NEW YORK (Reuters Health) The incidence of invasive fungal infections in very low birthweight neonates is significantly reduced in those given prophylactic bovine lactoferrin, an Italian group reports in the January issue of Pediatrics, online December 19.

Our data disclose that bLF (bovine lactoferrin) is not able to limit the onset of colonization after the contact of fungi with the host, but nonetheless bLF can act at a later stage in the process of the fungus host interaction, ultimately resulting in decreased odds of progressing to infection when getting colonized, the authors comment.

Dr. Paolo Manzoni with S. Anna Hospital, Torino, and colleagues note in the introduction to their paper that bovine lactoferrin has the same antimicrobial properties as human lactoferrin. The team recently demonstrated in a randomized trial that bovine lactoferrin prevents late-onset sepsis in preterm VLBW neonates.

For the current study, the authors conducted a secondary analysis of data from that trial to assess the effect of bovine lactoferrin on fungal colonization and infection in VLBW infants. In the original study, 472 newborns were randomly assigned to receive bovine lactoferrin 100 mg/day, bovine lactoferrin plus a probiotic, or placebo, from birth until the 30th or 45th day of life depending on birthweight.

Rates of fungal colonization in the three groups were essentially the same 17.6%, 16.6% and 18.5%, respectively the report indicates. However, rates of systemic fungal infection were significantly lower in the two groups given bovine lactoferrin (0.7% and 2.0%) than in the placebo group (7.7%), the investigators found.

This held true in infants weighing less than 1000 g and those weighing 1001-1500 g. Furthermore, there were no adverse effects attributable to bovine lactoferrin, Dr. Manzoni and colleagues report.

They conclude, Consistent with the experimental literature, this secondary analysis of the data from a large multicenter RCT shows that administration of bLF since the early moments of life is effective in preventing infections caused by Candida spp in preterm VLBW infants.

They add, The protective effect on IFI (invasive fungal infection) is likely due to limitation of ability of fungal colonies to progress toward invasion and systemic disease in the colonized infants.


Bovine Lactoferrin Prevents Invasive Fungal Infections in Very Low Birth Weight Infants: A Randomized Controlled Trial

Arch Surg 2011.