2016
DOI: 10.1590/0037-8682-0233-2016
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Abstract: Introduction:We aimed to evaluate the effectiveness of a symbiotic product to decolonize the intestinal tract of patients harboring multidrug-resistant (MDR) Gram-negative bacilli and to prevent nosocomial infections. Methods: This was a randomized, double blind, placebo-controlled clinical trial, conducted in a tertiary-care university hospital. All adult hospitalized patients with a positive clinical culture and a positive rectal swab for any MDR Gram-negative bacilli were potentially eligible. Exclusion cri… Show more

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Cited by 26 publications
(23 citation statements)
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“…However, we should take into consideration that a recent randomized control trial study did not find a successful long term eradication of extended-spectrum beta lactamases (ESBL), producing microorganisms in the gut of subjects receiving probiotics in comparison with a placebo [9]. Although the conclusion of the study was not to recommend probiotics as an ESBL decolonization strategy, the authors acknowledged that the study was underpowered and the results possibly influenced by the small sample size, rendering the conduction of further investigations necessary [9,16,17].…”
Section: Discussionmentioning
confidence: 99%
“…However, we should take into consideration that a recent randomized control trial study did not find a successful long term eradication of extended-spectrum beta lactamases (ESBL), producing microorganisms in the gut of subjects receiving probiotics in comparison with a placebo [9]. Although the conclusion of the study was not to recommend probiotics as an ESBL decolonization strategy, the authors acknowledged that the study was underpowered and the results possibly influenced by the small sample size, rendering the conduction of further investigations necessary [9,16,17].…”
Section: Discussionmentioning
confidence: 99%
“…Probiotics with bacteria that excel as gut colonizers are highly attractive agents. Two randomized studies reported success in the decolonization of patients with vancomycin-resistant enterococci using Lactobacillus rhamnosus GG [140,141], whereas the combination of Lactobacillus bulgaris and Lactobacillus rhamnosus had no effect on the colonization rate in the Gram-negative range [142].…”
Section: Probioticmentioning
confidence: 99%
“…Currently, 20 studies have tested or are testing probiotics, and one is testing a prebiotic for MDRO decolonization or prevention ( Table 3). Ten of these studies have shown no difference in colonization following probiotic therapy in subjects who were healthy volunteers [40], methicillin-resistant S. aureus (MRSA)-colonized [41], VRE-colonized [42,43], ESBL-colonized [31], MDR Escherichia coli-colonized [44], a mix of MDRO colonization [45], on antibiotics or a ventilator [46], preterm infants [47], or travelers [48]. While these results can seem dismal, most studies have used LGG or L. reuteri singularly, so much more remains to be explored.…”
Section: Probiotics and Prebioticsmentioning
confidence: 99%
“…An equivalent assessment to pharmacokinetic and pharmacodynamic studies, such as daily sequencing of stool samples to assess engraftment, would assist in determining dose and frequency effects, and commercial companies (e.g., CosmosID, CoreBiome, and Viome) have optimized shotgun sequencing of the whole microbiome to be extremely cost effective. Furthermore, if any microbiome therapy is going to be used for MDRO treatment or prevention, clear guidelines for use in gram-positive versus gram-negative infections and various mechanisms of resistance are necessary, as FMT has not been particularly efficacious with MDR gram-negative bacteria so far [44,45]. Some have speculated that FMT could be less effective for ESBL decolonization, although the mechanism by which this is possible has yet to be defined [25,58].…”
Section: Probiotics and Prebioticsmentioning
confidence: 99%