Vpliv probiotika Limosilactobacillus reuteri Protectis na pojavnost pleničnega izpuščaja pri novorojenčkih, ki potrebujejo antibiotično zdravljenje : magistrsko delo

Bojić, Slađana (author), Lozar Krivec, Jana (mentor), Soltirovska Šalamon, Aneta (comentor), Vettorazzi, Renata (comentor), Pandel Mikuš, Ruža (reviewer)

Uvod: Antibiotično zdravljenje, ki vpliva na mikrobioto novorojenčka, lahko pripomore k nastanku pleničnega izpuščaja, ki za starše pomeni dodaten zaplet in izziv pri negi novorojenčka. Z ustrezno zdravstveno nego anogenitalnega predela in zdravstveno vzgojo staršev pripomoremo k uspešnemu preprečevanju pleničnega izpuščaja. Namen: Namen magistrskega dela je ugotoviti, ali jemanje probiotikov pri novorojenčkih, ki so zdravljeni z antibiotiki, prepreči plenični in glivični izpuščaj. Metode dela: Izvedli smo randomizirano, dvojno slepo, s placebom nadzorovano preizkušanje. V raziskavo smo vključili donošene novorojenčke, ki so imeli v starosti do treh tednov predpisano antibiotično terapijo v treh zdravstvenih ustanovah: na Kliničnem oddelku za neonatologijo UKC Ljubljana, v Porodnišnici Postojna in na Pediatričnem oddelku Splošne bolnišnice Slovenj Gradec. Novorojenčke smo naključno razporedili v probiotično (raziskovalno) ali kontrolno (placebo) skupino. Raziskovalna skupina je prejemala pet kapljic probiotičnega pripravka Limosilactobacilus reuteri (L. reuteri), kontrolna pa placebo pripravek, ki ni vseboval probiotičnega seva. Uporabili smo podatke iz anketnega vprašalnika iz raziskave z naslovom »Vpliv probiotikov na pojav funkcionalnih gastrointestinalnih motenj in sestavo črevesne mikrobiote pri novorojenčkih, ki so bili zdravljeni z antibiotiki«. Vključevanje novorojenčkov je potekalo od novembra 2016 do marca 2020. Rezultati: V končno analizo je bilo vključenih 89 novorojenčkov, med katerimi je bilo 56 dečkov (66,3 %) in 33 deklic (37,1 %). Plenični izpuščaj je razvilo 25 % novorojenčkov, ki so v neonatalnem obdobju prejemali antibiotično terapijo. Med skupino, ki je prejemala probiotični dodatek L. reuteri, in kontrolno skupino ni bilo statistično pomembne razlike v pojavu pleničnega izpuščaja (p = 0,430). Prav tako ugotavljamo, da med skupinama ni bilo statistično pomembne razlike v pojavnosti glivičnega pleničnega izpuščaja (p = 0,709). Hipotezi, da dodatek probiotičnega seva zmanjša pojavnost pleničnega in glivičnega pleničnega izpuščaja, sta bili v naši raziskavi ovrženi. Razprava in zaključek: Antibiotično zdravljenje spremeni sestavo mikrobiote, dodatno pa lahko vpliva tudi na frekvenco odvajanja ter sestavo blata, kar poveča verjetnost nastanka pleničnega izpuščaja. Dokazano je, da probiotiki ugodno vplivajo na disbiozo, povzročeno z antibiotično terapijo, zato smo si zastavili raziskovalno vprašanje, ali lahko z dodajanjem probiotika med antibiotično terapijo in po njej zmanjšano pojavnost pleničnega izpuščaja. V raziskavi smo ugotovili, da dodatek probiotika L. reuteri ne vpliva na zmanjšanje pojava pleničnega ali glivičnega pleničnega izpuščaja. Potrebne so dodatne raziskave, s katerimi bomo ovrgli ali potrdili vlogo probiotikov ob antibiotičnem zdravljenju za preprečevanje pleničnega izpuščaja.

• Language: Slovenian
• Keywords: magistrska dela, zdravstvena nega, novorojenček, plenični izpuščaj, glivični izpuščaj, probiotik, antibiotično zdravljenje
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [S. Subotić]
• Year: 2025
• Number of pages: 62 str.
• PID: 20.500.12556/RUL-170460
• UDC: 616-083
• COBISS.SI-ID: 241600259
• Publication date in RUL: 06.07.2025

Secondary language

• Language: English
• Title: Effect of probiotic Limosilactobacillus reuteri Protectis on incidence of diaper dermatitis in neonates who are treated with antibiotics : master thesis

Abstract

Introduction: Antibiotic treatment that affects the newborns microbiota can contribute to the development of diaper rash, whic represents an additional complication and challenge for parents in the care of the newborn. Whit appropriate healthcare of the anogenital area and health education for parents, we contribute to the successful prevention of diaper rash. Purpose: The purpose of the masters thesis is to determine whether the intake of probiotics in newborns treated with antibiotics prevents diaper and fungal rash. Methods: We conducted a randomized, double-blind, placebo-controlled trial. The study included full-term newborns who werw prescribed antibiotic therapy within the first 3 weeks of age at three healthcare institutions: the Clinical Department of Neonatology of the University Medical Centre Ljubljana, the Postojna Maternity Hospital, and the Pediatric Department of the General Hospital Slovenj Gradec. Newborns were randomly assigned to a probiotic (research) or control (placebo) group. The research group received 5 drops of the probiotic preparation Limosilactobacillus reuteri (L. reuteri), while the control group received a placebo preparation that did not contain the probiotic strain. We used data from the questionnaire from the study titled: The impact of probiotics on the occurence of functional gastrointestinal disordes and the composition of gut microbiota in newborn treated with antibiotics. The inclusion of newborns took place from November 2016 to March 2020. Results: The final analysis included 89 newborns, of wich 56 were boys (66,3%) and 33 were girls (37,1%). Diaper rash developed in 25% of newborns who received antibiotic therapy during the neonatal period. There was no statistically significant difference in the occurrence of diaper rash between the group receiving the probiotic supplment L. reuteri and the control group (p=0,430). We also found that there was no statistically significant difference between the groups in the incidence of fungal diaper rash (p=0,709). The hypotheses that the addition of probiotic strain reduces the incidence of diaper and fungal diaper rash were refuted in our study. Discussion and Conclusion: Antibiotic treatment alters the composition of microbiota and may also affect the frequency of bowel movements and the composition of stool, increasing the likelihood of develpoing diaper rash. It has been proven that probiotics poistively influence dysbiosis caused by antibiotic therapy, whic led us to ask the research question of whether the addition of a probiotic during and after antibiotic therapy reduces the incidence of diaper rash. In the study, we found that the addition of the probiotic L. reuteri does not reduce the incidence of diaper or fungal diaper rash. Further research is needed to either refute or confirm the role of probiotics in the prevention of diaper rash during antibiotic tretament.

• Keywords: master's theses, nursing care, newborn, diaper rash, fungal rash, probiotic, antibiotic treatment