) 引起的感染是全球住院早产儿的主要健康问题。本研究的目的是探讨多菌株益生菌对早产儿 DR-GNB 直肠定植发生率的影响。进行了一项双盲、安慰剂对照、随机临床试验，纳入 200 名新生儿，随机分配至多菌株益生菌 (n = 100) 或安慰剂 (n = 100)。 15% 的新生儿在入组当天表现出 DR-GNB 直肠周围定植，表明可能存在母婴（垂直）细菌传播或分娩时的环境感染，组间没有差异。 DR-GNB 进一步定植的获得速度很快，从入组当天的 15% 增加到第 7 天的 77%，到第 14 天的 83%。到第 7 天（对应于早期肠道定植），益生菌组的新生儿直肠周围 DR-GNB 定植的可能性降低了 57% [OR：0.43 (0.20–0.95)；OR：0.43 (0.20–0.95)； p = 0.04] 到第 14 天（对应于晚期肠道定植），益生菌组中的新生儿直肠周围 DR-GNB 定植的可能性降低了 93% [OR：0.07 (0.02–0.23)； p < 0.001]。住院新生儿在入组时表现出大量 DR-GNB 直肠周围定植，并在生命的前 2 周内进一步快速获得 DR-GNB。使用多菌株益生菌可有效减少 DR-GNB 早期和晚期新生儿肠道定植。该试验已在泛非临床试验注册中心注册（PACTR202011513390736）。
Infections caused by drug resistant Gram-negative bacteria (DR-GNB) are a major health concern for hospitalized preterm neonates, globally. The aim of this study was to investigate the effect of a multi-strain probiotic on the incidence of rectal colonization with DR-GNB in preterm neonates. A double-blind, placebo-controlled, randomized clinical trial was conducted including 200 neonates, randomly allocated to a multi-strain probiotic (n = 100) or placebo (n = 100). Fifteen percent of the neonates showed peri-rectal colonization with DR-GNB on the day of enrolment indicating probable maternal-to-neonate (vertical) bacterial transmission or environmental acquisition at time of delivery, with no difference between groups. Acquisition of further DR-GNB colonization was rapid, with an increase from 15% on the day enrolment to 77% by day 7 and 83% by day 14 of life. By day 7 (corresponding to early gut colonization), neonates in the probiotic group were 57% less likely to have peri-rectal DR-GNB colonization [OR: 0.43 (0.20–0.95); p = 0.04] and by day 14 (corresponding to late gut colonization), neonates in the probiotic group were 93% less likely to have peri-rectal DR-GNB colonization [OR: 0.07 (0.02–0.23); p < 0.001]. Hospitalized neonates showed substantial peri-rectal colonization with DR-GNB at enrolment and further rapid acquisition of DR-GNB in the first 2 weeks of life. The use of a multi-strain probiotic was effective in reducing early and late neonatal gut colonization with DR-GNB. The trial was registered at the Pan African Clinical Trial Registry (PACTR202011513390736).
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影响因子：
5
作者：
Parker LA;Magalhães M;Desorcy-Scherer K;Torrez Lamberti M;Lorca GL;Neu J
通讯作者：
Neu J
影响因子：
2.6
作者：
Camacho-Gonzalez, Andres;Spearman, Paul W.;Stoll, Barbara J.
通讯作者：
Stoll, Barbara J.
影响因子：
5.5
作者：
Dramowski A;Aucamp M;Bekker A;Pillay S;Moloto K;Whitelaw AC;Cotton MF;Coffin S
通讯作者：
Coffin S
影响因子：
3
作者：
Exner M;Bhattacharya S;Christiansen B;Gebel J;Goroncy-Bermes P;Hartemann P;Heeg P;Ilschner C;Kramer A;Larson E;Merkens W;Mielke M;Oltmanns P;Ross B;Rotter M;Schmithausen RM;Sonntag HG;Trautmann M
通讯作者：
Trautmann M
影响因子：
5
作者：
Duar, Rebbeca M.;Henrick, Bethany M.;Frese, Steven A.
通讯作者：
Frese, Steven A.