ABSTRACT
Background: Sepsis related morbidity and mortality is a concern in neonatal intensive care units [NICUs]specially in preterm and Low birth weight [LBW] infants who are more vulnerable due to immaturity of immune defenses and protective barriers. Lactoferrin is an iron binding glycoprotein presents in mammalian milk and involved in innate immunity. Recent data suggest that bovine lactoferrin[BLF] might prevent late onset sepsis in preterm and LBW neonates
Objective; To evaluate the effectiveness of oral bovine lacoferrin in prevention of neonatal sepsis in Egyptian preterm neonates
Patients of Methods: A randomized clinical trial, double blind, placebo-controlled study was conducted on 135 preterm neonates [born before 37 weeks of gestation] admitted to the NICUs of Ain Shams University and Manshiet El Bakry Hospitals from February 20l3 to January 2015. Infants were randomly sub-divided into two groups: Group 1 consisted of 45 infant received oral lactoferrm supplementation [100 mg/day] within a day of starting feeds for 4 weeks. Group 2 consisted of 90 infants matching group 1 neonates, received placebo in the form distilled water in the same schedule. History and physical examination were carried out laying stress on signs of sepsis, severity [classified according to Tollnerscore], laboratory investigations were done: CBC with blood film [classified according to hematological scoring system], CRP, Blood culture upon admission and on suspicion of sepsis, other cultures and arterial blood gases when clinically indicated. Radiological investigation were done when clinically indicated, Data were analyzed using the Statistical Package for Social Sdences SPSS
Results: Lactoferrin group [45 preterm neonates] with mean gestational age [33.11 +/- 1.81 weeks]. 32 males [71%] and 13 females [29%]. Placebo group [90 preterm neonates] with mean gestational age [33.28 +/- 1.89 weeks], 45 males [50%] and 45 females [50%]. Lactoferrin group showed a significantly lower incidence of late onset sepsis according to Tollner score and Rodwell score and blood cultures [6.7%] compared to placebo group [17.8%]. E coli and Soureuswere the most common organisms found in septic neonates in the current study [28.6% for each]
Conclusion: BLF supplementation would be a suitable preventive tool for late onset neonatal sepsis in preterm neonates