ENTERAL SUPPLEMENTATION OF NEUTRAL AND ACIDIC OLIGOSACCHARIDES IN PRETERM INFANTS

Background. Serious infectious morbidity is high in preterm infants. Enteral supplementation of prebiotics may reduce the incidence of serious infections, especially infections related to the gastrointestinal tract. Objective. "e objective was to determine the e$ect of enteral supplementation of a prebiotic mixture consisting of neutral oligosaccharides (scGOS/lcFOS) and acidic oligosaccharides (pAOS) on serious infectious morbidity in preterm infants. Design. In a randomised controlled trial, preterm infants (gestational age <32 wk and/or birth weight <1500 g) received enteral supplementation of 80% scGOS/ lcFOS and 20% pAOS (1.5g/kg/d) or placebo (maltodextrin) between days 3 and 30 of life. Serious infectious morbidity was de!ned as a culture positive for sepsis, meningitis, pyelonephritis, or pneumonia. "e analysis was performed by intention-to-treat and per-protocol, de!ned as ≥50% supplementation dose during the study period. Results. In total, 113 preterm infants were included. Baseline and nutritional characteristics were not di$erent between groups. In the intention-to-treat analysis, the incidence of ≥1 serious infection, ≥1 serious endogenous infection, or ≥2 serious infectious episodes was not signi!cantly di$erent in the scGOS/lcFOS/pAOS-supplemented and placebo groups. In the per-protocol analysis, there was a trend toward a lower incidence of ≥1 serious endogenous infection and ≥2 serious infectious episodes in the scGOS/lcFOS/ pAOS-supplemented group compared with the placebo group (p=0.09 and p=0.07, respectively). Conclusions. Enteral supplementation of scGOS/lcFOS/pAOS does not signi!cantly reduce the risk of serious infectious morbidity in preterm infants. However, there was a trend toward a lower incidence of serious infectious morbidity, especially for infections with endogenous bacteria. "is !nding suggests a possible bene!cial e$ect that should be evaluated in a larger study.