5 results on '"Gomirato, G."'
Search Results
2. Oral supplementation with Lactobacillus casei subspecies rhamnosus prevents enteric colonization by Candida species in preterm neonates: a randomized study.
- Author
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Manzoni P, Mostert M, Leonessa ML, Priolo C, Farina D, Monetti C, Latino MA, and Gomirato G
- Subjects
- Administration, Oral, Candida classification, Candida isolation & purification, Candidiasis congenital, Humans, Infant, Newborn, Infant, Premature, Infant, Very Low Birth Weight, Candida physiology, Candidiasis prevention & control, Digestive System microbiology, Infant, Premature, Diseases prevention & control, Lacticaseibacillus rhamnosus physiology, Probiotics administration & dosage, Probiotics therapeutic use
- Abstract
Background: Colonization by Candida species is the most important predictor of the development of invasive fungal disease in preterm neonates, and the enteric reservoir is a major site of colonization. We evaluated the effectiveness of an orally supplemented probiotic (Lactobacillus casei subspecies rhamnosus; Dicoflor [Dicofarm spa]; 6 x 10(9) cfu/day) in the prevention of gastrointestinal colonization by Candida species in preterm, very low birth weight (i.e., < 1500-g) neonates during their stay in a neonatal intensive care unit., Methods: Over a 12-month period, a prospective, randomized, blind, clinical trial that involved 80 preterm neonates with a very low birth weight was conducted in a large tertiary neonatal intensive care unit. During the first 3 days of life, the neonates were randomly assigned to receive either an oral probiotic added to human (maternal or pooled donors') milk (group A) or human milk alone (group B) for 6 weeks or until discharge from the NICU, if the neonate was discharged before 6 weeks. On a weekly basis, specimens obtained from various sites (i.e., oropharyngeal, stool, gastric aspirate, and rectal specimens) were collected from all patients for surveillance culture, to assess the occurrence and intensity of fungal colonization in the gastrointestinal tract., Results: The incidence of fungal enteric colonization (with colonization defined as at least 1 positive culture result for specimens obtained from at least 1 site) was significantly lower in group A than in group B (23.1% vs. 48.8%; relative risk, 0.315 [95% confidence interval, 0.120-0.826]; P = .01). The numbers of fungal isolates obtained from each neonate (P = .005) and from each colonized patient (P = .005) were also lower in group A than in group B. L. casei subspecies rhamnosus was more effective in the subgroup of neonates with a birth weight of 1001-1500 g. There were no changes in the relative proportions of the different Candida strains. No adverse effects potentially associated with the probiotic were recorded., Conclusions: Orally administered L. casei subspecies rhamnosus significantly reduces the incidence and the intensity of enteric colonization by Candida species among very low birth weight neonates.
- Published
- 2006
- Full Text
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3. Prevention strategies in patients at high-risk for Candida infections: data from a neonatal intensive care setting.
- Author
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Manzoni P, Leonessa ML, Monetti C, Farina D, and Gomirato G
- Subjects
- Humans, Anti-Bacterial Agents therapeutic use, Candida drug effects, Cross Infection prevention & control, Intensive Care Units, Neonatal, Nystatin therapeutic use
- Published
- 2006
- Full Text
- View/download PDF
4. Fungal and bacterial sepsis and threshold ROP in preterm very low birth weight neonates
- Author
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Manzoni, P, Maestri, A, Leonessa, M, Mostert, M, Farina, D, and Gomirato, G
- Published
- 2006
- Full Text
- View/download PDF
5. Exposure to Gastric Acid Inhibitors Increases the Risk of Infection in Preterm Very Low Birth Weight Infants but Concomitant Administration of Lactoferrin Counteracts This Effect
- Author
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Paolo Manzoni, Ruben García Sánchez, Michael Meyer, Ilaria Stolfi, Lorenza Pugni, Hubert Messner, Silvia Cattani, Pasqua Maria Betta, Luigi Memo, Lidia Decembrino, Lina Bollani, Matteo Rinaldi, Maria Fioretti, Michele Quercia, Milena Maule, Elena Tavella, Alessandro Mussa, Chryssoula Tzialla, Nicola Laforgia, Fabio Mosca, Rosario Magaldi, Michael Mostert, Daniele Farina, Amelia Di Comite, Alessandro Borghesi, Giovanni Agriesti, Riccardo Arisio, Caterina Franco, Roberta Guardione, Elena Boano, Alessia Catarinella, Cristina Romano, Cesare Monetti, Ugo Sala, Caterina Carbonara, Emmanuele Mastretta, Paola Del Sordo, Claudio Priolo, Paolo Galletto, Francesca Campagnoli, Mauro Vivalda, Giuseppina Bonfante, Giovanna Gomirato, Davide Montin, Roberta Camilla, Alessandro Messina, Marta Pieretto, Domenico Cipolla, Mario Giuffrè, Giovanni Corsello, Fabio Natale, Gennaro Vetrano, Elisabetta Tridapalli, Giacomo Faldella, Maria Grazia Capretti, PierMichele Paolillo, Simonetta Picone, Serafina Lacerenza, Giancarlo Gargano, Cristiana Magnani, Onofrio Sergio Saia, Elena Della Casa, Manzoni, Paolo, García Sánchez, Ruben, Meyer, Michael, Stolfi, Ilaria, Pugni, Lorenza, Messner, Hubert, Cattani, Silvia, Betta, Pasqua Maria, Memo, Luigi, Decembrino, Lidia, Bollani, Lina, Rinaldi, Matteo, Fioretti, Maria, Quercia, Michele, Maule, Milena, Tavella, Elena, Mussa, Alessandro, Tzialla, Chryssoula, Laforgia, Nicola, Mosca, Fabio, Magaldi, Rosario, Mostert, Michael, Farina, Daniele, Giuffrè, Mario, Corsello, Giovanni, Manzoni P, García Sánchez R, Meyer M, Stolfi I, Pugni L, Messner H, Cattani S, Betta PM, Memo L, Decembrino L, Bollani L, Rinaldi M, Fioretti M, Quercia M, Maule M, Tavella E, Mussa A, Tzialla C, Laforgia N, Mosca F, Magaldi R, Mostert M, Farina D, and Di Comite A, Borghesi A, Agriesti G, Arisio R, Franco C, Guardione R, Boano E, Catarinella A, Romano C, Monetti C, Sala U, Carbonara C, Mastretta E, Del Sordo P, Priolo C, Galletto P, Campagnoli F, Vivalda M, Bonfante G, Gomirato G, Montin D, Camilla R, Messina A, Pieretto M, Cipolla D, Giuffrè M, Corsello G, Natale F, Vetrano G, Tridapalli E, Faldella G, Capretti MG, Paolillo P, Picone S, Lacerenza S, Gargano G, Magnani C, Sergio Saia O, Della Casa E
- Subjects
Colonization ,Proton Pump Inhibitor ,Neonatal intensive care unit ,Administration, Oral ,Histamine H2 Antagonist ,Probiotic ,Gastroenterology ,Pediatrics ,H2 blocker ,0302 clinical medicine ,Risk Factors ,Infant, Very Low Birth Weight ,030212 general & internal medicine ,Candida ,VLBW neonate ,Lacticaseibacillus rhamnosus ,Gestational age ,Perinatology and Child Health ,Histamine H2 Antagonists ,Italy ,Necrotizing enterocolitis ,medicine.symptom ,Infection ,Infant, Premature ,Human ,medicine.medical_specialty ,Birth weight ,Gastric Acid ,Sepsis ,03 medical and health sciences ,Enterocolitis, Necrotizing ,Intensive Care Units, Neonatal ,030225 pediatrics ,Internal medicine ,medicine ,H2 blockers ,Humans ,Dietary Supplement ,business.industry ,Risk Factor ,Probiotics ,Infant, Newborn ,Proton Pump Inhibitors ,medicine.disease ,Low birth weight ,Lactoferrin ,Concomitant ,Dietary Supplements ,Pediatrics, Perinatology and Child Health ,VLBW neonates ,Gastric acid ,Lactobacillus rhamnosu ,business ,New Zealand - Abstract
Objective: To investigate whether exposure to inhibitors of gastric acidity, such as H2 blockers or proton pump inhibitors, can independently increase the risk of infections in very low birth weight (VLBW) preterm infants in the neonatal intensive care unit. Study design: This is a secondary analysis of prospectively collected data from a multicenter, randomized controlled trial of bovine lactoferrin (BLF) supplementation (with or without the probiotic Lactobacillus rhamnosus GG) vs placebo in prevention of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) in preterm infants. Inhibitors of gastric acidity were used at the recommended dosages/schedules based on the clinical judgment of attending physicians. The distribution of days of inhibitors of gastric acidity exposure between infants with and without LOS/NEC was assessed. The mutually adjusted effects of birth weight, gestational age, duration of inhibitors of gastric acidity treatment, and exposure to BLF were controlled through multivariable logistic regression. Interaction between inhibitors of gastric acidity and BLF was tested; the effects of any day of inhibitors of gastric acidity exposure were then computed for BLF-treated vs -untreated infants. Results: Two hundred thirty-five of 743 infants underwent treatment with inhibitors of gastric acidity, and 86 LOS episodes occurred. After multivariate analysis, exposure to inhibitors of gastric acidity remained significantly and independently associated with LOS (OR, 1.03; 95% CI, 1.008-1.067; P = .01); each day of inhibitors of gastric acidity exposure conferred an additional 3.7% odds of developing LOS. Risk was significant for Gram-negative (P < .001) and fungal (P = .001) pathogens, but not for Gram-positive pathogens (P = .97). On the test for interaction, 1 additional day of exposure to inhibitors of gastric acidity conferred an additional 7.7% risk for LOS (P = .003) in BLF-untreated infants, compared with 1.2% (P = .58) in BLF-treated infants. Conclusion: Exposure to inhibitors of gastric acidity is significantly associated with the occurrence of LOS in preterm VLBW infants. Concomitant administration of BLF counteracts this selective disadvantage. Trial registration: isrctn.org: ISRCTN53107700.
- Published
- 2018
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