A tale of caution: prolonged Bacillus clausii bacteraemia after probiotic use in an immunocompetent child

Khatri, Akshay; Rai, Shipra; Shank, Caroline; McInerney, Alissa; Kaplan, Blanka; Hagmann, Stefan; Kainth, Mundeep K.

doi:10.1099/acmi.0.000205

Cited by 13 publications

(13 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Probiotics were administered as enteral supplementation in all cases: orally or via a nasogastric tube or through gastrostomy, according to patients' clinical conditions. In most reports, the etiological agents were identified both by blood cultures and strain-specific polymerase chain reaction (PCR) (61%) [27][28][29][30][31][32][33]35,42,[50][51][52][53][54]56,58,59,62]; in 17 cases (34%), causative microorganisms were isolated from cultures [27,[37][38][39][40][41][43][44][45]48,55,57,60,61], and in 3 of these (6%), the causative microorganisms were isolated both from blood culture and from central venous catheter (CVC) tip culture [46,47,49]. The pathogen was isolated from bronchoalveolar lavage (BAL) culture in the patient with pneumonia and confirmed with PCR analysis [36].…”

Section: Resultsmentioning

confidence: 99%

Invasive Infections Associated with the Use of Probiotics in Children: A Systematic Review

et al. 2021

View full text Add to dashboard Cite

Although the effectiveness of probiotics has only been proven in specific conditions, their use in children is massively widespread because of their perception as harmless products. Recent evidence raises concerns about probiotics’ safety, especially but not only in the paediatric population due to severe opportunistic infections after their use. This review aimed at summarising available case reports on invasive infections related to probiotics’ use in children. For this purpose, we assessed three electronic databases to identify papers describing paediatric patients with documented probiotic-derived invasive infections, with no language restrictions. A total of 49 case reports from 1995 to June 2021 were identified. The infections were caused by Lactobacillus spp. (35%), Saccharomyces spp. (29%), Bifidobacterium spp. (31%), Bacillus clausii (4%), and Escherichia coli (2%). Most (80%) patients were younger than 2 years old and sepsis was the most observed condition (69.4%). All the patients except one had at least one condition facilitating the development of invasive infection, with prematurity (55%) and intravenous catheter use (51%) being the most frequent. Three (6%) children died. Given the large use of probiotics, further studies aiming at evaluating the real incidence of probiotic-associated systemic infections are warranted.

show abstract

Section: Resultsmentioning

confidence: 99%

Invasive Infections Associated with the Use of Probiotics in Children: A Systematic Review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…on cytotoxic properties, was provided. The paper of Khatri et al (2021) described a bacteraemia case after probiotic use of Bacillus clausii by a 17-year-old person. The identification to the species level was performed by MALDI-TOF MS and confirmed by a 'state reference laboratory' without further details.…”

Section: Gram-positive Spore-forming Bacteriamentioning

confidence: 99%

Update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA 15: suitability of taxonomic units notified to EFSA until September 2021

Koutsoumanis¹,

Allende²,

Álvarez‐Ordóñez³

et al. 2022

EFS2

View full text Add to dashboard Cite

The qualified presumption of safety (QPS) approach was developed to provide a generic pre‐evaluation of the safety of biological agents. The QPS approach is based on an assessment of published data for each agent, with respect to its taxonomic identity, the body of relevant knowledge and safety concerns. Safety concerns are, where possible, confirmed at the species/strain or product level and reflected by ‘qualifications’. The QPS list was updated in relation to the revised taxonomy of the genus Bacillus, to synonyms of yeast species and for the qualifications ‘absence of resistance to antimycotics’ and ‘only for production purposes’. Lactobacillus cellobiosus has been reclassified as Limosilactobacillus fermentum. In the period covered by this statement, no new information was found that would change the status of previously recommended QPS taxonomic units (TU)s. Of the 70 microorganisms notified to EFSA, 64 were not evaluated: 11 filamentous fungi, one oomycete, one Clostridium butyricum, one Enterococcus faecium, five Escherichia coli, one Streptomyces sp., one Bacillus nakamurai and 43 TUs that already had a QPS status. Six notifications, corresponding to six TUs were evaluated: Paenibacillus lentus was reassessed because an update was requested for the current mandate. Enterococcus lactis synonym Enterococcus xinjiangensis, Aurantiochytrium mangrovei synonym Schizochytrium mangrovei, Schizochytrium aggregatum, Chlamydomonas reinhardtii synonym Chlamydomonas smithii and Haematococcus lacustris synonym Haematococcus pluvialis were assessed for the first time. The following TUs were not recommended for QPS status: P. lentus due to a limited body of knowledge, E. lactis synonym E. xinjiangensis due to potential safety concerns, A. mangrovei synonym S. mangrovei, S. aggregatum and C. reinhardtii synonym C. smithii, due to lack of a body of knowledge on its occurrence in the food and feed chain. H. lacustris synonym H. pluvialis is recommended for QPS status with the qualification ‘for production purposes only’.

show abstract

“…However, it must be noted that a small number of isolated case studies have reported occurrence of bacteremia or septicemia in immunocompetent individuals taking B. clausii probiotic preparations, mostly for management of diarrhea. Bacteremia following prolonged administration of B. clausii has been observed in several individuals with underlying comorbidities, although no specific risk factors for infection have been identified [ 94 ]. An isolated case of B. clausii septicemia was reported in a very young (4-month-old) patient with congenital heart disease being treated for diarrhea; Klebsiella pneumoniae was also detected in a blood culture from this patient [ 95 ].…”

Section: Commentarymentioning

confidence: 99%

Bacillus clausii for Gastrointestinal Disorders: A Narrative Literature Review

Acosta-Rodríguez-Bueno

Abreu

Guarner

et al. 2022

Adv Ther

View full text Add to dashboard Cite

The gut microbiota is intrinsically linked to human health; disturbances in microbial homeostasis are implicated in both intestinal and extraintestinal disorders. Probiotics are “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host,” and many commercial preparations comprising a diverse range of species are available. While probiotics have been much researched, better understanding of the probiotic effects and applications of species such as Bacillus clausii is warranted. In this narrative literature review, we review the characteristics and mechanisms of action supporting B. clausii as a probiotic and discuss the evidence from clinical studies evaluating B. clausii probiotics for the management of a variety of gastrointestinal disorders and symptoms in children and adults. Finally, we highlight the challenges of future research and the need for more robust and diverse clinical evidence to guide physicians in the clinical application of probiotics for gastrointestinal disorders and other conditions. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02285-0.

show abstract

A tale of caution: prolonged Bacillus clausii bacteraemia after probiotic use in an immunocompetent child

Cited by 13 publications

References 17 publications

Invasive Infections Associated with the Use of Probiotics in Children: A Systematic Review

Invasive Infections Associated with the Use of Probiotics in Children: A Systematic Review

Update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA 15: suitability of taxonomic units notified to EFSA until September 2021

Bacillus clausii for Gastrointestinal Disorders: A Narrative Literature Review

Contact Info

Product

Resources

About