Study On The Preventive Effect Of Lactoferrin On Nosocomial Infection In NICU Very Premature Infants

Objective:To study the preventive effect of lactoferrin on nosocomial infection and anemia in very preterm infants in NICU（Newborn Intensive Care Unit）,and to provide clinical basis and data for the popularization and use of lactoferrin in NICU.Methods:According to the latest definition of the fifth edition of"Practical Neonatology"published in 2019,very preterm infants are premature infants with a gestational age of 28 to 31⁺⁶weeks.Therefore,the NICU of Dalian Maternity and Child Health Hospital from September 2019 to December 2020 is selected.Premature infants with a gestational age of 28 weeks to 31⁺⁶weeks in hospital were selected as the research objects and met the relevant inclusion and exclusion criteria（detailed in the text）.The study subjects were randomly divided into observation group and control group,with 80 very premature infants in each group.In a randomized controlled study,the two groups of children were given corresponding medical monitoring after entering NICU,and routine supportive treatment was given according to etiology,warmth and so on.According to the feeding recommendations of premature infants/low birth weight infants made by Neonatology Group and Child Health Care Group of Chinese Medical Association,those who have no congenital digestive tract malformations and serious diseases and can tolerate intestinal feeding should start feeding as soon as possible.Those with body weight more than 1000g and relatively stable condition can start feeding at 12 hours after birth.According to the above criteria for starting feeding,combined with the situation of children and mothers,breast feeding is preferred when there is sufficient breast milk,and breast milk can be mixed with in-hospital formula for premature infants when there is insufficient breast milk.In the absence of breast milk,pure premature infants are fed with in-hospital formula,and the ingredients in the hospital formula of premature infants do not contain lactoferrin.According to whether the calorie of enteral nutrition meets the needs of growth and combined with parenteral nutrition,on the premise of enteral feeding tolerance,total enteral feeding is gradually realized.If the two groups of children have poor growth conditions such as body weight during the follow-up hospitalization,breast milk fortifier should be added to breast milk as appropriate.Within 72 hours of admission in the observation group,lactoferrin powder preparation was added to the enteral feeding breast milk or premature infant hospital formula,the dose of lactoferrin was 100 mg/time,twice a day until discharged,while the control group was not given lactoferrin preparation.The general demographic characteristics,maternal pregnancy,risk factors of septicemia,nutritional characteristics,nosocomial infection and treatment in the two groups were recorded by doctors in detail.By comparing the incidences of late septicemia,neonatal necrotizing enterocolitis,neonatal pneumonia,urinary tract infection and suppurative meningitis between the two groups during NICU hospitalization,as well as the total incidence of nosocomial infection,the days of hospitalization,the effect of lactoferrin was confirmed.T-test,chi-square test and other methods were used to complete the statistical analysis of the data.Results:1.There was no significant difference in general demographic characteristics,maternal pregnancy,drug use,risk factors and nutritional characteristics of late septicemia between the two groups（P>0.05）,which could be compared and analyzed.2.There were 16 cases of nosocomial infection,including 3 cases（3.8%）in the observation group and 13 cases（16.7%）in the control group（16.7%）.The total incidence of nosocomial infection in the observation group was significantly lower than that in the control group（P<0.05）.The incidence of late septicemia in the observation group（1.3%）was lower than that in the control group（9.0%）,and the difference was statistically significant（P<0.05）.There was no significant difference in the incidence of neonatal pneumonia,neonatal necrotizing enterocolitis,urinary tract infection and suppurative meningitis between the two groups（P>0.05）.3.The blood culture results of late-onset septicemia between the two groups showed that there was no significant difference in the distribution of Gram-positive bacteria and Gram-negative bacteria between the two groups（P>0.05）.4.The hospitalization days of the two groups were 28.27±2.65 in the observation group and 34.56±3.45 in the control group.The days in the observation group were significantly shorter than those in the control group（P<0.05）.5.Anemia occurred in 6 cases（7.6%）in the observation group and 18 cases（23.1%）in the control group.The incidence of anemia in the observation group decreased,and the difference was statistically significant（P<0.05）.Conclusion:1.The application of lactoferrin has a significant preventive effect on nosocomial infection in very premature infants with NICU,and shortens the duration of hospitalization.2.Lactoferrin can prevent the occurrence of anemia in very premature infants.3.The long-term benefits of long-term use of lactoferrin require longer medication and follow-up,as well as larger randomized controlled trials.