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Title:Vpliv probiotikov na preprečevanje okužb in bakterijske sepse ter rast nedonošenčkov zelo male porodne teže (pod 1500 g)
Authors:ID Kanič, Zlatka (Author)
ID Mičetić Turk, Dušanka (Mentor) More about this mentor... New window
Files:.pdf DOK_Kanic_Zlatka_2015.pdf (4,03 MB)
MD5: 1570FD5D934065A32648E0FF735C296A
 
Language:Slovenian
Work type:Doctoral dissertation
Organization:MF - Faculty of Medicine
Abstract:Bolnišnične okužbe, zlasti pa kasne, bolnišnične sepse pri novorojenčkih zelo male porodne teže predstavljajo pomemben delež obolevnosti in tudi umrljivosti. Namen raziskave iz naključno zbranega vzorca otrok je bil ugotoviti ali vpliva dajanje probiotikov Lactobacillus acidophylus, Enterococcus faecium in Bifidobacterium infantum v razmerju 1,5:1:1,5, ki so jih nednošenčki dobivali v odmerku 0,6x 107 števila enot, ki tvorijo kolonije (CFU) dvakrat dnevno z mlekom, na zmanjšanje števila bolnišničnih okužb in bolnišničnih seps ter na rast. V raziskavi smo polovici od 80 naključno zbranih otrok s porodno težo pod 1500 g z mlekom dajali probiotike Lactobacillus acidophylus, Enterococcus faecium in Bifidobacterium infantum v razmerju 1,5:1:1,5 v odmerku 0,6x 107 števila enot, ki tvorijo kolonije (CFU) dvakrat dnevno z mlekom, druga polovica probiotikov ni dobila. Primarni cilj opazovanja je bilo ševilo kasnih seps in drugih okužb, rast otrok in korigirana gestacijska starost ob odpustu. Kasne sepse smo definirali z upoštevanjem kombinacije anamnestičnih in kliničnih dejavnikov, kliničnih meril za sistemski vnetni odgovor značilen za sepso in pozitivne parne hemokulture ter izdelali merila za uvrstitev sepse v različne skupine (sepso s pozitivno hemokulturo in klinično sliko sistemskega vnetnega odgovora, klinično sepso in sumljivo sepso/okužbo). Rast telesne teže otrok smo spremljali s sledenjem dinamike na 1, 4, 8 in 12 tednov po sprejemu ter ob odpustu, oziroma, kar je bilo prej. Rast obsega glavice in telesne dolžine smo spremljali enkrat mesečno in ob odpustu. S primerjavo skupine otrok, ki je dobila probiotike in otrok, ki jih niso dobili, smo ugotovili statistično pomembno manj obolelih otrok s kasno sepso (sepsa s pozitivno hemokulturo in klinično sliko sistemskega vnetnega odgovora ter klinična sepsa). V skupini s probiotiki je obolelo 16 otrok (40%), v skupini brez njih pa 29 otrok (72,5%); p= 0,006. Število vseh kasnih septičnih epizod je bilo v skupini s probiotiki 30, kar je bilo statistično pomembno manj, kot v skupini brez njih, kjer jih je bilo 69; p = 0,003. Statistično pomembno manj otrok je prebolelo najmanj eno od bolnišničnih okužb, v skupini s probiotiki je obolelo 20 otrok (50%), v skupini brez njih pa 32 otrok (80%); p= 0,009. V skupini s probiotiki je bilo pomembno manjše število epizod vseh kasnih okužb (35 epizod), kot v skupini brez probiotikov (79 epizod); p = 0,002 Primerjava odpustne teže, dolžine in obsega glavice med skupinama ni pokazala statistično značilne razlike v rasti, s statistično značilno manjšo gestacijsko starostjo pa so bili odpuščeni otroci, ki so dobivali probiotike. V nobeni hemokulturi in v nobeni drugi kužnini ni bil osamljeni noben od dodajanih probiotikov. Otroci, ki so profilaktično dobivali probiotike Lactobacillus acidophylus, Enterococcus faecium in Bifidobacterium infantum v razmerju 1,5:1:1,5 v odmerku 1,2x 107 CFU od prvih obrokov mleka do odpusta so imeli manj bolnišničnih seps in ostalih okužb. Vpliva na rast pri uporabi probiotikov ni bilo, otroci s probiotiki so bili odpuščeni z manjšo gestacijsko starostjo. Neželenih učinkov zaradi uporabi probiotikov ni bilo.
Keywords:nedonšenček zelo male porodne teže, probiotiki, kasna sepsa, kasne okužbe
Place of publishing:Maribor
Year of publishing:2015
PID:20.500.12556/DKUM-54858 New window
COBISS.SI-ID:283353344 New window
NUK URN:URN:SI:UM:DK:82BPWMUP
Publication date in DKUM:10.02.2016
Views:2389
Downloads:297
Metadata:XML DC-XML DC-RDF
Categories:MF
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Secondary language

Language:English
Title:The efficacy of an oral probiotic combination on late onset infections, bacterial sepsis and growth of very low birth weight preterm infants (less than 1500 g)
Abstract:Nosocomial infections, especially hospital-acquired sepsis, in infants with very low birth weight present an important share of morbidity as well as mortality. The purpose of the study was to establish from a randomly chosen group of children whether supplementing infants milk feedings with probiotics Lactobacillus acidophylus, Enterococcus faecium and Bifidobacterium infantum with the ratio of 1.5:1:1.5 at a dosage of 0.6 x 107 CFU twice a day decreases the number of nosocomial infections and hospital-acquired sepses as well as affects infants’ growth. Half of the randomly chosen infants with birth weight under 1500g had their milk feedings supplemented with probiotics Lactobacillus acidophylus, Enterococcus faecium and Bifidobacterium infantum with the ratio of 1.5:1:1.5 at a dosage of 0.6 x 107 CFU whereas the other half did not receive the probiotics. The primary objective was to observe the number of late onset sepses and other infections, infants’ growth and corrected gestational age at discharge. Cases of late onset sepsis were defined by considering the combination of anamnestic and clinical factors, clinical criteria for systemic inflammatory response typical for sepsis and positive two hemocultures. We created the criteria for categorizing sepsis into different groups (sepsis with positive hemocultures and clinical symptoms of systemic inflammatory response, clinical sepsis and suspected sepsis/infection). The growth of bodyweight in infants was followed by observing the dynamics at 1st, 2nd, 4th, 8th and 12th week after admission and at discharge. The growth of head circumference and body length was measured once a month and at discharge. By comparing groups of children who received probiotics and those who did not, we established a lower statistically significant number of children with late onset sepsis (sepsis with positive hemocultures and clinical symptoms of systemic inflammatory response as well as clinical sepsis). In the group receiving probiotics, 16 children (40%) became ill and in the group without probiotics 29 children (72.5%); p= 0.006. The number of all late onset sepsis in the group with probiotics was 30, which was statistically less significant than in the group without probiotics, where 69 cases were recorded; p = 0.003. Statistically significant less children were treated for at least one nosocomial infection. In the group with probiotics 20 children (50%) had a nosocomial infection and 32 children (80%) in the group without probiotics; p= 0.009. In the group with probiotics we recorded a statistically significant lower number of episodes of all nosocomial infections (35 episodes) than in the group without probiotics (79 episodes); p = 0.002. A comparison of weight, length and head circumference at discharge between groups did not show any statistically significant difference in growth. Children who received probiotics were discharged with a smaller statistically significant gestational age. None of the added probiotics was isolated in any of the hemocultures or other cultures. Children receiving prophylactic probiotics Lactobacillus acidophylus, Enterococcus faecium and Bifidobacterium infantum with a ratio 1.5:1:1.5 at a dosage of 1.2x 107 CFU with their first milk feeding until discharge had less nosocomial and other infections. Probiotics did not show any effect on the growth and children with probiotics were discharged with smaller gestational age. Adverse effects of using probiotics were not recorded.
Keywords:very low birth weight premature infant, probiotics, late-onset sepsis, late-onset infection


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