Effect of probiotics on the incidence of ventilator-associated pneumonia in critically ill patients: a randomized controlled multicenter trial
| Autor: | Jin-jiao Jiang, Fu-Shen Zhang, Hong-sheng Ren, Juan Zeng, Shi-Fu Wang, Mei Meng, Chunting Wang, Quan-Sheng Du, Feng Qi, Shuang Ma, Chun-Hua Li, Min Si, Lu-Yi Liu, Yu-feng Chu, Yuan-Zhong Li, Yun Li, Shu-Liu Zhang, Song Cui, He-Ling Zhao, Yan Qu, Zhao-Tao Tian, Yuping Wang, Min Ding, Hui Tian, Tie-Jun Wu, Ji-cheng Zhang, Zhuang Ma |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Pediatrics Time Factors medicine.medical_treatment Critical Illness Stomach Diseases Oropharynx Critical Care and Intensive Care Medicine Enterococcus faecalis 03 medical and health sciences Young Adult 0302 clinical medicine Internal medicine Multicenter trial Medicine Humans Mechanical ventilation biology business.industry Stomach Incidence (epidemiology) Probiotics Ventilator-associated pneumonia Pneumonia Ventilator-Associated 030208 emergency & critical care medicine Bacterial Infections Middle Aged medicine.disease biology.organism_classification Antimicrobial Respiration Artificial Pneumonia Intensive Care Units medicine.anatomical_structure 030228 respiratory system Female business Bacillus subtilis |
| Zdroj: | Intensive care medicine. 42(6) |
| ISSN: | 1432-1238 |
| Popis: | To evaluate the potential preventive effect of probiotics on ventilator-associated pneumonia (VAP). This was an open-label, randomized, controlled multicenter trial involving 235 critically ill adult patients who were expected to receive mechanical ventilation for ≥48 h. The patients were randomized to receive (1) a probiotics capsule containing live Bacillus subtilis and Enterococcus faecalis (Medilac-S) 0.5 g three times daily through a nasogastric feeding tube plus standard preventive strategies or (2) standard preventive strategies alone, for a maximum of 14 days. The development of VAP was evaluated daily, and throat swabs and gastric aspirate were cultured at baseline and once or twice weekly thereafter. The incidence of microbiologically confirmed VAP in the probiotics group was significantly lower than that in the control patients (36.4 vs. 50.4 %, respectively; P = 0.031). The mean time to develop VAP was significantly longer in the probiotics group than in the control group (10.4 vs. 7.5 days, respectively; P = 0.022). The proportion of patients with acquisition of gastric colonization of potentially pathogenic microorganisms (PPMOs) was lower in the probiotics group (24 %) than the control group (44 %) (P = 0.004). However, the proportion of patients with eradication PPMO colonization on both sites of the oropharynx and stomach were not significantly different between the two groups. The administration of probiotics did not result in any improvement in the incidence of clinically suspected VAP, antimicrobial consumption, duration of mechanical ventilation, mortality and length of hospital stay. Therapy with the probiotic bacteria B. Subtilis and E. faecalis are an effective and safe means for preventing VAP and the acquisition of PPMO colonization in the stomach. |
| Databáze: | OpenAIRE |
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