2 Infant Bacterial Therapeutics AB 142 180 227 23 55 94 89 - PowerPoint PPT Presentation

Disclaimer 142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 2

Infant Bacterial Therapeutics AB 142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 3

The IBT concept 142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 4

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13

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142 180 227 23 55 94 89 89 Mortality 89 191 191 191 148 138 84 13 13 13 CDC/NCHS, National Vital Statistics System 7

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 8

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 9

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 10

142 180 227 23 55 94 501-750g 42.0% 89 89 751-1,000g 29.4% 89 1,001-1250g 21.3% 191 191 191 1,251-1,500g 15.9% 148 138 1,501-2,500g 12,7% 84 13 13 13 11

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 NEC Economic Burden is estimated to be 20% of the total cost of initial care and $5 Billion spent annually on NEC in the USA Ganapathy 2011, Niño 2016 12

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142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 14

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 15

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 17

142 180 227 23 2013 2016 2020 2030 2035 55 94 89 89 89 191 191 191 + 2y pedia 148 138 84 13 13 13 18

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 19

142 180 227 23 55 94 89 89 Control 89 Control 191 191 191 NEC NEC NEC NEC 148 138 84 13 NEC+Lr NEC+Lr NEC+Lr NEC + L. reuteri 13 13 Reduced intestinal damage Improved survival from NEC 20

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 Schaefer 2010, Walter 2011, Wu 2013, West 2020 21 Walter et al., 2011 Walter et al., 2011

142 180 227 NEC Controls 23 55 94 89 89 89 191 191 191 148 138 84 13 13 Days after birth 13 Source Warner et al, 2016, Pammi et al. 2017 22

138 148 191 191 191 227 180 142 13 13 13 84 89 89 89 94 55 23 Number of positive feces samples for identified pathogens from 30 infants * * * P≤0.05 23

142 180 227 Bacteria 23 ▪ ▪ Bacillus subtilis Escherichia coli (patogena) 55 ▪ ▪ Listeria monocytogenes Salmonella typhimurium 94 ▪ ▪ Campylobacter jejuni Enterobacter sakazakii 89 ▪ ▪ Porphyromonas gingivalis Shigella spp 89 ▪ ▪ Clostridium perfringens Fusobacterium nucleatum 89 ▪ ▪ Prevotella intermedia Staphylococcus aureus 191 ▪ ▪ Clostridium difficile Helicobacter pylori 191 ▪ ▪ Pseudomonas fluorescens Streptococcus mutans 191 148 L. reuteri inhibits S. aureus Yeast and fungi 138 ▪ 84 Candida albicans ▪ Aspergillus flavus 13 ▪ Fusarium samiaciens 13 13 24

142 180 227 * P≤0.05 23 Treg * 55 FoxP3 94 89 89 89 191 191 191 148 Placebo 138 84 L. reuteri 13 13 13 25

142 180 227 Treg Teff Treg cell modulation Teff cell modulation 23 FoxP3 L. reuteri L. L. reuteri L. 55 B acidophilus A acidophilus 94 89 89 89 191 191 191 148 138 84 13 13 13 26

* * P≤0.05 142 * 180 227 No. of episodes of 23 regurgitation 55 94 89 89 89 Formula Formula 191 + L. reuteri + placebo 191 * * 191 148 No. of episodes of evacuations 138 84 13 13 13 Formula Formula + L. reuteri + placebo 27

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 28

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 * reduction in episodes of feeding intolerance ** reduction in time to full enteral feeding 30

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 31

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 Favors L. reuteri Favors placebo 32

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 Kornhauser 2010 33

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 35

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13 http://ibtherapeutics.com/wp-content/uploads/2016/03/Hot-topics-poster-1128.pdf 36

142 180 227 23 55 94 ◆ ◆ 89 89 ◆ ◆ 89 191 ◆ ◆ 191 191 148 ◆ 138 ◆ 84 ◆ 13 ◆ 13 13 37

142 ❏ 180 227 23 55 ❏ 94 89 89 89 ❏ 191 191 191 148 138 ❏ 84 13 13 ❏ 13 38

142 180 227 ✔ 23 ✔ 55 94 ✔ 89 ✔ 89 89 ✔ 191 ✔ 191 191 ✔ 148 138 ✔ 84 ✔ 13 13 13 39

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13

142 180 227 23 55 94 89 89 89 191 191 191 148 138 84 13 13 13