Comparison between killed and living probiotics usage versus placebo for the prevention of necrotizing enterocolitis and sepsis in neonates

Abstract EN

Background: probiotics are widely used in the treatment and prevention of gastrointestinal problems.

However, with some immune compromised populations, the administrations of live microorganisms may not appropriate.

A potential alternative to liv microorganisms is to use killed probiotics if the beneficial function could be retained Aims: the aim of the present work was to evaluate the possible role Lactobacillus acidophilus (LP) in reducing the incidence of neonatal sepsis (NS) and Necrotizing enter colitis (NEC) and to compare the potential role of the killed form (KP) as a safer tool in comparison to the viable one and to placebo.

Methods : 150 neonates admitted to the NICU were enrolled in a randomized Double-blind placebo study, on day 1 of admission, to receive either oral LP (n = 60), KP (n = 60) or placebo (n = 30).

One gram of stools was collected and sent for culture on admission, at day 7, at day 14, as well as on development of suspected NE Corns.

Results : LP and KP were preventive factors for both NEC and NS, with an absolute risk reduction (ARR) of 16% and 15%, respectively, for NEC, and 18% and 10%, respectively, for NS compared to placebo.

The incidence of NEC and NS did not differ significantly between neonates Supplemented with either LP or KP.

Preterm neonates supplemented with KP showed significantly lower incidence of NEC compared to placebo, .while.

The Incidence of NS showed no significant difference between both groups.

There was a significant reduction in NS and NEC among neonates with positive Lactobacillus colonization of gut compared to those not colonized at day7 (27.9% vs85.9% for NS, 0% Vs 7.8% for NEC) and at day 14 (48.7% Vs 91.7% for NS and 0% vs 20.8% for NEC).

Overall comparison among the three groups showed statistical significant reduction in the incidence of NEC.

Conclusion : early gut colonization with beneficial bacteria lowers the incidence of NEC and NS.

KP retained similar benefits to live bacteria.