[Effect of care in a protected environment on the occurrence of nosocomial infections, mucosal colonization of pathogenic microflora and development of indicators of immunity in premature infants].
OBJECTIVE
Prevention of hospital infections in premature infants by treatment in protected environment and intentional colonization of the intestine by oral administration of non-enteropathogenic E. coli.


METHODS
Original article.


METHODS
Institute for Care of Mother and Child, Prague.


METHODS
Fifty premature infants were followed at the Intensive Care Unit. Twenty five infants were treated after birth in protected environment and colonized during the first 48 hours by oral administration of a apathogenic E. coli strain (Vaccine COLINFANT, registered and produced in the Czech Republic), 25 infants were treated in conventional environment. Bacteriological examinations: stool, nose, throat, ear, stomach end other smears were taken 2-3 times during first week and further once a week and examined by aerobic cultivation. Immunological examinations: globulin levels (IgG, IgM) were estimated in blood samples by ELISA, using specific polyclonal antibodies. As early marker of infection T and B subpopulations were measured by FACS analysis using double labelling of cells.


RESULTS
Birth weight, birth length, gestational age, Apgar score, were relatively equal in both groups. Time of hospitalization was 7.3 days shorter in infants treated in protected environment. Colonization with pathogens (130), number of infections (16%) and need for antibiotics (16%) were significantly lower in infants treated in protected environment than in infants treated in the conventional one (238 isolated pathogens, nosocomial infections in 40%, need for antibiotical treatment in 48% if infants). Serum IgM levels were lower in infants treated in protected environment other immunological parameters did not differ in the two groups.


CONCLUSIONS
Treatment of premature and high-risk infants in protected, pathogen-free environment and intentional colonization with apathogenic E. coli reduced significantly the number of isolated pathogens, number of hospital infections, need for antibiotics and shortened the time of hospitalization in comparison with infants treated in conventional environment.
Lodinová-Zádníková
R
R
Ustav pro péci o matku a dítĕ, Praha.
Cukrovská
B
B
Stranák
Z
Z
D000284:Administration, Oral; D000917:Antibody Formation; D015703:Antigens, CD / Q000032:analysis; D001419:Bacteria / Q000302:isolation & purification*; D003428:Cross Infection / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control*; D004926:Escherichia coli / Q000254:growth & development / Q000276:immunology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control*; D011247:Pregnancy; D019936:Probiotics / Q000008:administration & dosage*
D015703:Antigens, CD; D007074:Immunoglobulin G; D007075:Immunoglobulin M
Vliv osetrování v chránĕném prostredí na výskyt nozokomiálních infekcí, osídlení sliznic patogenní mikroflórou a vývoj nĕkterých ukazatelů imunity u nedonosených dĕtí.