Lactobacillus GG u prevenciji gastrointestinalnih i respiratornih infekcija u hospitalizirane djece i djece u kolektivu

Hojsak, Iva (2010) Lactobacillus GG u prevenciji gastrointestinalnih i respiratornih infekcija u hospitalizirane djece i djece u kolektivu. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Objective: The aim of our study was to investigate the role of Lactobacillus GG (LGG) in the prevention of gastrointestinal and respiratory tract infections in hospitalised children and children who attend day care centres. The primary hypothesis was that the administration of LGG would reduce the number of gastrointestinal and/or respiratory infections in studied population. ----- Patients and Methods: We conducted a randomized, double-blind, placebo-controlled trial in 742 hospitalised children and 281 children who attend day care centres. They were randomly allocated to receive either LGG at a dose of 109 CFU in 100 ml of a fermented milk product or placebo which was the same fermented milk product without LGG. ----- Results – hospitalized children: In the LGG group, compared to the placebo group, we found a significantly reduced risk of gastrointestinal (RR 0,4; 95% CI 0,25 – 0,7; NNT15, 95% CI 9 - 34) and respiratory tract infections (RR 0,38; 95% CI 0,18 – 0,85; NNT 30, 95% CI 16 - 159). ----- Results – children in day care centre: Compared to the placebo group, children in the LGG group had a significantly reduced risk of upper respiratory tract infections (RR 0,66; 95% CI 0,52 – 0,82; NNT 5, 95% CI 4 - 10), but had no significant reduction in the risk of gastrointestinal infections (RR 0,63; 95% CI 0,38 – 1,06). ----- Conclusion: LGG administration can be recommended as a valid measure for decreasing the risk of upper respiratory tract infections in children attending day care centres and for decreasing the risk of nosocomial gastrointestinal and respiratory tract infections in paediatric facilities. Therefore their use can be recommended: 1) For hospitalized children: a) in children of younger age (preschool children), b) in prolonged hospitalization, c) during the time of the year with increased infections incidence, d) during outbreaks of hospital infections (increased possibility of infection spreading); 2) In day care centres: a) in children of younger age, b) in children with recurrent gastrointestinal and/or respiratory tract infections, c) during outbreaks of respiratory/gastrointestinal infections (increased possibility of infection spreading).

Abstract in Croatian

Uvod: Cilj našeg je istraživanja bio odrediti ulogu Lactobacillus GG (LGG) u prevenciji gastrointestinalnih i respiratornih infekcija u hospitalizirane djece i djece u dječjem vrtiću. Hipoteza je da primjena LGG-a smanjuje broj gastrointestinalnih i/ili respiratornih infekcija u navedenim populacijama. ----- Ispitanici i metode: Proveli smo randomiziranu, dvostruko slijepu, placebo kontroliranu studiju na 742 hospitalizirane djece i 281 djetetu koje pohađa dječji vrtić. Ispitanici su randomizirani u dvije skupine od kojih je jedna uzimala LGG u dozi od 109 CFU u 100 ml fermentiranog mliječnog pripravka, a druga placebo, odnosno fermentirani mliječni pripravak bez LGG-a. ----- Rezultati – hospitalizirana djeca: U LGG skupini, u usporedbi s placebom, našli smo značajno niži rizik od gastrointestinalnih infekcija (RR 0,4; 95% CI 0,25 – 0,7; NNT 15, 95% CI 9 - 34) i respiratornih infekcija (RR 0,38; 95% CI 0,18 – 0,85; NNT 30, 95% CI 16 - 159). ----- Rezultati – djeca u dječjem vrtiću: U usporedbi s placebom, djeca koja su uzimala LGG imala su značajno smanjen rizik od infekcija gornjeg dišnog sustava (RR 0,66; 95% CI 0,52 – 0,82; NNT 5, 95% CI 4 - 10), ali nisu imala smanjen rizik od gastrointestinalnih infekcija (RR 0,63; 95% CI 0,38 – 1,06). ----- Zaključak: Primjena LGG-a može se preporučiti kao valjana mjera u smanjenju rizika od infekcija gornjih dišnih putova u djece u vrtiću te nozokomijalnih gastrointestinalnih i respiratornih infekcija na pedijatrijskim odjelima. Slijedom navedenog njihova primjena može se preporučiti: 1) na bolničkim odjelima: a) mlađe djece (predškolske dobi), b) kod duljeg trajanja hospitalizacije, c) u doba godine kada očekujemo veći broj infekcija, d) kada to zahtijeva epidemiološka situacija na odjelu (veći broj već zaražene djece te stoga veća mogućnost širenja infekcije); 2) u dječjim vrtićima: a) u djece mlađe predškolske dobi, b) u djece s recidivirajućim respiratornim i/ili gastrointestinalnim infekcijama, c) kada to nalaže epidemiološka situacija u vrtiću (veći broj zaražene djece, lakša mogućnost širenja infekcije).

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