No differences were observed in the prevention of necrotizing enterocolitis and late–onset sepsis among preterm infants who received either single–species or multi–species probiotics

Abstract

Background

Probiotic prophylaxis has been suggested to reduce the incidence of necrotizing enterocolitis (NEC) and late–onset sepsis (LOS) in very preterm newborns. However, choosing the optimal probiotic is difficult due to variations in strain–specific effects and interactions facilitated by the use of combination species.

Aims

To compare clinical outcomes of very preterm infants receiving multi or single–species probiotics.

Study design

Retrospective, single–center, cohort study.

Subjects

Very preterm infants (<32 weeks' gestation) born between 2019 and 2022 at a tertiary perinatal center received either a multi–species (Lactobacillus rhamnosus 45 %, Lactobacillus casei 15 %, Lactobacillus acidophilus 15 %, Bifidobacterium infantis 15 %, Bifidobacterium bifidum 10 %; n = 228) or a single–species (Bifidobacterium breve BR03 and B632; n = 227) probiotic formulation.

Main outcome measures

NEC, LOS, and mortality.

Results

The overall incidence of NEC and LOS was 3.1 % and 13.8 %, respectively. There were no differences between the multi–species and single–species probiotic groups in the rate of NEC (3.5 % vs 2.6 %; p = 0.787), LOS (15.4 % vs 12.3 %; p = 0.416), mortality (0.9 % vs 1.8 %; p = 0.449), or composite outcome (NEC, LOS and/or death; 16.7 % vs 12.8 %; p = 0.290).

Conclusion

The clinical outcomes of very preterm newborns receiving multi vs. single–species probiotic formulations were similar in our study. In view of the sample size and low baseline rate of NEC in our unit, further trials are warranted to investigate the effects of specific probiotics for prevention of serious neonatal morbidities.