Chapter 18 - Probiotics in Neonatal Sepsis Associated with Necrotizing Enterocolitis and Meningitis

Abstract

This chapter discusses the studies that suggest that probiotics can be useful to correct ecological disorders in human intestinal microbiota associated with neonatal sepsis and meningitis and may play a protective role in excluding pathogens from the intestine and preventing infections. Probiotics prevent microbial infection in neonates. Clinical or preclinical studies show that probiotics might reduce the risk of sepsis, necrotizing enterocolitis (NEC), and meningitis in neonates. Despite the considerable differences in type, dose, and duration of organisms used, the age of commencement, and the use of antibiotics, the remarkable progress suggests that probiotics might be a promising way to prevent sepsis, NEC, and meningitis in newborns with the choice of an effective probiotic regimen. Large well-designed trials are needed to support the routine use of probiotics in preterm and mature neonates. Prematurity, which is the most important risk factor, may impede the use of probiotic supplementation alone in preterm neonates. Results from several clinical trials suggest that probiotics reduce the risk of sepsis associated with NEC in preterm neonates. The prophylactic efficacy of Lactobacillus rhamnosus GG in meningitic infection is examined by using in vitro inhibition assays with E44 (a CSF isolate from a newborn baby with E. coli meningitis) and the neonatal rat model of E. coli sepsis and meningitis.