الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
It has been suggested that the over growth of pathogens might be br prevented by inducing the colonization of the bowel with nonpathogenic br bacteria (probiotics) of species normally resident in the gut of preterm br and full-term infants. In particular, probiotics compete with other br microbes binding sites and substrates in the bowel and produce a wide br range of antimicrobial substances such as bacteriocins, microcins, br reuterin, hydrogen peroxide and hydrogen ion. Lactobacillus GG, a strain br of lactobacillus casaii which can be found in breast-fed infants’ stools was br found effective in the treatment and prevention of infantile diarrhea, br indicating a role of this probiotic in stimulating and regulating the br intestine’s host defense mechanisms. Moreover, it is known that br supplementation with Lactobacillus GG is effective in colonizing the br bowel of preterm infants with out nutritional adverse effects. br We, thus, hypothesized that lactobacillus GG supplementation br could reduce the incidence of UTI, bacterial sepsis and NEC in preterm br infants. br It is well accepted that there is an interaction between the diet, the br intestinal flora, and the development of GIT and immune system. It has br been suggested that probiotics can reduce the overgrowth of pathogens in br the bowels of preterm infants and contribute to the reduction of the br incidence of nosocomial infections in NICU which are associated with br increased morbidity and mortality in preterm infants. The br supplementation of infant formula with probiotics bacteria is currently br under consideration. However, the data regarding the impact of br lactobacillus GG on growth are not published. br The purposes of this study were to evaluate the protective role of br probiotics supplementation in neonatal sepsis in preterm and to br investigate their effect on preterm infants’ growth during the neonatal br period. br Our study was a randomized control, follow-up clinical trial br conducted on 50 preterm neonates, who were admitted to the NICUs in br general hospitals in Dakhlia governorate during the period -#102;-#114;-#111;-#109; January br 2012 to July 2012, they were divided into two groups, Group 1 included br 30 preterm newborn infants who received standard formula supplemented br by lactobacillus GG (-#102;-#114;-#111;-#109; Christian Hansen culture collection) with an br added dose of 6x109 (CFUxgm-1) once daily for 4 weeks, starting with br the first feed. They were 18 females and 12 males. There mean GA was br 33.83±2.321 (weeks) and a mean weight of (1836.67±389.31) gm. while br Group 2 included 20 preterm newborn infants who did not receive any br probiotics supplementation serving as controls. They were 8 females and br 12 males. There mean GA was 33.3± 2.273 (weeks) and with a mean br weight of (2039.5±531.066) gm. All Studied preterm newborn infants br were subjected to full prenatal history taking including antenatal history br of maternal infection, drug intake, PROM, maternal drug intake, natal br history including GA and postnatal history including BW, age of onset of br oral feeding and type of feeding. They were also subjected to thorough br clinical examination to exclude signs of sepsis and congenital anomalies, br anthropometric measurements including weight, length and HC A br laboratory work up was done to exclude sepsis at enrollment, then followup br was carried on for diagnosis of sepsis starting 7 days after br commencement of probiotics intake (such period was considered the br minimal time required by lactobacillus GG to colonize the bowel and to br exert its effect (Millar et al., 1993.( br The same criteria for diagnosis of sepsis applied at the beginning br of the study were used during the period of follow up. Follow up of br growth parameters including weight/grams, length/cms and head br circumference/cms were also performed during the period of the study till br the end of the study. br All clinical and laboratory parameters were statistically non br significant when comparing the probiotics and the control groups. br In our study, the incidence of sepsis was lower (although nonsignificantin the probiotics group (4/30-13.3%) when compared to the br control group (6/20-30%) E.coli was the most common organism (9/10 .( br Also growth rate was higher but “still non-significant “among br probiotics group compared with control group . br In our study, all extrinsic factors promoting sepsis in NICU were br statistically non-significant in both the probiotics and the control groups. br We conclude that br Probiotics supplementation has a protective role against late neonatal br sepsis in preterm neonates. Furthermore, its positive impact on growth is br yet to be elucidated .