title: Probiotic supplementation in neonates with major gastrointestinal surgical conditions: a systematic review.
abstract: OBJECTIVE
  Neonates with major gastrointestinal surgical conditions frequently suffer from prolonged feed intolerance, infections, and need multiple courses of antibiotics. All these put them at risk of gut dysbiosis. Probiotic supplementation has the potential to minimise dysbiosis and improve clinical outcomes in such infants. Hence, we aimed to conduct a systematic review of probiotics in neonates with major surgical conditions of the gut.
  
  
  METHODS
  Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and other databases were searched in September 2016.
  
  
  RESULTS
  Two randomised controlled trials (RCTs) were included; the first was conducted in 24 neonates with gastroschisis, the second in eight neonates with various surgical conditions. In the first study, the overall microbial communities were not significantly different between groups, though analysis of the final specimens demonstrated higher Bifidobacteriaceae, lower Clostridiaceae, and trends toward lower Enterobacteriaceae, Enterococcaceae, Staphylococcaceae, and Streptococcaceae in the probiotic group. In the second study, there were significantly more Streptcoccaceae in the faecal samples in the probiotic group and significantly more Bifidobacteriaceae in the no probiotic group (p < .05).
  
  
  CONCLUSIONS
  There is limited evidence regarding the role of probiotics in neonates with gastrointestinal surgical conditions. Adequately powered RCTs are needed to address this issue.
authors.affiliation: a Neonatal Intensive Care Unit, Princess Margaret Hospital for Children , Subiaco , Australia.|b Neonatal Intensive Care Unit, King Edward Memorial Hospital for Women , Subiaco , Australia.|c Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia , Crawley , Australia.
authors.forename: Shripada
authors.initials: S
authors.lastname: Rao
authors.affiliation: a Neonatal Intensive Care Unit, Princess Margaret Hospital for Children , Subiaco , Australia.|b Neonatal Intensive Care Unit, King Edward Memorial Hospital for Women , Subiaco , Australia.|c Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia , Crawley , Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Simmer
authors.affiliation: a Neonatal Intensive Care Unit, Princess Margaret Hospital for Children , Subiaco , Australia.|c Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia , Crawley , Australia.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Patole
mesh_terms: D013505:Digestive System Surgical Procedures; D064806:Dysbiosis / Q000517:prevention & control*; D020139:Gastroschisis; D006801:Humans; D007231:Infant, Newborn; D011183:Postoperative Complications / Q000517:prevention & control*; D019936:Probiotics
keywords: Probiotic; dysbiosis; gut; newborn infant; surgery