Evaluation of Enterococcal Probiotic Usage and Review of Potential Health Benefits, Safety, and Risk of Antibiotic-Resistant Strain Emergence

Abstract

Enterococci are often used in probiotics but can also cause nosocomial infections. As such, enterococcal consumption may have beneficial health effects, but a thorough evaluation of virulence absence and risk of antibiotic resistance spread is needed at the strain level. This article reviewed ten online health product shopping websites in the US. On these websites, 23 probiotic products using enterococci were found across 12 companies. In addition, this article reviewed studies that demonstrated the probiotic potential of enterococcal consumption (e.g., gastrointestinal and respiratory disease, hyperlipidemia alleviation, as well as infection prevention). To investigate the safety aspects of enterococci, the present work examined studies evaluating virulence factors and antibiotic resistance. Furthermore, this article assessed research that explored these virulent factors, specifically in probiotics containing enterococci, as well as the potential transfer mechanism of their antibiotic resistance. Based on reviewed data, enterococcal probiotic consumption has been proven beneficial for conditions or symptoms of multiple diseases without any apparent adverse effects. However, due to the plasmid- or transposon-mediated gene transfer ability of enterococci, surveillance monitoring and further studies regarding enterococcal consumption are warranted. Future studies that identify enterococcal strains safe to use in probiotics without virulence factors and antibiotic resistance are imperative for evidence-based decisions by health organizations and government agencies.

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“…However, also the release via membrane vesicles could be an explanation which is supported by vesicle releasing L. plantarum (Yu et al 2022). Interestingly, systematic analysis of the signal peptides and culture filtrates of different lactobacilli suggested that further bacterial species from the genera Lactobacillus, Akkermansia, and Enterococcus with described probiotic potential (Li et al 2024; Im et al 2023) release putative FPR2 ligands.…”

The Networked Interaction between Probiotics and Intestine in Health and Disease: A Promising Success Story

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An Updated Review on Probiotic Production and Applications

“…To meet the clinical requirements, EFSA (European Food Safety Authority), WHO, and FAO issued mandatory guidelines to probiotic researchers, stating that the strains must meet safety and functionality requirements, such as the route of strain selection, nonpathogenic, non-immunogenic nature, resistance to antibiotics, long durability in the gastrointestinal tract, and the ability to maintain their activity during production, processing, and preservation, which are crucial for patient safety [5,6]. The carriers or matrix employed in the formulation are also vital since they can impair the strain's viability, lowering the product's quality [7,8].…”