Humans ; Papua New Guinea/epidemiology ; Pneumonia/*epidemiology/microbiology/prevention & control

OBJECTIVETo study the effect of mouth-fed probiotics on pathogenic bacteria colonization of the oropharynx and lower respiratory tract in neonates undergoing mechanical ventilation.

METHODSRandomized control method was employed to divide the neonates undergoing mechanical ventilation into probiotics (n=82) and control groups (n=83). The control group received routine treatment. The probiotics group was administered with oral probiotics in addition to routine treatment. The number of pathogenic bacteria colonized on the oropharynx and lower respiratory tract, and the number of the bacterial strain of ventilator-associated pneumonia (VAP) in the two groups were examined. The timing of the bacteria colonization and VAP occurrence were also examined.

RESULTSThe probiotics group presented a lower bacterial strain colonization rate of the oropharynx pathogenic bacteria than the control group (35% vs 51%; P<0.05). The colonization time of pathogenic bacteria of the oropharynx and lower respiratory tract, and the time of VAP occurrence lagged behind in the probiotics group compared with that the control group (P<0.05). No adverse reaction caused by probiotics was found.

CONCLUSIONSProbiotics administration is effective in decreasing pathogenic bacteria colonization on the oropharynx, in postponing the pathogenic bacteria colonization on the oropharynx and lower respiratory tract and in delaying the occurrence of VAP in neonates undergoing mechanical ventilation.

Bacteria ; isolation & purification ; Female ; Humans ; Incidence ; Infant, Newborn ; Male ; Oropharynx ; microbiology ; Pneumonia, Ventilator-Associated ; epidemiology ; etiology ; prevention & control ; Probiotics ; adverse effects ; pharmacology ; Respiration, Artificial ; Respiratory System ; microbiology

OBJECTIVETo study the effects of bifidobacterium on respiratory and gastrointestinal tracts in neonates receiving mechanical ventilation.

METHODSThe eligible neonates were randomly assigned into two groups: observed (n=38) and control (n=43). The observed group was given bifidobacteria daily (one capsule per time, for 7 days) by nasal feeding from the next day after mechanical ventilation. Gastric pH, gastric bacteria colonization, feeding intolerance, weight gain, the incidence of ventilator-associated pneumonia (VAP), and the homology between the bacteria isolated from intra-gastric colonization with those causing VAP were observed.

RESULTSThe incidence of gastric pH≤3 in the observed group was significantly higher than that in the control group 3, 5 and 7 days after mechanical ventilation (P<0.01). The rate of gastric bacteria colonization in the observed group was significantly lower than that in the control group 5 and 7 days after mechanical ventilation (P<0.01). The incidences of feeding intolerance and VAP in the observed group were significantly lower than those in the control group (P<0.05, P<0.01, respectively). The rate of homology of the bacteria isolated from intra-gastric colonization with those causing VAP in the observed group was significantly lower than that in the control group (P<0.01). There were no significant differences in the weight gain between the two groups.

CONCLUSIONSBifidobacterium can decrease gastric pH, gastric bacteria colonization and feeding intolerance, thus blocks the infection route "stomach-oropharynx-respiratory tract" indirectly and decreases the incidence of endogenous VAP in neonates receiving mechanical ventilation.

Bifidobacterium ; physiology ; Female ; Gastric Acidity Determination ; Gastrointestinal Tract ; microbiology ; Humans ; Infant, Newborn ; Male ; Pneumonia, Ventilator-Associated ; epidemiology ; prevention & control ; Respiration, Artificial ; adverse effects ; Weight Gain