Probiotic strategies to prevent necrotizing enterocolitis in preterm infants: a meta-analysis

  • Le-wee Bi
  • Bei-lei Yan
  • Qian-yu Yang
  • Miao-miao Li
  • Hua-lei CuiEmail author
Original Article



We aimed to compare probiotics with placebo for necrotizing enterocolitis in preterm infants and to evaluate the safety and effect and strict effect of specific probiotic genera.


Data recorded until January 2019 were searched, and relevant academic articles from PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were selected by two independent reviewers. Two reviewers independently included randomized controlled trials that compared probiotics and placebo in preterm infants. The outcomes included more than one of the following outcomes: incidence of necrotizing enterocolitis, necrotizing enterocolitis-related mortality, incidence of sepsis, and all-cause mortality. Two reviewers independently extracted data and assessed the risk of bias and quality of evidence.


We identified 34 eligible studies of 9161 participants. This meta-analysis showed an overall advantage of probiotics to prevent the incidence of necrotizing enterocolitis (3.54%) and gut-associated sepsis (15.59%), and decrease mortality (5.23%) in preterm infants. A probiotic mixture showed a huge advantage and vitality in preventing necrotizing enterocolitis (2.48%) and gut-associated sepsis (18.39%), and in reducing mortality (5.57%) in preterm infants.


The probiotic mixture showed advantages over the single strains to decrease the incidences of necrotizing enterocolitis and gut-associated sepsis, and mortality in preterm infants.


Probiotic genera Necrotizing enterocolitis Preterm infants Meta-analysis 



We wish to thank Tianjin Medical University for providing us with databases.

Author contributors

LB conceptualized and designed the study, drafted the initial manuscript, and interpreted the data; BY conducted the initial analyses and drafted the initial manuscript; QY conceptualized and designed the study and supervised the analysis; ML conducted the meta-analyses, interpreted the data, and reviewed the manuscript; and HC conceptualized and designed the study, supervised the analysis, interpreted the data, and reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.


This work was supported by funding from standardization of endoscopic treatment of acute abdomen in children (number 14RCGFSY00150).

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to disclose.


  1. 1.
    Arbra CA, Oprisan A, Wilson DA, Ryan RM, Lesher AP (2018) Time to reintroduction of feeding in infants with nonsurgical necrotizing enterocolitis. J Pediatr Surg 53(6):1187–1191. CrossRefPubMedGoogle Scholar
  2. 2.
    Barron LK, Warner BB, Tarr PI, Shannon WD, Deych E, Warner BW (2017) Independence of gut bacterial content and neonatal necrotizing enterocolitis severity. J Pediatr Surg 52(6):993–998. CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Hong CR, Fullerton BS, Mercier CE, Morrow KA, Edwards EM, Ferrelli KR, Soll RF, Modi BP, Horbar JD, Jaksic T (2018) Growth morbidity in extremely low birth weight survivors of necrotizing enterocolitis at discharge and two-year follow-up. J Pediatr Surg 53(6):1197–1202. CrossRefPubMedGoogle Scholar
  4. 4.
    Hammerman C, Bin-Nun A, Kaplan M (2004) Germ warfare: probiotics in defense of the premature gut. Clin Perinatol 31(3):489–500. CrossRefPubMedGoogle Scholar
  5. 5.
    Martin CR, Walker WA (2008) Probiotics: role in pathophysiology and prevention in necrotizing enterocolitis. Semin Perinatol 32(2):127–137. CrossRefPubMedGoogle Scholar
  6. 6.
    Braga TD, da Silva GA, de Lira PI, de Carvalho Lima M (2011) 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 93(1):81–86. CrossRefPubMedGoogle Scholar
  7. 7.
    Lin HC, Su BH, Chen AC, Lin TW, Tsai CH, Yeh TF, Oh W (2005) Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants. Pediatrics 115(1):1–4. CrossRefPubMedGoogle Scholar
  8. 8.
    Al-Hosni M, Duenas M, Hawk M, Stewart LA, Borghese RA, Cahoon M, Atwood L, Howard D, Ferrelli K, Soll R (2012) Probiotics-supplemented feeding in extremely low-birth-weight infants. J Perinatol 32(4):253–259. CrossRefPubMedGoogle Scholar
  9. 9.
    Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 350:g7647. CrossRefGoogle Scholar
  10. 10.
    Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928. CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Higgins JPT, Green S (2011) Cochrane handbook for systematic reviews of interventions, version 5.1.0. The cochrane collaboration. Accessed 20 July 2019
  12. 12.
    Pottie K, Welch V, Morton R, Akl EA, Eslava-Schmalbach JH, Katikireddi V, Singh J, Moja L, Lang E, Magrini N, Thabane L, Stanev R, Matovinovic E, Snellman A, Briel M, Shea B, Tugwell P, Schunemann H, Guyatt G, Alonso-Coello P (2017) GRADE equity guidelines 4: considering health equity in GRADE guideline development: evidence to decision process. J Clin Epidemiol 90:84–91. CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Chou IC, Kuo HT, Chang JS, Wu SF, Chiu HY, Su BH, Lin HC (2010) Lack of effects of oral probiotics on growth and neurodevelopmental outcomes in preterm very low birth weight infants. J Pediatr 156(3):393–396. CrossRefPubMedGoogle Scholar
  14. 14.
    Lin HC, Hsu CH, Chen HL, Chung MY, Hsu JF, Lien RI, Tsao LY, Chen CH, Su BH (2008) Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Pediatrics 122(4):693–700. CrossRefPubMedGoogle Scholar
  15. 15.
    Hays S, Jacquot A, Gauthier H, Kempf C, Beissel A, Pidoux O, Jumas-Bilak E, Decullier E, Lachambre E, Beck L, Cambonie G, Putet G, Claris O, Picaud JC (2016) Probiotics and growth in preterm infants: a randomized controlled trial, PREMAPRO study. Clin Nutr 35(4):802–811. CrossRefPubMedGoogle Scholar
  16. 16.
    Jacobs SE, Tobin JM, Opie GF, Donath S, Tabrizi SN, Pirotta M, Morley CJ, Garland SM, ProPrems Study G (2013) Probiotic effects on late-onset sepsis in very preterm infants: a randomized controlled trial. Pediatrics 132(6):1055–1062. CrossRefPubMedGoogle Scholar
  17. 17.
    Patole S, Keil AD, Chang A, Nathan E, Doherty D, Simmer K, Esvaran M, Conway P (2014) Effect of Bifidobacterium breve M-16 V supplementation on fecal bifidobacteria in preterm neonates—a randomised double blind placebo controlled trial. PLoS One 9(3):e89511. CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Costalos C, Skouteri V, Gounaris A, Sevastiadou S, Triandafilidou A, Ekonomidou C, Kontaxaki F, Petrochilou V (2003) Enteral feeding of premature infants with Saccharomyces boulardii. Early Hum Dev 74(2):89–96. CrossRefPubMedGoogle Scholar
  19. 19.
    Roy A, Chaudhuri J, Sarkar D, Ghosh P, Chakraborty S (2014) 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 6(1):50–57. CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Sari FN, Eras Z, Dizdar EA, Erdeve O, Oguz SS, Uras N, Dilmen U (2012) Do oral probiotics affect growth and neurodevelopmental outcomes in very low-birth-weight preterm infants? Am J Perinatol 29(8):579–586. CrossRefPubMedGoogle Scholar
  21. 21.
    Costeloe K, Hardy P, Juszczak E, Wilks M, Millar MR (2016) Bifidobacterium breve BBG-001 in very preterm infants: a randomised controlled phase 3 trial. Lancet 387(10019):649–660. CrossRefPubMedGoogle Scholar
  22. 22.
    Fernández-Carrocera LA, Solis-Herrera A, Cabanillas-Ayón M, Gallardo-Sarmiento RB, García-Pérez CS, Montaño-Rodríguez R, Echániz-Aviles MOL (2013) 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 98(1):F5–F9. CrossRefPubMedGoogle Scholar
  23. 23.
    Manzoni P, Mostert M, Leonessa ML, Priolo C, Farina D, Monetti C, Latino MA, Gomirato G (2006) Oral supplementation with Lactobacillus casei subspecies rhamnosus prevents enteric colonization by Candida species in preterm neonates: a randomized study. Clin Infect Dis 42(12):1735–1742. CrossRefPubMedGoogle Scholar
  24. 24.
    Mihatsch WA, Vossbeck S, Eikmanns B, Hoegel J, Pohlandt F (2010) Effect of Bifidobacterium lactis on the incidence of nosocomial infections in very-low-birth-weight infants: a randomized controlled trial. Neonatology 98(2):156–163. CrossRefPubMedGoogle Scholar
  25. 25.
    Oncel MY, Sari FN, Arayici S, Guzoglu N, Erdeve O, Uras N, Oguz SS, Dilmen U (2014) Lactobacillus reuteri for the prevention of necrotising enterocolitis in very low birthweight infants: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 99(2):F110–F115. CrossRefPubMedGoogle Scholar
  26. 26.
    Rojas MA, Lozano JM, Rojas MX, Rodriguez VA, Rondon MA, Bastidas JA, Perez LA, Rojas C, Ovalle O, Garcia-Harker JE, Tamayo ME, Ruiz GC, Ballesteros A, Archila MM, Arevalo M (2012) Prophylactic probiotics to prevent death and nosocomial infection in preterm infants. Pediatrics 130(5):e1113–e1120. CrossRefPubMedGoogle Scholar
  27. 27.
    Rouge C, Piloquet H, Butel MJ, Berger B, Rochat F, Ferraris L, Des Robert C, Legrand A, de la Cochetiere MF, N’Guyen JM, Vodovar M, Voyer M, Darmaun D, Roze JC (2009) Oral supplementation with probiotics in very-low-birth-weight preterm infants: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 89(6):1828–1835. CrossRefPubMedGoogle Scholar
  28. 28.
    Samanta M, Sarkar M, Ghosh P, Jk Ghosh, Mk Sinha, Chatterjee S (2008) Prophylactic probiotics for prevention of necrotizing enterocolitis in very low birth weight newborns. J Trop Pediatr 55(2):128–131. CrossRefPubMedGoogle Scholar
  29. 29.
    Stratiki Z, Costalos C, Sevastiadou S, Kastanidou O, Skouroliakou M, Giakoumatou A, Petrohilou V (2007) The effect of a bifidobacter supplemented bovine milk on intestinal permeability of preterm infants. Early Hum Dev 83(9):575–579. CrossRefPubMedGoogle Scholar
  30. 30.
    Chowdhury T, Ali MM, Hossain MM, Singh J, Yousuf AN, Yasmin F, Chowdhury FR (2016) 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 Phys Surg Pak JCPSP 26(9):770–774Google Scholar
  31. 31.
    Demirel G, Celik IH, Erdeve O, Saygan S, Dilmen U, Canpolat FE (2013) Prophylactic Saccharomyces boulardii versus nystatin for the prevention of fungal colonization and invasive fungal infection in premature infants. Eur J Pediatr 172(10):1321–1326. CrossRefPubMedGoogle Scholar
  32. 32.
    Dani C, Biadaioli R, Bertini G, Martelli E, Rubaltelli FF (2002) Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in preterm infants. A prospective double-blind study. Biol Neonate 82(2):103–108. CrossRefPubMedGoogle Scholar
  33. 33.
    Sari FN, Dizdar EA, Oguz S, Erdeve O, Uras N, Dilmen U (2011) Oral probiotics: lactobacillus sporogenes for prevention of necrotizing enterocolitis in very low-birth weight infants: a randomized, controlled trial. Eur J Clin Nutr 65(4):434–439. CrossRefPubMedGoogle Scholar
  34. 34.
    Demirel G, Erdeve O, Celik IH, Dilmen U (2013) Saccharomyces boulardii for prevention of necrotizing enterocolitis in preterm infants: a randomized, controlled study. Acta Paediatr 102(12):e560–e565. CrossRefPubMedGoogle Scholar
  35. 35.
    Dilli D, Aydin B, Fettah ND, Ozyazici E, Beken S, Zenciroglu A, Okumus N, Ozyurt BM, Ipek MS, Akdag A, Turan O, Bozdag S (2015) The propre-save study: effects of probiotics and prebiotics alone or combined on necrotizing enterocolitis in very low birth weight infants. J Pediatr 166(3):545–551. (e541) CrossRefPubMedGoogle Scholar
  36. 36.
    Fujii T, Ohtsuka Y, Lee T, Kudo T, Shoji H, Sato H, Nagata S, Shimizu T, Yamashiro Y (2006) Bifidobacterium breve enhances transforming growth factor beta1 signaling by regulating Smad7 expression in preterm infants. J Pediatr Gastroenterol Nutr 43(1):83–88. CrossRefPubMedGoogle Scholar
  37. 37.
    Kanic Z, Micetic Turk D, Burja S, Kanic V, Dinevski D (2015) Influence of a combination of probiotics on bacterial infections in very low birthweight newborns. Wien Klin Wochenschr 127(Suppl 5):S210–S215. CrossRefPubMedGoogle Scholar
  38. 38.
    Saengtawesin V, Tangpolkaiwalsak R, Kanjanapattankul W (2014) Effect of oral probiotics supplementation in the prevention of necrotizing enterocolitis among very low birth weight preterm infants. J Med Assoc Thail 97(Suppl 6):S20–S25Google Scholar
  39. 39.
    Serce O, Benzer D, Gursoy T, Karatekin G, Ovali F (2013) Efficacy of Saccharomyces boulardii on necrotizing enterocolitis or sepsis in very low birth weight infants: a randomised controlled trial. Early Hum Dev 89(12):1033–1036. CrossRefPubMedGoogle Scholar
  40. 40.
    Tewari VV, Dubey SK, Gupta G (2015) Bacillus clausii for prevention of late-onset sepsis in preterm infants: a randomized controlled trial. J Trop Pediatr 61(5):377–385. CrossRefPubMedGoogle Scholar
  41. 41.
    Totsu S, Yamasaki C, Terahara M, Uchiyama A, Kusuda S, Probiotics Study Group in J (2014) Bifidobacterium and enteral feeding in preterm infants: cluster-randomized trial. Pediatr Int 56(5):714–719. CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Kitajima H, Sumida Y, Tanaka R, Yuki N, Takayama H, Fujimura M (1997) Early administration of Bifidobacterium breve to preterm infants: randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 76(2):F101–F107. CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Bin-Nun A, Bromiker R, Wilschanski M, Kaplan M, Rudensky B, Caplan M, Hammerman C (2005) Oral probiotics prevent necrotizing enterocolitis in very low birth weight neonates. J Pediatr 147(2):192–196. CrossRefPubMedGoogle Scholar
  44. 44.
    Eyal F, Sagi E, Arad I, Avital A (1982) Necrotising enterocolitis in the very low birthweight infant: expressed breast milk feeding compared with parenteral feeding. Arch Dis Child 57(4):274–276. CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    van Elburg RM, Fetter WP, Bunkers CM, Heymans HS (2003) Intestinal permeability in relation to birth weight and gestational and postnatal age. Arch Dis Child Fetal Neonatal Ed 88(1):F52–F55. CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Frost BL, Modi BP, Jaksic T, Caplan MS (2017) New medical and surgical insights into neonatal necrotizing enterocolitis: a review. JAMA Pediatr 171(1):83–88. CrossRefPubMedGoogle Scholar
  47. 47.
    Hagen PC, Skelley JW (2019) Efficacy of bifidobacterium species in prevention of necrotizing enterocolitis in very-low birth weight infants. A systematic review. J Pediatri Pharmacol Ther JPPT 24(1):10–15. CrossRefGoogle Scholar
  48. 48.
    Baranowski JR, Claud EC (2019) Necrotizing enterocolitis and the preterm infant microbiome. Adv Exp Med Biol. CrossRefPubMedGoogle Scholar
  49. 49.
    Underwood MA (2019) Arguments for routine administration of probiotics for NEC prevention. Curr Opin Pediatr 31(2):188–194. CrossRefPubMedGoogle Scholar
  50. 50.
    Underwood MA (2019) Probiotics and the prevention of necrotizing enterocolitis. J Pediatr Surg 54(3):405–412. CrossRefPubMedGoogle Scholar
  51. 51.
    Dermyshi E, Wang Y, Yan C, Hong W, Qiu G, Gong X, Zhang T (2017) The “golden age” of probiotics: a systematic review and meta-analysis of randomized and observational studies in preterm infants. Neonatology 112(1):9–23. CrossRefPubMedGoogle Scholar
  52. 52.
    Guarner F, Malagelada JR (2003) Gut flora in health and disease. Lancet 361(9356):512–519. CrossRefPubMedGoogle Scholar
  53. 53.
    Deshpande G, Rao S, Patole S (2007) Probiotics for prevention of necrotising enterocolitis in preterm neonates with very low birthweight: a systematic review of randomised controlled trials. Lancet 369(9573):1614–1620. CrossRefPubMedGoogle Scholar
  54. 54.
    Barclay AR, Stenson B, Simpson JH, Weaver LT, Wilson DC (2007) Probiotics for necrotizing enterocolitis: a systematic review. J Pediatr Gastroenterol Nutr 45(5):569–576. CrossRefPubMedGoogle Scholar
  55. 55.
    Alfaleh K, Anabrees J, Bassler D (2010) Probiotics reduce the risk of necrotizing enterocolitis in preterm infants: a meta-analysis. Neonatology 97(2):93–99. CrossRefPubMedGoogle Scholar
  56. 56.
    Aceti A, Gori D, Barone G, Callegari ML, Di Mauro A, Fantini MP, Indrio F, Maggio L, Meneghin F, Morelli L, Zuccotti G, Corvaglia L (2015) Probiotics for prevention of necrotizing enterocolitis in preterm infants: systematic review and meta-analysis. Ital J Pediatr. CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Baucells BJ, Hally MM, Sánchez ATÁ, Aloy JF (2016) Probiotic associations in the prevention of necrotising enterocolitis and the reduction of late-onset sepsis and neonatal mortality in preterm infants under 1500g. A systematic review. Anales de Pediatría (English Edition) 85(5):247–255. CrossRefGoogle Scholar
  58. 58.
    Alfaleh K, Anabrees J, Bassler D, Al-Kharfi T (2011) Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev. CrossRefPubMedGoogle Scholar
  59. 59.
    van den Akker CHP, van Goudoever JB, Szajewska H, Embleton ND, Hojsak I, Reid D, Shamir R (2018) Probiotics for preterm infants. J Pediatr Gastroenterol Nutr 67(1):103–122. CrossRefPubMedGoogle Scholar
  60. 60.
    Di Cerbo A, Palmieri B, Aponte M, Morales-Medina JC, Iannitti T (2016) Mechanisms and therapeutic effectiveness of lactobacilli. J Clin Pathol 69(3):187–203. CrossRefPubMedGoogle Scholar
  61. 61.
    Hidalgo-Cantabrana C, Delgado S, Ruiz L, Ruas-Madiedo P, Sanchez B, Margolles A (2017) Bifidobacteria and their health-promoting effects. Microbiol Spectr. CrossRefPubMedGoogle Scholar
  62. 62.
    Sun J, Marwah G, Westgarth M, Buys N, Ellwood D, Gray PH (2017) 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 8(5):749–763. CrossRefPubMedPubMedCentralGoogle Scholar
  63. 63.
    Zhu XL, Tang XG, Qu F, Zheng Y, Zhang WH, Diao YQ (2019) Bifidobacterium may benefit the prevention of necrotizing enterocolitis in preterm infants: a systematic review and meta-analysis. Int J Surg 61:17–25. CrossRefPubMedGoogle Scholar
  64. 64.
    Isolauri E, Sutas Y, Kankaanpaa P, Arvilommi H, Salminen S (2001) Probiotics: effects on immunity. Am J Clin Nutr 73(2 Suppl):444s–450s. CrossRefPubMedGoogle Scholar
  65. 65.
    Milani C, Duranti S, Bottacini F, Casey E, Turroni F, Mahony J, Belzer C, Delgado Palacio S, Arboleya Montes S, Mancabelli L, Lugli GA, Rodriguez JM, Bode L, de Vos W, Gueimonde M, Margolles A, van Sinderen D, Ventura M (2017) The first microbial colonizers of the human gut: composition, activities, and health implications of the infant gut microbiota. Microbiol Mol Biol Rev MMBR. CrossRefPubMedGoogle Scholar
  66. 66.
    Katakura Y, Sano R, Hashimoto T, Ninomiya K, Shioya S (2010) Lactic acid bacteria display on the cell surface cytosolic proteins that recognize yeast mannan. Appl Microbiol Biotechnol 86(1):319–326. CrossRefPubMedGoogle Scholar
  67. 67.
    Land MH, Rouster-Stevens K, Woods CR, Cannon ML, Cnota J, Shetty AK (2005) Lactobacillus sepsis associated with probiotic therapy. Pediatrics 115(1):178–181. CrossRefPubMedGoogle Scholar
  68. 68.
    Broughton RA, Gruber WC, Haffar AA, Baker CJ (1983) Neonatal meningitis due to Lactobacillus. Pediatr Infect Dis 2(5):382–384CrossRefGoogle Scholar
  69. 69.
    Hammerman C, Bin-Nun A, Kaplan M (2006) Safety of probiotics: comparison of two popular strains. BMJ 333(7576):1006–1008. CrossRefPubMedPubMedCentralGoogle Scholar
  70. 70.
    Kunz AN, Noel JM, Fairchok MP (2004) Two cases of Lactobacillus bacteremia during probiotic treatment of short gut syndrome. J Pediatr Gastroenterol Nutr 38(4):457–458CrossRefGoogle Scholar
  71. 71.
    Ohishi A, Takahashi S, Ito Y, Ohishi Y, Tsukamoto K, Nanba Y, Ito N, Kakiuchi S, Saitoh A, Morotomi M, Nakamura T (2010) Bifidobacterium septicemia associated with postoperative probiotic therapy in a neonate with omphalocele. J Pediatr 156(4):679–681. CrossRefPubMedGoogle Scholar
  72. 72.
    Zbinden A, Zbinden R, Berger C, Arlettaz R (2015) Case series of Bifidobacterium longum bacteremia in three preterm infants on probiotic therapy. Neonatology 107(1):56–59. CrossRefPubMedGoogle Scholar
  73. 73.
    Bertelli C, Pillonel T, Torregrossa A, Prod’hom G, Fischer CJ, Greub G, Giannoni E (2015) Bifidobacterium longum bacteremia in preterm infants receiving probiotics. Clin Infect Dis 60(6):924–927. CrossRefPubMedGoogle Scholar
  74. 74.
    Grev J, Berg M, Soll R (2018) Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants. Cochrane Database Syst Rev 12:cd012519. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Le-wee Bi
    • 1
  • Bei-lei Yan
    • 1
  • Qian-yu Yang
    • 1
  • Miao-miao Li
    • 2
  • Hua-lei Cui
    • 2
    Email author
  1. 1.Department of the Graduate SchoolTianjin Medical UniversityTianjinChina
  2. 2.Department of General SurgeryTianjin Children’s HospitalTianjinChina

Personalised recommendations