Authors (including presenting author) :
Lee SYR (1) Yong R (2) Yeung W (1)
Affiliation :
(1) Department of Paediatrics and Adolescent Medicine (2) Department of Dietetics
Introduction :
Necrotizing enterocolitis (NEC) is a serious disease that affects the bowel of premature infants. Meta-analysis of studies published in 2014 in Cochrane library found the use of probiotics reduces the occurrence of NEC and death in premature infants born weighing less than 1500 grams. In Hong Kong, we are one of the hospitals pioneering the introduction of probiotics for premature neonates.
Objectives :
To review the incidence of NEC before and after introduction of probiotics.
Methodology :
Starting from Dec 21, 2017, we began to introduce probiotics into our NICU. The dose was 3 billion CFU daily per oral for all premature infants admitted to NICU. Initially the probiotics we used contained Lactobacillus acidophilus and Bifidobacterium lactis. In mid-April, we used probiotics which contained Lactobacillus acidophilus Rosell-52, Bifidobacterium infantis Rosell-33, Bifidobacterium bifidum Rosell-71.
Result & Outcome :
The incidence of NEC in the year 2016, 2017 before introduction of probiotics was 10, 13 and after introduction of probiotics in 2018 was 8. The number of stage III NEC was reduced from 3 and 4 in 2016 and 2017 respectively to 1 in 2018. There was a trend towards reduction of occurrence of stage III NEC and surgery performed as a result of NEC although there was no obvious decrease in overall incidence of NEC of all stages. This is in agreement with the result of the Cochrane meta-analysis in 2018. The number of surgical NEC as defined by serious NEC as to require surgery in the year 2018 was 1. This was the lowest among all the HA hospitals with NICU in the year 2018. The limitation of the current study is that the sample size is small and we have just carried on the practice for one year. However, the preliminary reason of this study is encouraging. In addition, published studies so far show the efficacy of prevention of serious NEC with the use of probiotics in premature infants. Therefore, we advocate the introduction of probiotics into NICU in Hong Kong.
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