title: Early use of probiotics is important therapy in infants with severe congenital anomaly.
abstract: BACKGROUND
  Infants with severe congenital anomaly often need to undergo operation followed by antibiotic therapy. As a result they inevitably acquire abnormal intestinal microbiota, which cause severe infections such as necrotizing enterocolitis. Also, intestinal function deteriorates and their nutritional state is very poor. In order to prevent these situations probiotic therapy is proposed as an effective supporting treatment. Probiotic therapy were therefore applied to infants with severe congenital anomaly as early as possible to ascertain its efficacy.
  
  
  METHODS
  As probiotics, two bacteria were used: Bifidobacterium breve Yakult and Lactobacillus casei Shirota. Probiotic therapy was used in four infants with severe congenital anomaly as early as possible after surgery. Their intestinal microbiota and physical growth were followed through the treatment course.
  
  
  RESULTS
  Two patients suffered from meconium peritonitis with ileal atresia. One patient was born with complex anomalies (omphalocele, bladder exstrophy, myelomeningocele). The fourth patient suffered from complete urorectal septum malformation. The intestinal microbiota of these four patients was first induced to be probiotic dominant and finally changed to commensal anaerobe dominant that was similar to normal intestinal microbiota. Pathogenic bacteria were seldom detected. The patients' physical growth was excellent despite short bowel and pulmonary hypoplasia.
  
  
  CONCLUSIONS
  Probiotic therapy was effective in inducing probiotic dominant intestinal microbiota and normal intestinal microbiota in infants with severe congenital anomalies. As a result their intestinal absorptive functions were activated and severe infections were completely prevented. All of the infants grew well despite their physical disadvantages.
authors.affiliation: Department of Pediatric Surgery, University of Tokyo Hospital, Bunkyo-ku, Japan. kanamori-psu@h.u-tokyo.ac.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kanamori
authors.forename: Tadashi
authors.initials: T
authors.lastname: Iwanaka
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugiyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Komura
authors.forename: Takuya
authors.initials: T
authors.lastname: Takahashi
authors.forename: Norikatsu
authors.initials: N
authors.lastname: Yuki
authors.forename: Masami
authors.initials: M
authors.lastname: Morotomi
authors.forename: Ryuichiro
authors.initials: R
authors.lastname: Tanaka
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D001644:Bifidobacterium; D002657:Child Development / Q000187:drug effects; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007410:Intestinal Diseases / Q000188:drug therapy; D007422:Intestines / Q000382:microbiology; D007564:Japan; D007780:Lacticaseibacillus casei; D008297:Male; D011182:Postoperative Care / Q000379:methods; D019936:Probiotics / Q000627:therapeutic use*; D012720:Severity of Illness Index; D058616:Synbiotics; D013997:Time Factors; D016896:Treatment Outcome