Fungämie nach oraler Gabe von<i>Saccharomyces boulardii</i>bei einem multimorbiden Patienten

Lestin, F.; Pertschy, Annette; Rimek, Dagmar

doi:10.1055/s-2003-44948

Cited by 25 publications

(3 citation statements)

References 3 publications

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“…At least 8 cases of Lactobacillus bacteremia 21 - 26 and 9 cases of overt sepsis associated with Saccharomyces boulardii (cerevisiae), Lactobacillus GG, Bacillus subtilis, Bifidobacterium breve , or combination probiotics have been reported. 27 - 33 Moreover, S cerevisiae fungemia has been described in immunosuppressed (19 patients [31%]) and critically ill patients (28 [46%]), indicating that probiotics should be carefully used, particularly in patients with weakened immune systems. 34 …”

Section: Introductionmentioning

confidence: 99%

Probiotic Survey in Cancer Patients Treated in the Outpatient Department in a Comprehensive Cancer Center

et al. 2016

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Purpose. Availability without prescription restriction, low cost, and simple oral administration allow cancer patients to use probiotics without knowledge of potential risks. We present a survey of probiotic use and the association with patient tumor characteristics in cancer patients treated at the outpatient department of the National Cancer Institute in Slovakia. Patients and Methods. Between March and December 2014, 499 patients were asked to evaluate their overall experience with probiotics by questionnaire form, including the length and method of use relative to anticancer therapy, expectations, side-effect experiences, understanding of the possible risks, dietary supplement use, and others. The relevant data were statistically evaluated. Results. The cohort consisted of 323 women (64.7%) and 176 men (35.3%); 91.6% were undergoing chemotherapy (2.6% together with radiotherapy) and 8.4% had no anticancer therapy. The prevalence of probiotic use was 28.5% and only 12 patients using probiotics (8.5%) described negative side effects. Most patients declared consideration of probiotic use based on recommendation from a physician (37.3%) or a pharmacist (14.8%). Nevertheless, up to 86.6% of patients declared no knowledge of possible risks. Statistically significant correlation was found between probiotic use and age of patients (P < .008), gender (P < .023), and taking other dietary supplements (P < .000002). Conclusions. In this prospective study, we present for the first time the prevalence, side-effect experience, and aspects that most likely influence probiotic use in cancer patients. Minimal knowledge of risks underlines the importance of an active approach by oncologists to inform patients about probiotic safety.

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Section: Introductionmentioning

confidence: 99%

Probiotic Survey in Cancer Patients Treated in the Outpatient Department in a Comprehensive Cancer Center

et al. 2016

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“…However, their safety—particularly in imunocompromised patients—remains a controversial issue [ 1 , 7 , 16 ]. Several authors emphasise that caution is necessary when administering probiotics to the patients with impaired immunity and risk-benefit potential should be evaluated [ 2 , 5 , 6 , 10 , 12 , 32 ]. This is particularly important while administering probiotics containing yeasts to the immunocompromised patients [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, since the 1990s, an increasing number of publications of fungemia and invasive infections caused by Saccharomyces cerevisiae ( boulardii ), particularly among intensive care unit (ICU) patients and individuals with multiple co-morbidities, have been reported in literature in patients treated with a probiotic preparation containing this yeast [ 1 , 2 , 5 , 6 , 11 , 17 – 21 ]. Furthermore, it can also cause infections in otherwise healthy individuals [ 13 , 17 , 22 – 24 ].…”

Section: Introductionmentioning

confidence: 99%

Experience with Saccharomyces boulardii Probiotic in Oncohaematological Patients

Sulik-Tyszka

Snarski

Niedźwiedzka

et al. 2017

Probiotics & Antimicro. Prot.

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Very few reports have been published to date on the bloodstream infections caused by Saccharomyces spp. in oncohaematological patients, and there are no guidelines on the use of this probiotic microorganism in this population. We describe the use of probiotic preparation containing Saccharomyces boulardii in a large group of oncohaematological patients. We retrospectively analysed the data from 32,000 patient hospitalisations at the haematological centre during 2011–2013 (including 196 haematopoietic stem cell transplant recipients) in a tertiary care university-affiliated hospital. During the study period, 2270 doses of Saccharomyces boulardii probiotic were administered to the oncohaematological patients. In total, 2816 mycological cultures were performed, out of which 772 (27.4%) were positive, with 52 indicating digestive tract colonisation by Saccharomyces spp., mainly in patients with acute myeloid leukaemia (AML), myelodysplastic syndrome (MDS) or multiple myeloma (MM). While colonised, they were hospitalised for 1683 days and 416 microbiological cultures of their clinical samples were performed. In the studied group of patients, there were six blood cultures positive for fungi; however, they comprised Candida species: two C. glabrata, one C. albicans, one C. krusei, one C. tropicalis and one C. parapsilosis. There was no blood culture positive for Saccharomyces spp. Our study indicates that despite colonisation of many oncohaematological patients with Saccharomyces spp., there were no cases of fungal sepsis caused by this species.

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Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea

Hempel

Newberry

Maher

et al. 2012

JAMA

682

146

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Context Probiotics are live microorganisms intended to confer a health benefit when consumed. One condition for which probiotics have been advocated is the diarrhea that is a common adverse effect of antibiotic use. Objective To evaluate the evidence for probiotic use in the prevention and treatment of antibiotic-associated diarrhea (AAD). Data Sources Twelve electronic databases were searched (DARE, Cochrane Library of Systematic Reviews, CENTRAL, PubMed, EMBASE, CINAHL, AMED, MANTIS, TOXLINE, ToxFILE, NTIS, and AGRICOLA) and references of included studies and reviews were screened from database inception to February 2012, without language restriction. Study Selection Two independent reviewers identified parallel randomized controlled trials (RCTs) of probiotics (Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, and/or Bacillus) for the prevention or treatment of AAD. Data Extraction Two independent reviewers extracted the data and assessed trial quality. Results A total of 82 RCTs met inclusion criteria. The majority used Lactobacillusbased interventions alone or in combination with other genera; strains were poorly documented. The pooled relative risk in a DerSimonian-Laird random-effects metaanalysis of 63 RCTs, which included 11 811 participants, indicated a statistically significant association of probiotic administration with reduction in AAD (relative risk, 0.58; 95% CI, 0.50 to 0.68; PϽ.001; I 2 , 54%; [risk difference, −0.07; 95% CI, −0.10 to −0.05], [number needed to treat, 13; 95% CI, 10.3 to 19.1]) in trials reporting on the number of patients with AAD. This result was relatively insensitive to numerous subgroup analyses. However, there exists significant heterogeneity in pooled results and the evidence is insufficient to determine whether this association varies systematically by population, antibiotic characteristic, or probiotic preparation. Conclusions The pooled evidence suggests that probiotics are associated with a reduction in AAD. More research is needed to determine which probiotics are associated with the greatest efficacy and for which patients receiving which specific antibiotics.

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Fungämie nach oraler Gabe vonSaccharomyces boulardiibei einem multimorbiden Patienten

Cited by 25 publications

References 3 publications

Probiotic Survey in Cancer Patients Treated in the Outpatient Department in a Comprehensive Cancer Center

Probiotic Survey in Cancer Patients Treated in the Outpatient Department in a Comprehensive Cancer Center

Experience with Saccharomyces boulardii Probiotic in Oncohaematological Patients

Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea

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