Eight infections in 19,990 probiotic-exposed preterm infants: rare, not zero

A 107,505-infant US cohort found Bifidobacterium or Lactobacillus in blood cultures of 8/19,990 probiotic-exposed infants versus 3/87,515 unexposed infants—an absolute excess of 0.04 percentage points. Without strain typing or a causal effectiveness analysis, the study measures a rare risk but cannot settle the NEC trade-off.

THE HOT TAKE

The absolute difference is tiny, but it is measurable: eight genus-defined bloodstream infections among 19,990 probiotic-exposed infants. This study cannot prove those organisms came from the administered product—or tell us whether the risk outweighs any NEC benefit.

Patel and colleagues studied 107,505 infants born at 22 weeks 0 days through 32 weeks 6 days and discharged from Pediatrix NICUs in 33 US states and Puerto Rico from 2016 through 2023. The retrospective cohort used prospectively collected clinical records and followed infants until discharge, death, or transfer. Tables identify 19,990 infants with probiotic supplementation and 87,515 without it.