益生菌可预防母乳喂养的低出生体重早产儿迟发性败血症

这是关于潜在有益菌应用于早产婴儿晚发性败血症预防的系统性综述，对相关研究进行了总结分析。结果很有参考意义，特别推荐。

论文摘要

Late onset sepsis (LOS) is one of the most common causes of morbidity and mortality in preterm infants [1,2]. It occurs in approximately 20% of very low birth weight (VLBW) infants, has a significant overall mortality [3], and a high risk of long-term neurodevelopmental sequelae [4]. 

Beyond an immature skin-mucosal barrier and immune response, other well-recognized risk factors for LOS include long-term use of invasive interventions, failure of early enteral feeding with breast milk, prolonged duration of parenteral nutrition, hospitalization, surgery, and underlying respiratory and cardiovascular diseases [2]. 

Growing evidence supports the key role of a healthy gut microbiota in promoting and maintaining a balanced immune response and in the establishment of the gut barrier in the immediate postnatal life [5]. However, in preterm infants, the development of the microbial community is disrupted by events related to prematurity: Mode of delivery, antenatal and postnatal use of antibiotics, minimal exposure to maternal flora, and low intake of breast milk [6]. Such disruption, called dysbiosis, results in an altered barrier and immune function and an imbalance between pro- and anti-inflammatory responses, and has been associated with necrotizing enterocolitis (NEC) and LOS [7,8]. 

Probiotics, defined as live micro-organisms that confer health benefits to the host through an interaction with gut microbiota and immune function when administered at adequate doses [9], have been proposed as potential tools to prevent NEC and LOS [10]. 

实验综述

① 选取25项随机对照试验（RCT）进行系统性综述及meta分析，评估益生菌对早产婴儿的晚发性败血症（LOS）的影响；

② 仅选取报道了婴儿喂养类型的RCT进行分析；

③ 总体来说，益生菌可显著降低LOS的发病率；

④ 根据喂养类型分类，发现益生菌仅在母乳喂养的早产婴儿中有保护效果；

⑤ 在母乳喂养的早产婴儿中，仅有混合益生菌，而非单菌株益生菌课有效降低LOS的发病率。