title: Efficacy of different probiotic combinations on death and necrotizing enterocolitis in a premature rat model.
abstract: OBJECTIVE
  The aim of the present study was to investigate the most effective probiotic combinations to prevent death and necrotizing enterocolitis (NEC) in a premature rat model.
  
  
  METHODS
  One hundred fifty-eight premature Sprague-Dawley premature rats were enrolled. Probiotic strains Bifidobacterium bifidum, B longum, Lactobacillus acidophilus, L plantarum, and B breve were fed as a single strain or mixture with 2 or 3 strains for a total of 9 study groups; control groups received no exogenous probiotic supplement. Fecal samples were collected for 72 hours to detect probiotic strains and pathologic strains by real-time polymerase chain reaction. Colony counts of probiotic strains Escherichia coli and Klebsiella were compared between groups before and after 36 hours of the study period. The incidence of death and NEC were compared via Fisher exact test between groups.
  
  
  RESULTS
  The results demonstrated that L plantarum alone (P = 0.0026) and B bifidum with B longum together (P = 0.0017) were more effective in reducing NEC as compared with the control group. All of the study groups except B breve and B bifidum with B breve definitely prevented death compared with controls. B bifidum and B longum together had significantly lower mortality than the control group (P < 0.0001). Colony counts of E coli and Klebsiella in stool samples were significantly decreased in the B bifidum, B longum, and L plantarum group compared with the other study and control groups after 36 hours.
  
  
  CONCLUSIONS
  Administration of a mixture of probiotic strains with B bifidum and B longum was most effective in preventing death and NEC in this animal model, and these observations provide an evidence-based strategy for designing further neonatal clinical trials.
authors.affiliation: Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Wu
authors.forename: Hsiao-Yu
authors.initials: HY
authors.lastname: Chiu
authors.forename: An-Chyi
authors.initials: AC
authors.lastname: Chen
authors.forename: Hsiang-Yu
authors.initials: HY
authors.lastname: Lin
authors.forename: Hung-Chih
authors.initials: HC
authors.lastname: Lin
authors.forename: Michael
authors.initials: M
authors.lastname: Caplan
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D001644:Bifidobacterium / Q000145:classification / Q000254:growth & development / Q000302:isolation & purification; D015169:Colony Count, Microbial; D004195:Disease Models, Animal; D020345:Enterocolitis, Necrotizing / Q000209:etiology / Q000382:microbiology / Q000473:pathology / Q000517:prevention & control*; D004926:Escherichia coli / Q000145:classification / Q000254:growth & development / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology; D005260:Female; D007413:Intestinal Mucosa / Q000382:microbiology / Q000473:pathology; D007709:Klebsiella / Q000145:classification / Q000254:growth & development / Q000302:isolation & purification; D007778:Lactobacillus / Q000145:classification / Q000254:growth & development / Q000302:isolation & purification; D008297:Male; D056265:Microbial Interactions; D058889:Molecular Typing; D011247:Pregnancy; D047928:Premature Birth / Q000503:physiopathology*; D019936:Probiotics / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley