Abstract
Nosocomial sepsis is associated with increased mortality and morbidity including neurodevelopmental impairment and prolonged hospital stay. Prevention of sepsis especially in the preterm infants in the neonatal intensive care unit remains a major challenge. The gastrointestinal tract is an important source of potential pathogens causing nosocomial sepsis as the immature intestinal epithelium can permit translocation of bacteria and yeast. The intestinal tract and its microflora play an important role in the immunity. Altering the gut microflora has been extensively studied for immunomodulation in preterm infants. Probiotics are live microorganisms which when administered in adequate amounts confer a health benefit on the host. Probiotics have been used for prevention and treatment of various medical conditions in children and adults. Studies on probiotics in premature infants have focused on normalizing intestinal flora, improvement in feeding intolerance, prevention of necrotizing enterocolitis and sepsis. In this paper, we discuss the intestinal bacterial colonization pattern; the rational for probiotics and prebiotic therapy with special focus on the prevention of nosocomial sepsis in preterm infants.
Highlights
Nosocomial infection ( referred to as late onset neonatal sepsis (LOS) or health care associated infection) in the neonatal intensive care units (NICU) is associated with morbidity and mortality, prolonged hospitalization, and increased medical costs [1]
We examine the neonatal gut colonization, mechanisms of probiotics, and prebiotic and International Journal of Pediatrics their role in prevention of nosocomial infections in preterm infants
Probiotics are de ned as live microorganisms which when administered in adequate amounts confer a health bene t on the host [15]. e term probiotics was initially used in the 1960s and comes from the Greek word meaning “for life.”
Summary
Nosocomial infection ( referred to as late onset neonatal sepsis (LOS) or health care associated infection) in the neonatal intensive care units (NICU) is associated with morbidity and mortality, prolonged hospitalization, and increased medical costs [1]. We examine the neonatal gut colonization, mechanisms of probiotics, and prebiotic and International Journal of Pediatrics their role in prevention of nosocomial infections in preterm infants. E pattern and rates of neonatal colonization are in uenced by gestational age, the route of delivery, maternal bacterial ora, antenatal and postnatal antibiotic use, hygiene of the neonatal environment, and type of feeding. Frequent use of antibiotic therapy, and altered acquisition of normal digestive micro ora are important contributing factors for the increased risk of NEC in preterm infants and sepsis is o en a complication of NEC. Normalizing the gut ora of preterm infants by administration of bene cial bacteria, in the form of probiotics, may help in reducing the incidence of NEC and nosocomial sepsis. Normalizing the gut ora of preterm infants by administration of bene cial bacteria, in the form of probiotics, may help in reducing the incidence of NEC and nosocomial sepsis. erefore, probiotics have been tried in preterm infants for this purpose
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