Probiotics Reduce Necrotizing Enterocolitis Severity in HIV-exposed Premature Infants.
OBJECTIVE
To assess the effect of probiotics on the incidence of necrotizing enterocolitis (NEC) in premature infants born to human immunodeficiency virus (HIV)-positive and HIV-negative women.


METHODS
HIV-exposed and HIV-unexposed premature infants were randomized to either the probiotic or the placebo group. The probiotic consisted of 1 × 10(9) colony-forming units, Lactobacillus rhamnosus GG and Bifidobacterium infantis per day.


RESULTS
In total, 74 HIV-exposed and 110 HIV-unexposed infants were enrolled and randomized. The incidence of death [4 (5.4%) vs. 7 (6%); p = 0.79] and NEC [4 (5%) vs. 5 (5%); p = 0.76] did not differ significantly between the HIV-exposed and HIV-unexposed groups. A significant difference was found for total NEC incidence between the study and control groups [3 (3%) vs. 6 (6%); p = 0.029]. The incidence of NEC in the HIV-exposed group differed significantly [Bells I 2 (5%) vs. Bells III 2 (5%); p = 0.045).


CONCLUSIONS
Probiotic supplementation reduced the incidence of NEC in the premature very low birth weight infants; however, results failed to show a lower incidence of NEC in HIV-exposed premature infants. A reduction in the severity of disease was found in the HIV-exposed study group.
Division Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa evettev@sun.ac.za.
Evette
E
Van Niekerk
Department of Statistics and Actuarial Science, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Daniel G
DG
Nel
Division Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Reneé
R
Blaauw
Division of Neonatology, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Gert F
GF
Kirsten
D001644:Bifidobacterium; D019587:Dietary Supplements; D004311:Double-Blind Method; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology; D005260:Female; D015658:HIV Infections; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D052201:Lacticaseibacillus rhamnosus; D019936:Probiotics / Q000627:therapeutic use*; D012720:Severity of Illness Index
human immunodeficiency virus; necrotizing enterocolitis; premature infant; probiotic; very low birth weight