ЧИ Є МАЙБУТНЕ У ПРОБІОТИКІВ В НЕОНАТОЛОГІЇ? (АНАЛІЗ ОСТАННІХ ДАНИХ, ЧАСТИНА 2)

Автор(и)

  • Т. Знаменська ДУ «Інститут педіатрії, акушерства і гінекології імені академіка О.М. Лук’янової НАМН України» , Ukraine
  • О. Воробйова ДУ «Інститут педіатрії, акушерства і гінекології імені академіка О.М. Лук’янової НАМН України» , Ukraine

DOI:

https://doi.org/10.24061/2413-4260.XI.3.41.2021.7

Ключові слова:

пробіотики; передчасно народженні діти; мікробіом, біфідобактерії; лактобактерії

Анотація

Питання доцільності та ефективності використання пробіотиків у новонароджених залиша- ється дискутабельним. У травні 2020 року в журналі «Дитяча гастроентерологія та харчування» було опу- бліковано позиційний лист Комітету з питань харчування Європейського товариства дитячої гастроенте- рології, гепатології та харчування та Робочої групи Європейського товариства дитячої гастроентерології, гепатології та харчування з питань пробіотиків та пребіотиків щодо використання пробіотиків у перед- часно народжених дітей. Було зазначено, що у рандомізованих контрольованих випробуваннях пробіотиків у всьому світі брали участь понад 10 000 недоношених дітей. Доведено, що пробіотики в цілому можуть зни- зити рівень некротизуючого ентероколіту, сепсису та смертності. Однак залишається відкритим питання вибору штаму мікроорганізмів, дозування та тривалість курсу прийому. З іншого боку, все більша кількість комерційних продуктів, що містять пробіотики, доступні з іноді неоптимальної якості. Крім того, велика кількість відділень у всьому світі регулярно пропонують пробіотичні добавки як стандарт лікування, не- зважаючи на відсутність вагомих доказів. За даними останнього мета-аналізу ефективність у зниженні смертності та захворюваності була виявлена лише у меншості досліджених штамів або комбінацій. У цьому документі про позицію автори прагнули надати поради, які конкретні штами потенційно можуть бути ви- користані, а які - ні. Крім того, акцентувалась увага на питаннях безпеки добавок пробіотиків для недоноше- них немовлят. Гарантією якості пробіотичного продукту є позбавлення штамів пробіотиків трансферними генами стійкості до антибіотиків і можливість регулярно виявляти пробіотичний сепсис. За умови дотри- мання всіх питань безпеки наразі існує умовна рекомендація (з низькою достовірністю доказів) надати або Lactobacillus rhamnosus GG ATCC53103, або комбінацію Bifidobacterium infantis Bb-02, Bifidobacterium lactis Bb-12 та Streptococcus thermophilus TH-4 для зменшення ризику реалізації некротизуючого ентероколіту.

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2021-11-16

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