title: Comparison of Lactobacillus reuteri and nystatin prophylaxis on Candida colonization and infection in very low birth weight infants.
abstract: OBJECTIVE
  The aim of this study was to compare the efficacy of orally administered Lactobacillus reuteri (L. reuteri) versus nystatin in prevention of fungal colonization and invasive candidiasis in very low birth weight infants.
  
  
  METHODS
  A prospective, randomized comparative study was conducted in preterm infants with a gestational age of ≤32 weeks and birth weight of ≤1500 g. Patients were randomized into two groups, to receive L. reuteri or nystatin. Skin and stool cultures were performed once a week for colonization and blood cultures for invasive infections. The trial was registered to ClinicalTrials.gov under identifier NCT01531192.
  
  
  RESULTS
  A total of 300 preterm infants were enrolled (n = 150, for each group). Gastrointestinal colonization and skin colonization rates were not significantly different between the groups (18.7% versus 16%, p = 0.54 and 14% versus 12%, p = 0.6, respectively). Invasive candidiasis was detected in two patients of the probiotic group and one patient of the antifungal group. Proven sepsis, feeding intolerance, and duration of hospitalization were significantly lower in the probiotics group than in the antifungal group.
  
  
  CONCLUSIONS
  Prophylactic L. reuteri supplementation is as effective as nystatin, and more effective in reducing the incidence of proven sepsis in addition to its favorable effect on feeding intolerance.
authors.affiliation: a Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital , Ankara , Turkey .
authors.forename: Mehmet Yekta
authors.initials: MY
authors.lastname: Oncel
authors.forename: Sema
authors.initials: S
authors.lastname: Arayici
authors.forename: Fatma Nur
authors.initials: FN
authors.lastname: Sari
authors.forename: Gulsum Kadioglu
authors.initials: GK
authors.lastname: Simsek
authors.forename: Sadik
authors.initials: S
authors.lastname: Yurttutan
authors.forename: Omer
authors.initials: O
authors.lastname: Erdeve
authors.forename: Sibel
authors.initials: S
authors.lastname: Saygan
authors.forename: Nurdan
authors.initials: N
authors.lastname: Uras
authors.forename: Serife Suna
authors.initials: SS
authors.lastname: Oguz
authors.forename: Ugur
authors.initials: U
authors.lastname: Dilmen
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida / Q000187:drug effects / Q000254:growth & development; D002177:Candidiasis / Q000517:prevention & control*; D058365:Candidiasis, Invasive / Q000517:prevention & control; D018890:Chemoprevention / Q000379:methods; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000178:diet therapy* / Q000188:drug therapy*; D019102:Infant, Very Low Birth Weight; D052200:Limosilactobacillus reuteri / Q000502:physiology*; D008297:Male; D009761:Nystatin / Q000627:therapeutic use*; D019936:Probiotics / Q000627:therapeutic use*; D018805:Sepsis / Q000517:prevention & control
chemical_list: D000935:Antifungal Agents; D009761:Nystatin
keywords: Candidal colonization; Lactobacillus reuteri; invasive candidiasis; nystatin; preterm infants