Effect of Enteral Lactoferrin Administration on Invasive Fungal Infections In Preterm Neonates

Authors: Maha H. Mohamed; Hebat Allah A. Shaaban; Marwa S. Fathi; Mohamed S. Abdelkader and Menatallah M. El Tagoury

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Keywords: Pediatrics


Background: Lactoferrin is an iron binding protein and one of the main component of breast milk that showed in the last decade very promising results in the prophylaxis against neonatal sepsis, NEC, fungal infections, anaemia of prematurity and infancy.

Objective: Our primary aim was to prove that LF has a beneficial effect in the prevention of IFIs in the preterm neonates in NICUs.

Methods: Our study was conducted on 40 preterm neonates in the NICUs of maternity and pediatrics hospitals, faculty of medicine, Ain Shams University in the period from March 2017 to May 2017. The 40 neonates were subdivided into 2 groups: Group A: 20 neonates who received LF in a dose of 100 mg/day for 4- 6 weeks starting from day of enrolment. Group B: 20 neonates who received placebo in form of distilled water for 4-6 weeks starting from day of enrolment. The neonates included in this study were subjected to full history taking,  clinical examination laying stress on clinical signs of infection and laboratory investigations including CBC with differential cell count, CRP, blood culture and fungal cultures that were withdrawn on day of enrolment, day 7, 14, 21 and 28.

Results: Our 1ry outcome was to prove the antifungal effect of LF and it really helped to decrease the incidence as well as the severity of IFIs in the preterm neonates who received it versus those who didn’t. As a 2ry outcome, our study showed that LF played a beneficial role in the enhancement of hemoglobin and hematocrit status and as a prophylaxis against anemia of prematurity. In addition to all this, LF promoted the general condition of the studied neonates and significantly decreased the signs of sepsis, the feeding intolerance, the length of hospital stay and the mortality rate as well as helped those who received it to progress rapidly in feeding, need less invasive procedures and less antibiotics.

Conclusion: Lactoferrin is a safe drug that generally promotes the wellbeing of neonates and promotes their health and need to be taken into consideration by all the neonatal care health units in the developed and developing countries as it might help to decrease the incidence of complications of prematurity and its burdens on the individual and the society.