INFECTION IN ELBW INFANTS:PROTECTION WITH MOTHER'S MILK

低出生体重婴儿的感染：母乳的保护

• 批准号: 6293280
• 负责人: NANCY A RODRIGUEZ
• 金额: $ 3.28万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-01-08 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6293280
• 关键词: clinical research; developmental immunology; developmental nutrition; human milk; human subject; immunoglobulin A; immunomodulators; lactoferrin; low birth weight infant human; mother child interaction; nosocomial infection control; nutrition related tag; tube feeding

The focus of this Level l application is the identification and testing of strategies for using own mothers' milk (OMM) to provide protection from infection for extremely low-birthweight (ELBW; <1000g) infants. Immunoincompetence plus exposure to pathogenic microorganisms in the neonatal intensive care unit (NICU) predispose ELBW infants to nosocomial infections, which result in short-and long-term sequelae, and increase the cost of the NICU stay by a mean of $ 10,440 per infection. Clinical studies have documented a lower incidence and severity of nosocomial infections in OMM-fed than formula-fed preterm infants. Immunologic research has identified specific protective factors in OMM that provide passive and active immunity for the infant; many are concentrated more highly in OMM from mothers of preterm than term infants. Selected immunologic factors, such as secretory immunoglobulin A, are absorbed and excreted in the infant's urine; lactoferrin, with enhanced bacteriocidal properties, has been recaptured from feces. Thus, OMM may provide significant protection for ELBW infants; additionally, OMM is inexpensive, and facilitates mothers' participation in infant care. The dissertation will test strategies for using OMM to provide protection from infection during the early post-birth period when ELBW infants cannot tolerate enteral nutrition. An example is the use of OMM for routine infant mouth care and/or for gut-priming, e.g., minimal enteral feedings that stimulate maturation and barrier protection of the gastrointestinal tract. Outcome measures might include whether specific immune components of OMM are recaptured in infants' urine and feces.

本一级申请的重点是确定和测试使用自己的母乳（OMM）为极低出生体重（ELBW; <1000g）婴儿提供感染保护的策略。新生儿重症监护病房（NICU）的免疫功能不全加上接触致病性微生物使新生儿易发生院内感染，导致短期和长期的后遗症，并使每次感染平均增加10,440美元的NICU住院费用。临床研究表明，与配方奶喂养的早产儿相比，用omm喂养的早产儿医院感染的发生率和严重程度较低。免疫学研究已经确定了OMM中为婴儿提供被动和主动免疫的特定保护因素；与足月婴儿相比，早产儿母亲的OMM发病率更高。选定的免疫因子，如分泌性免疫球蛋白A，在婴儿尿液中被吸收和排泄；已从粪便中重新获得具有增强杀菌特性的乳铁蛋白。因此，OMM可能对ELBW婴儿提供重要的保护；此外，OMM费用低廉，有助于母亲参与婴儿护理。论文将测试策略，使用OMM提供保护，防止感染在早期出生后时期，当ELBW婴儿不能耐受肠内营养。一个例子是使用OMM进行常规婴儿口腔护理和/或肠道启动，例如，刺激成熟和胃肠道屏障保护的最小肠内喂养。结果测量可能包括是否在婴儿尿液和粪便中重新捕获OMM的特定免疫成分。