The introduction of multi-strain probiotics to preterm infants in a regional hospital: An observational study
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Abstract
Background. Worldwide 1 in 10 infants is born preterm. Late-onset sepsis (LOS) and necrotising enterocolitis (NEC) are important causes of mortality and morbidity in this vulnerable group, especially in those with birthweights less than 1 500 g. Probiotics may help to decrease the incidence of these conditions, although controversies remain.
Objectives. To describe the introduction of multi-strain probiotics to infants with birthweights ranging from 800 to 1 200 g at a regional hospital, determine the incidence of NEC, LOS and mortality in this group, and to compare the findings with previous years when there were no probiotics or single-strain probiotics.
Methods. We conducted a retrospective observational study of infants who received probiotics at a regional hospital between February 2019 and July 2020. Outcome data, including mortality, NEC and LOS were collected. These data were compared with previous time periods.
Results. Seventy-seven infants were included. All infants who qualified for probiotics received them. They had a median (IQR) weight of 1 000 (900 - 1 200) g and a median (IQR) gestation of 30 (28 - 31) weeks. All infants received breastmilk. A total of 11 (14.3%) infants had positive blood cultures which were predominantly gram-negative organisms and there were no cultures of probiotic organisms. Infants with birthweights less than 1 kg contributed 75% of the sepsis episodes. There were seven deaths (9%) of which 3 occurred before 72 hours of life. Four of the deaths were attributed to LOS. There were no cases of NEC during this period. Compared with previous time periods, there were similar rates of LOS, but a reduction of NEC.
Conclusion. The introduction of probiotics to a regional hospital is possible. Less NEC was observed when multi-strain probiotics were used.
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