[Value of probiotic in reducing frequency of infectious complications in premature infants].

Fifty five premature infants with very low body weight were observed as inpatients to assess effectiveness of the nursing. The standard program of the care included: adequate primary resuscitation, respiratory support (use of surfactant), thermal mode, early provision of nutrients with full or partial parenteral nutrition, antimicrobial therapy and if possible early enteral nutrition. The patients of the main group (n = 29) along with the standard therapy (the volume of the enteral nutrition of 5 ml or more) were treated orally with liquid probiotic based on E. faecium L3 in a dose of 0.5 ml (5 x 10(8) CFU) 3 times a day for 14 days. The control group (n = 26) was under the standard therapy. The effectiveness of the infants management was estimated by the frequency of disruption of the nutrition, the frequency of infectious complications, the changes in the hematologic indices, the dynamics of the composition of the intestinal microflora. The infectious complications were evident from perinatal viral infection, intraamniotic infection, necrotizing enterocolitis. In the main group patients there was recorded a significant decrease of the frequency of infectious complications: 20.7% against 53.9% in the control group patients. The use of probiotic strain E. faecium L3 in the preterm infants promoted conservation of the immunomodulatory function of the intestinal indigenic microflora and restricted the growth of the nosocomial flora.

[Dynamics of contamination and persistence of Clostridium difficile in intestinal microbiota in newborn infants during antibiotic therapy and use of probiotic strain enterococcus faecium L3].

Ninety four infants were observed as inpatients. Thirty nine of them were mature neonates and 55 were premature infants with a very low body weight. The majority of the patients were treated with antibiotics. The mature infants were treated with penicillins, aminoglycosides, cephalosporins and the premature neonates were treated in addition with carbapenems, fluoroquinolones, glycopeptides. The mature infants were randomized into 2 groups: the control group (n=18) received the standard therapy and the main group (n=21) in addition received 1 ml of liquid probiotic Enterococcus faecium L3 (with a titer of 5x10(8) CFU/ml) 2 times a day for 10 days. The premature newborn infants were also randomized into 2 groups. The control group (n=26) received the standard therapy. The main group (n=29) additionally received 1 ml of liquid probiotic E.faecium L3 2 times a day for 10 days. The effectiveness of the therapy in the mature neonates was evaluated by the frequency of dyspeptic disorders and in the premature infants by the frequency of infectious complications and the episodes of food intolerance. The intestinal microbiota of the infants was investigated by the real-time PCR and bacteriological analyses of the feces: in the mature infants on admission to the hospital and 10 days after the treatment (periods 1-2), in the premature infants on admission to the hospital and then twice with an interval of 14 days (periods 1-2-3). It was shown that the use of the probiotic strain E.faecium L3 during the antibiotic therapy in the premature infants promoted significant reduction in the frequency of infectious complications. In the mature neonates the probiotic therapy reduced the risk of dyspeptic disorder. The studies showed reduction in persistence of Clostridium difficile in the intestinal microbiota of the newborn infants receiving the antibiotic therapy in combination with probiotic E.faecium L3, that was accompanied by preserving and growth of bifidobacteria and lactobacilli and reduction of the number of opportunistic microorganisms.