Probiotic supplementation for preventing invasive fungal infections in preterm neonates--a systematic review and

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Sachin Agrawal1,2,3, Shripada Rao1,2,3, Sanjay Patole1,2,3

  • 1Department of Neonatal Paediatrics, KEM Hospital, Perth, WA, Australia.

Mycoses
|October 16, 2015
PubMed

Insights

Probiotic supplementation may reduce invasive fungal infections in preterm neonates. However, evidence is limited, with no significant benefits found after excluding a high-incidence study, necessitating further research.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Microbiology

Background:

  • Invasive fungal infections (IFI) pose a significant health risk to preterm neonates.
  • Effective preventative strategies are crucial for improving outcomes in this vulnerable population.

Purpose of the Study:

  • To systematically review the effect of probiotic supplementation (PS) in preventing IFIs in preterm neonates.
  • To assess the impact of PS on fungal gut colonization as a secondary outcome.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) published up to August 2014.
  • Searched multiple databases including Cochrane, Medline, Embase, and CINAHL.
  • Included RCTs of PS in neonates born before 37 weeks gestation, focusing on IFI and fungal gut colonization.

Main Results:

  • A fixed-effects meta-analysis indicated a reduced risk of IFI with PS (RR: 0.50, 95% CI: 0.34, 0.73).
  • However, random-effects model results were not significant (RR: 0.64, 95% CI: 0.30, 1.38).
  • Excluding a study with high baseline IFI incidence showed no significant benefit of PS (RR: 0.89; 95% CI: 0.44, 1.78).
  • Probiotic effects on fungal gut colonization were inconsistent across studies.

Conclusions:

  • Current evidence on the efficacy of probiotic supplementation for preventing invasive fungal infections and gut colonization in preterm neonates is limited.
  • Further high-quality research is needed to establish definitive conclusions.
  • The heterogeneity in study designs and outcomes complicates firm recommendations.

Keywords:
Infantsneonatespretermprobiotic supplementationreview

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