Probiotics for Preterm Infants: A Strain-Specific Systematic Review and Network Meta-analysis

Journal of Pediatric Gastroenterology and Nutrition

Volumn 67, Issue 1, 2018, Pages 103-122

  Van Den Akker, Chris H P ^a   Van Goudoever, Johannes B ^a,b   Szajewska, Hania ^c   Embleton, Nicholas D ^d   Hojsak, Iva ^e   Reid, Daan ^f   Shamir, Raanan ^g  

^a EMMA CHILDREN S HOSPITAL   (Netherlands)

^b VU UNIVERSITY MEDICAL CENTER   (Netherlands)

^c MEDICAL UNIVERSITY OF WARSAW   (Poland)

^d NEWCASTLE UNIVERSITY   (United Kingdom)

^e Croatia   (Croatia)

^f UNIVERSITY MEDICAL CENTER GRONINGEN   (Netherlands)

^g TEL AVIV UNIVERSITY   (Israel)

Author keywords

enteral tolerance; microbiota; necrotizing enterocolitis; premature neonates; sepsis

Indexed keywords

PROBIOTIC AGENT;

ARTICLE; DRUG EFFICACY; ENTERIC FEEDING; HUMAN; INFANT MORTALITY; META ANALYSIS; MORTALITY RATE; NECROTIZING ENTEROCOLITIS; NONHUMAN; PREMATURITY; PRIORITY JOURNAL; SEPSIS; SYSTEMATIC REVIEW; BACILLUS CLAUSII; BACILLUS COAGULANS; BIFIDOBACTERIUM; LACTOBACILLUS; NETWORK META-ANALYSIS; NEWBORN; SACCHAROMYCES BOULARDII; STREPTOCOCCUS THERMOPHILUS; SURVIVAL RATE; TIME FACTOR;

BACILLUS CLAUSII; BACILLUS COAGULANS; BIFIDOBACTERIUM; ENTERAL NUTRITION; ENTEROCOLITIS, NECROTIZING; HUMANS; INFANT, NEWBORN; INFANT, PREMATURE; LACTOBACILLUS; NETWORK META-ANALYSIS; PROBIOTICS; SACCHAROMYCES BOULARDII; SEPSIS; STREPTOCOCCUS THERMOPHILUS; SURVIVAL RATE; TIME FACTORS;

EID: 85045792012     PISSN: 02772116     EISSN: 15364801     Source Type: Journal    
DOI: 10.1097/MPG.0000000000001897     Document Type: Article

References (123)

1. Niño DF, Sodhi CP, Hackam DJ. Necrotizing enterocolitis: new insights into pathogenesis and mechanisms. Nat Rev Gastroenterol Hepatol 2016;13:590-600.
2. Denning TL, Bhatia AM, Kane AF, et al. Pathogenesis of NEC: role of the innate and adaptive immune response. Semin Perinatol 2017;41: 15-28.
3. Eaton S, Rees CM, Hall NJ. Current research on the epidemiology, pathogenesis, and management of necrotizing enterocolitis. Neonatology 2017;111:423-30.
4. Frost BL, Modi BP, Jaksic T, et al. New medical and surgical insights into neonatal necrotizing enterocolitis: a review. JAMA Pediatr 2017;171:83-8.
5. Samuels N, van de Graaf RA, de Jonge RCJ, et al. Risk factors for necrotizing enterocolitis in neonates: a systematic review of prognostic studies. BMC Pediatr 2017;17:105.
6. Terrin G, Stronati L, Cucchiara S, et al. Serum markers of necrotizing enterocolitis: a systematic review. J Pediatr Gastroenterol Nutr 2017;65:e120-32.
7. Rusconi B, Good M, Warner BB. The microbiome and biomarkers for necrotizing enterocolitis: are we any closer to prediction? J Pediatr 2017;189:40.e2-7.e2.
8. Corpeleijn WE, Kouwenhoven SM, Paap MC, et al. Intake of own mother's milk during the first days of life is associated with decreased morbidity and mortality in very low birth weight infants during the first 60 days of life. Neonatology 2012;102:276-81.
9. O'Connor DL, Gibbins S, Kiss A, et al. Effect of supplemental donor human milk compared with preterm formula on neurodevelopment of very low-birth-weight infants at 18 months: a randomized clinical trial. JAMA 2016;316:1897-905.
10. Shulhan J, Dicken B, Hartling L, et al. Current knowledge of necrotizing enterocolitis in preterm infants and the impact of different types of enteral nutrition products. Adv Nutr 2017;8:80-91.
11. Hill C, Guarner F, Reid G, et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol 2014;11:506-14.
12. Underwood MA. Impact of probiotics on necrotizing enterocolitis. Semin Perinatol 2017;41:41-51.
13. YuW, SuiW, Mu L, et al. Preventing necrotizing enterocolitis by food additives in neonates: A network meta-analysis revealing the efficacy and safety. Medicine (Baltimore) 2017;96:e6652.
14. Peterson LW, Artis D. Intestinal epithelial cells: regulators of barrier function and immune homeostasis. Nat Rev Immunol 2014;14:141-53.
15. Pammi M, Cope J, Tarr PI, et al. Intestinal dysbiosis in preterm infants preceding necrotizing enterocolitis: a systematic review and metaanalysis. Microbiome 2017;5:31.
16. Warner BB, Tarr PI. Necrotizing enterocolitis and preterm infant gut bacteria. Semin Fetal Neonatal Med 2016;21:394-9.
17. Kolaček S, Hojsak I, Canani RB, et al., ESPGHANWorking Group for Probiotics and Prebiotics. Commercial probiotic products: a call for improved quality control. A Position Paper by the ESPGHANWorking Group for Probiotics and Prebiotics. J Pediatr Gastroenterol Nutr 2017;65:117-24.
18. Agostoni C, Buonocore G, Carnielli VP, et al. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr 2010;50:85-91.
19. Aceti A, Gori D, Barone G, et al. Probiotics and time to achieve full enteral feeding in human milk-fed and formula-fed preterm infants: systematic review and meta-analysis. Nutrients 2016;8:pii: E471. doi: 10.3390/nu8080471.
20. Aceti A, Maggio L, Beghetti I, et al. Probiotics prevent late-onset sepsis in human milk-fed, very low birth weight preterm infants: systematic review and meta-analysis. Nutrients 2017;9:pii: E904. doi: 10.3390/nu9080904.
21. Athalye-Jape G, Rao S, Patole S. Lactobacillus reuteri DSM 17938 as a probiotic for preterm neonates: a strain-specific systematic review. JPEN J Parenter Enteral Nutr 2016;40:783-94.
22. Athalye-Jape G, Rao S, Simmer K, et al. Bifidobacterium breve M-16V as a probiotic for preterm infants: a strain-specific systematic review. JPEN J Parenter Enteral Nutr 2017. doi: 10.1177/0148607117722749.
23. Baucells BJ, Mercadal Hally M, Alvarez Sanchez AT, et al. Probiotic associations in the prevention of necrotising enterocolitis and the reduction of late-onset sepsis and neonatal mortality in preterm infants under 1,500 g: A systematic review. An Pediatr (Barc) 2016;85:247-55.
24. Billimoria ZC, Pandya S, Bhatt P, et al. Probiotics-to use, or not to use? An updated meta-analysis. Clin Pediatr (Phila) 2016;55:1242-4.
25. Chang HY, Chen JH, Chang JH, et al. Multiple strains probiotics appear to be the most effective probiotics in the prevention of necrotizing enterocolitis and mortality: an updated meta-analysis. PLoS One 2017;12:e0171579.
26. Dermyshi E, Wang Y, Yan C, et al. The "Golden Age" of probiotics: a systematic review and meta-analysis of randomized and observational studies in preterm infants. Neonatology 2017;112:9-23.
27. Hu HJ, Zhang GQ, Zhang Q, et al. Probiotics prevent Candida colonization and invasive fungal sepsis in preterm neonates: a systematic review and meta-analysis of randomized controlled trials. Pediatr Neonatol 2017;58:103-10.
28. Rao SC, Athalye-Jape GK, Deshpande GC, et al. Probiotic supplementation and late-onset sepsis in preterm infants: a meta-analysis. Pediatrics 2016;137:e20153684.
29. Sawh SC, Deshpande S, Jansen S, et al. Prevention of necrotizing enterocolitis with probiotics: a systematic review and meta-analysis. PeerJ 2016;4:e2429.
30. Sun J, Marwah G, Westgarth M, et al. Effects of probiotics on necrotizing enterocolitis, sepsis, intraventricular hemorrhage, mortality, length of hospital stay, and weight gain in very preterm infants: a meta-analysis. Adv Nutr 2017;8:749-63.
31. Thomas JP, Raine T, Reddy S, et al. Probiotics for the prevention of necrotising enterocolitis in very low-birth-weight infants: a metaanalysis and systematic review. Acta Paediatr 2017;106:1729-41.
32. Zhang GQ, Hu HJ, Liu CY, et al. Probiotics for preventing late-onset sepsis in preterm neonates: a PRISMA-compliant systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2016;95:e2581.
33. Hutton B, Salanti G, Caldwell DM, et al. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med 2015;162:777-84.
34. Bell MJ, Ternberg JL, Feigin RD, et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg 1978;187:1-7.
35. Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am 1986;33:179-201.
36. Kliegman RM, Walsh MC. Neonatal necrotizing enterocolitis: pathogenesis, classification, and spectrum of illness. Curr Probl Pediatr 1987;17:213-88.
37. Altmann F, Kosma P, O'Callaghan A, et al. Genome analysis and characterisation of the exopolysaccharide produced by Bifidobacterium longum subsp. longum 35624. PLoS One 2016;11:e0162983.
38. European Food Safety Authority (EFSA). Scientific opinion on the substantiation of health claims related to Bifidobacterium animalis ssp. lactis Bb-12. EFSA J 2011;9:2047-66.
39. Drago L, De Vecchi E. Should Lactobacillus sporogenes and Bacillus coagulans have a future? J Chemother 2009;21:371-7.
40. Rosander A, Connolly E, Roos S. Removal of antibiotic resistance gene-carrying plasmids from Lactobacillus reuteri ATCC 55730 and characterization of the resulting daughter strain, L. reuteri DSM 17938. Appl Environ Microbiol 2008;74:6032-40.
41. Crittenden RG, Morris LF, Harvey ML, et al. Selection of a Bifidobacterium strain to complement resistant starch in a synbiotic yoghurt. J Appl Microbiol 2001;90:268-78.
42. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 2005;5:1-10.
43. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011].The Cochrane Collaboration; 2011:Available at: http://handbook.cochrane.orgs. Accessed September 4, 2017.
44. Efthimiou O, Debray TP, van Valkenhoef G, et al. GetReal in network meta-analysis: a review of the methodology. Res Synth Methods 2016;7:236-63.
45. Turner RM, Davey J, Clarke MJ, et al. Predicting the extent of heterogeneity in meta-analysis, using empirical data from the Cochrane Database of Systematic Reviews. Int J Epidemiol 2012;41: 818-27.
46. Drugis.org. Aggregate Data Drug Information System (ADDIS), version 2. https://drugis.org/software/addis2/index.
47. van Valkenhoef G, Lu G, de Brock B, et al. Automating network metaanalysis. Res Synth Methods 2012;3:285-99.
48. R Core Team. R: A Language and Environment for Statistical Computing. Vienna, Austria; 2017. Accessed at: https://www.Rproject.org.
49. Review Manager (RevMan) [Computer program]. Version 5.3.5. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration; 2014.
50. van Valkenhoef G, Dias S, Ades AE, et al. Automated generation of node-splitting models for assessment of inconsistency in network meta-analysis. Res Synth Methods 2016;7:80-93.
51. Al-Hosni M, Duenas M, Hawk M, et al. Probiotics-supplemented feeding in extremely low-birth-weight infants. J Perinatol 2012; 32:253-9.
52. Arora S, Khurana MS, Saini R. To study the role of probiotics in the prevention of necrotizing enterocolitis in preterm neonates. Int J Contemp Pediatr 2017;4:1792-7.
53. Awad H, Mokhtar H, Imam SS, et al. Comparison between killed and living probiotic usage versus placebo for the prevention of necrotizing enterocolitis and sepsis in neonates. Pak J Biol Sci 2010;13:253-62.
54. Bin-Nun A, Bromiker R, Wilschanski M, et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight neonates. J Pediatr 2005;147:192-6.
55. Braga TD, da Silva GA, de Lira PI, et al. Efficacy of Bifidobacterium breve and Lactobacillus casei oral supplementation on necrotizing enterocolitis in very-low-birth-weight preterm infants: a double-blind, randomized, controlled trial. Am J Clin Nutr 2011;93:81-6.
56. Chrzanowska-Liszewska D, Seliga-Siwecka J, Kornacka MK. The effect of Lactobacillus rhamnosus GG supplemented enteral feeding on the microbiotic flora of preterm infants-double blinded randomized control trial. Early Hum Dev 2012;88:57-60.
57. Costalos C, Skouteri V, Gounaris A, et al. Enteral feeding of premature infants with Saccharomyces boulardii. Early Hum Dev 2003;74:89-96.
58. Costeloe K, Hardy P, Juszczak E, et al. Bifidobacterium breve BBG- 001 in very preterm infants: a randomised controlled phase 3 trial. Lancet 2016;387:649-60.
59. Dani C, Biadaioli R, Bertini G, et al. Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in preterm infants. A prospective double-blind study. Biol Neonate 2002;82:103-8.
60. Demirel G, Erdeve O, Celik IH, et al. Saccharomyces boulardii for prevention of necrotizing enterocolitis in preterm infants: a randomized, controlled study. Acta Paediatr 2013;102:e560-5.
61. Dilli D, Aydin B, Fettah ND, et al. The propre-save study: effects of probiotics and prebiotics alone or combined on necrotizing enterocolitis in very low birth weight infants. J Pediatr 2015;166:545.e1-51.e1.
62. Dutta S, Ray P, Narang A. Comparison of stool colonization in premature infants by three dose regimes of a probiotic combination: a randomized controlled trial. Am J Perinatol 2015;32:733-40.
63. Fernández-Carrocera LA, Solis-Herrera A, Cabanillas-Ayon M, et al. Double-blind, randomised clinical assay to evaluate the efficacy of probiotics in preterm newborns weighing less than 1500 g in the prevention of necrotising enterocolitis. Arch Dis Child Fetal Neonatal Ed 2013;98:F5-9.
64. Fujii T, Ohtsuka Y, Lee T, et al. Bifidobacterium breve enhances transforming growth factor beta1 signaling by regulating Smad7 expression in preterm infants. J Pediatr Gastroenterol Nutr 2006;43:83-8.
65. Havranek T, Al-Hosni M, Armbrecht E. Probiotics supplementation increases intestinal blood flow velocity in extremely low birth weight preterm infants. J Perinatol 2013;33:40-4.
66. Hays S, Jacquot A, Gauthier H, et al. Probiotics and growth in preterm infants: a randomized controlled trial, PREMAPRO study. Clin Nutr 2016;35:802-11.
67. Hikaru U, Koichi S, Yayoi S, et al. Bifidobacteria prevents preterm infants from developing infection and sepsis. Int J Probiotics Prebiotics 2010;5:33-6.
68. Indrio F, Riezzo G, Tafuri S, et al. Probiotic supplementation in preterm: feeding intolerance and hospital cost. Nutrients 2017;9: 965-72.
69. Jacobs SE, Tobin JM, Opie GF, et al. Probiotic effects on late-onset sepsis in very preterm infants: a randomized controlled trial. Pediatrics 2013;132:1055-62.
70. Kanic Z, Micetic Turk D, Burja S, et al. Influence of a combination of probiotics on bacterial infections in very low birthweight newborns. Wien Klin Wochenschr 2015;127(suppl 5):S210-5.
71. Lin HC, Su BH, Chen AC, et al. Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants. Pediatrics 2005;115:1-4.
72. Lin HC, Hsu CH, Chen HL, et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Pediatrics 2008;122:693-700.
73. Manzoni P, Mostert M, Leonessa ML, et al. Oral supplementation with Lactobacillus casei subspecies rhamnosus prevents enteric colonization by Candida species in preterm neonates: a randomized study. Clin Infect Dis 2006;42:1735-42.
74. Manzoni P, Rinaldi M, Cattani S, et al. Bovine lactoferrin supplementation for prevention of late-onset sepsis in very low-birth-weight neonates: a randomized trial. JAMA 2009;302:1421-8.
75. Manzoni P, Meyer M, Stolfi I, et al. Bovine lactoferrin supplementation for prevention of necrotizing enterocolitis in very-low-birth-weight neonates: a randomized clinical trial. Early Hum Dev 2014;90(suppl 1):S60-5.
76. Mihatsch WA, Vossbeck S, Eikmanns B, et al. Effect of Bifidobacterium lactis on the incidence of nosocomial infections in very-low-birthweight infants: a randomized controlled trial. Neonatology 2010;98: 156-63.
77. Millar MR, Bacon C, Smith SL, et al. Enteral feeding of premature infants with Lactobacillus GG. Arch Dis Child 1993;69 (5 Spec No):483-7.
78. Mohan R, Koebnick C, Schildt J, et al. Effects of Bifidobacterium lactis Bb12 supplementation on intestinal microbiota of preterm infants: a double-blind, placebo-controlled, randomized study. J Clin Microbiol 2006;44:4025-31.
79. Oncel MY, Sari FN, Arayici S, et al. Lactobacillus reuteri for the prevention of necrotising enterocolitis in very low birthweight infants: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 2014;99:F110-5.
80. Pärtty A, Luoto R, Kalliomaki M, et al. Effects of early prebiotic and probiotic supplementation on development of gut microbiota and fussing and crying in preterm infants: a randomized, double-blind, placebo-controlled trial. J Pediatr 2013;163:1272-7e1-2.
81. Patole S, Keil AD, Chang A, et al. Effect of Bifidobacterium breve M- 16V supplementation on fecal bifidobacteria in preterm neonates - a randomised double blind placebo controlled trial. PLoS One 2014;9: e89511.
82. Reuman PD, Duckworth DH, Smith KL, et al. Lack of effect of Lactobacillus on gastrointestinal bacterial colonization in premature infants. Pediatr Infect Dis 1986;5:663-8.
83. Rojas MA, Lozano JM, Rojas MX, et al. Prophylactic probiotics to prevent death and nosocomial infection in preterm infants. Pediatrics 2012;130:e1113-20.
84. Romeo MG, Romeo DM, Trovato L, et al. Role of probiotics in the prevention of the enteric colonization by Candida in preterm newborns: incidence of late-onset sepsis and neurological outcome. J Perinatol 2011;31:63-9.
85. Rougé C, Piloquet H, Butel MJ, et al. Oral supplementation with probiotics in very-low-birth-weight preterm infants: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 2009;89: 1828-35.
86. Roy A, Chaudhuri J, Sarkar D, et al. Role of enteric supplementation of probiotics on late-onset sepsis by Candida species in preterm low birth weight neonates: a randomized, double blind, placebo-controlled trial. N Am J Med Sci 2014;6:50-7.
87. Saengtawesin V, Tangpolkaiwalsak R, Kanjanapattankul W. Effect of oral probiotics supplementation in the prevention of necrotizing enterocolitis among very low birth weight preterm infants. J Med Assoc Thai 2014;97(suppl 6):S20-5.
88. Samanta M, Sarkar M, Ghosh P, et al. Prophylactic probiotics for prevention of necrotizing enterocolitis in very low birth weight newborns. J Trop Pediatr 2009;55:128-31.
89. Sari FN, Dizdar EA, Oguz S, et al. Oral probiotics: Lactobacillus sporogenes for prevention of necrotizing enterocolitis in very low-birth weight infants: a randomized, controlled trial. Eur J Clin Nutr 2011;65:434-9.
90. Serce O, Benzer D, Gursoy T, et al. Efficacy of Saccharomyces boulardii on necrotizing enterocolitis or sepsis in very low birth weight infants: a randomised controlled trial. Early Hum Dev 2013;89:1033-6.
91. Shadkam MN, Jalalizadeh F, Nasiriani K. Effects of probiotic Lactobacillus reuteri (DSM 17938) on the incidence of necrotizing enterocolitis in very low birth weight premature infants. Iranian J Neonatol 2015;6:15-20.
92. Shashidhar A, Suman Rao PN, Nesargi S, et al. Probiotics for promoting feed tolerance in very low birth weight neonates - a randomized controlled trial. Indian Pediatr 2017;54:363-7.
93. Stratiki Z, Costalos C, Sevastiadou S, et al. The effect of a bifidobacter supplemented bovine milk on intestinal permeability of preterm infants. Early Hum Dev 2007;83:575-9.
94. Tewari VV, Dubey SK, Gupta G. Bacillus clausii for prevention of lateonset sepsis in preterm infants: a randomized controlled trial. J Trop Pediatr 2015;61:377-85.
95. Totsu S, Yamasaki C, Terahara M, et al. Bifidobacterium and enteral feeding in preterm infants: cluster-randomized trial. Pediatr Int 2014;56:714-9.
96. Underwood MA, Salzman NH, Bennett SH, et al. A randomized placebo-controlled comparison of 2 prebiotic/probiotic combinations in preterm infants: impact on weight gain, intestinal microbiota, and fecal short-chain fatty acids. J Pediatr Gastroenterol Nutr 2009;48: 216-25.
97. Van Niekerk E, Nel DG, Blaauw R, et al. Probiotics reduce necrotizing enterocolitis severity in HIV-exposed premature infants. J Trop Pediatr 2015;61:155-64.
98. Wang C, Shoji H, Sato H, et al. Effects of oral administration of Bifidobacterium breve on fecal lactic acid and short-chain fatty acids in low birth weight infants. J Pediatr Gastroenterol Nutr 2007;44:252-7.
99. Xu L, Wang Y, Wang Y, et al. A double-blinded randomized trial on growth and feeding tolerance with Saccharomyces boulardii CNCM I- 745 in formula-fed preterm infants. J Pediatr (Rio J) 2016;92:296-301.
100. Zeber-Lubecka N, Kulecka M, Ambrozkiewicz F, et al. Effect of Saccharomyces boulardii and mode of delivery on the early development of the gut microbial community in preterm infants. PLoS One 2016;11:e0150306.
101. Zhang AM, Sun ZQ, Zhang LM. Mosapride combined with probiotics on gastrointestinal function and growth in premature infants. Exp Ther Med 2017;13:2675-80.
102. Costeloe K, Bowler U, Brocklehurst P, et al. A randomised controlled trial of the probiotic Bifidobacterium breve BBG-001 in preterm babies to prevent sepsis, necrotising enterocolitis and death: the Probiotics in Preterm infantS (PiPS) trial. Health Technol Assess 2016;20:1-194.
103. Demirel G, Celik IH, Erdeve O, et al. Impact of probiotics on the course of indirect hyperbilirubinemia and phototherapy duration in very low birth weight infants. J Matern Fetal Neonatal Med 2013; 26:215-8.
104. Manzoni P, Stolfi I, Messner H, et al. Bovine lactoferrin prevents invasive fungal infections in very low birth weight infants: a randomized controlled trial. Pediatrics 2012;129:116-23.
105. Patole SK, Keil AD, Nathan E, et al. Effect of Bifidobacterium breve M-16V supplementation on faecal bifidobacteria in growth restricted very preterm infants-analysis from a randomised trial. J Matern Fetal Neonatal Med 2016;29:3751-5.
106. Van Niekerk E, Kirsten GF, Nel DG, et al. Probiotics, feeding tolerance, and growth: a comparison between HIV-exposed and unexposed very low birth weight infants. Nutrition 2014;30: 645-53.
107. Li Y, Shimizu T, Hosaka A, et al. Effects of Bifidobacterium breve supplementation on intestinal flora of low birth weight infants. Pediatr Int 2004;46:509-15.
108. Agarwal R, Sharma N, Chaudhry R, et al. Effects of oral Lactobacillus GG on enteric microflora in low-birth-weight neonates. J Pediatr Gastroenterol Nutr 2003;36:397-402.
109. Indrio F, Riezzo G, Raimondi F, et al. The effects of probiotics on feeding tolerance, bowel habits, and gastrointestinal motility in preterm newborns. J Pediatr 2008;152:801-6.
110. Indrio F, Riezzo G, Raimondi F, et al. Effects of probiotic and prebiotic on gastrointestinal motility in newborns. J Physiol Pharmacol 2009;60(suppl 6):S27-31.
111. Kitajima H, Sumida Y, Tanaka R, et al. Early administration of Bifidobacterium breve to preterm infants: randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 1997;76:F101-7.
112. Mohan R, Koebnick C, Schildt J, et al. Effects of Bifidobacterium lactis Bb12 supplementation on body weight, fecal pH, acetate, lactate, calprotectin, and IgA in preterm infants. Pediatr Res 2008; 64:418-22.
113. Stansbridge EM, Walker V, Hall MA, et al. Effects of feeding premature infants with Lactobacillus GG on gut fermentation. Arch Dis Child 1993;69 (5 Spec No):488-92.
114. Akar M, Eras Z, Oncel MY, et al. Impact of oral probiotics on neurodevelopmental outcomes in preterm infants. J Matern Fetal Neonatal Med 2017;30:411-5.
115. Chou IC, Kuo HT, Chang JS, et al. Lack of effects of oral probiotics on growth and neurodevelopmental outcomes in preterm very low birth weight infants. J Pediatr 2010;156:393-6.
116. Chowdhury T, Ali MM, Hossain MM, et al. Efficacy of probiotics versus placebo in the prevention of necrotizing enterocolitis in preterm very low birth weight infants: a double-blind randomized controlled trial. J Coll Physicians Surg Pak 2016;26:770-4.
117. Nandhini LP, Biswal N, Adhisivam B, et al. Synbiotics for decreasing incidence of necrotizing enterocolitis among preterm neonates - a randomized controlled trial. J Matern Fetal Neonatal Med 2016; 29:821-5.
118. Oncel MY, Arayici S, Sari FN, et al. Comparison of Lactobacillus reuteri and nystatin prophylaxis on Candida colonization and infection in very low birth weight infants. J Matern Fetal Neonatal Med 2015;28:1790-4.
119. Demirel G, Celik IH, Erdeve O, et al. Prophylactic Saccharomyces boulardii versus nystatin for the prevention of fungal colonization and invasive fungal infection in premature infants. Eur J Pediatr 2013;172:1321-6.
120. Sinha A, Gupta SS, Chellani H, et al. Role of probiotics VSL#3 in prevention of suspected sepsis in low birthweight infants in India: a randomised controlled trial. BMJ Open 2015;5:e006564.
121. Hill C, Scott K, Klaenhammer TR, et al. Probiotic nomenclature matters. Gut Microbes 2016;7:1-2.
122. Lewis ZT, Shani G, Masarweh CF, et al. Validating bifidobacterial species and subspecies identity in commercial probiotic products. Pediatr Res 2016;79:445-52.
123. Imperial IC, Ibana JA. Addressing the antibiotic resistance problem with probiotics: reducing the risk of its double-edged sword effect. Front Microbiol 2016;7:1-10.