Gastrointestinal Zygomycosis in a Preterm Neonate Associated With Contaminated Probiotics

Bizzarro, Matthew J.; Peaper, David R.; Morotti, Raffaella; Paci, George; Rychalsky, Michelle; Boyce, John M.

doi:10.1097/inf.0000000000003063

Cited by 4 publications

(3 citation statements)

References 7 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, when it comes to use in neonates and infants, special care needs to be exercised to handle their immature gut integrity and underdeveloped immune systems. Contamination with fungal strains during production can be problem 63 , 64 and although rare, multiple adverse events have been reported in neonates and infants after receiving probiotics. 65 These events are uncommon but attract attention due to the devastating consequences, and every measure should be taken to avoid them.…”

Section: Quality Control Contamination and Adverse Eventsmentioning

confidence: 99%

The neonatal gut microbiome and global health

Panigrahi

2024

Gut Microbes

View full text Add to dashboard Cite

The role of gut microbiome in health, a century-old concept, has been on the center stage of medical research recently. While different body sites, disease conditions, and populations have been targeted, neonatal and early infancy appear to be the most suitable period for such interventions. It is intriguing to note that, unlike traditional use in diarrhea and maintenance of gastrointestinal health, microbiome-mediating therapies have now addressed the most serious medical conditions in young infants such as necrotizing enterocolitis and neonatal sepsis. Unfortunately, almost all new endeavors in this space have been carried out in the Western world leaving behind millions of neonates that can benefit from such manipulations while serving as a large resource for further learning. In this review, an attempt has been made to quantify the global burden of neonatal morbidity and mortality, examples presented on interventions that have failed as a result of drawing from studies conducted in the West, and a case made for manipulating the neonatal gut microbiome to address the biggest killers in early life. A brief comparative analysis has been made to demonstrate the differences in the gut microbiota of North and South and a large clinical trial of synbiotics conducted by our group in a South Asian setting has been presented. Although challenging, the value of conducting such global health research is introduced with an intent to invite medical scientists to engage in well-planned, scientifically robust research endeavors. This can bring about innovation while saving and serving the most vulnerable citizens now and protecting them from the negative health consequences in the later part of their lives, ultimately shaping a resilient and equitable world as pledged by 193 United Nations member countries in 2015.

show abstract

Section: Quality Control Contamination and Adverse Eventsmentioning

confidence: 99%

The neonatal gut microbiome and global health

Panigrahi

2024

Gut Microbes

View full text Add to dashboard Cite

show abstract

“… 27 Stringent quality control ascertaining the safety and efficacy of these products for use in preterm infants is necessary, particularly given their fragile physiological condition and higher likelihood of having indwelling medical supports that act as sites at risk of infection. 169 , 170 While infrequent, reports of infections linked to contaminated probiotics exist, 171 further emphasizing the need for the implementation of strict quality control measures to prevent these avoidable and potentially life-threatening clinical events. Recommendations regarding trusted probiotic formulations and suppliers, alongside regular quality control checks on probiotic composition and dose, are needed before probiotic supplementation becomes a routine part of clinical care.…”

Section: Clinical Considerations For Probiotic Supplementation In Pre...mentioning

confidence: 99%

Probiotics to improve the gut microbiome in premature infants: are we there yet?

Mercer

Arrieta

2023

Gut Microbes

View full text Add to dashboard Cite

Gut microbiome maturation in infants born prematurely is uniquely influenced by the physiological, clinical, and environmental factors surrounding preterm birth and early life, leading to altered patterns of microbial succession relative to term infants during the first months of life. These differences in microbiome composition are implicated in acute clinical conditions that disproportionately affect preterm infants, including necrotizing enterocolitis (NEC) and late-onset sepsis (LOS). Probiotic supplementation initiated early in life is an effective prophylactic measure for preventing NEC, LOS, and other clinical concerns relevant to preterm infants. In parallel, reported benefits of probiotics on the preterm gut microbiome, metabolome, and immune function are beginning to emerge. This review summarizes the current literature on the influence of probiotics on the gut microbiome of preterm infants, outlines potential mechanisms by which these effects are exerted, and highlights important clinical considerations for determining the best practices for probiotic use in premature infants.

show abstract

“…After a fatal gastrointestinal infection in a premature neonate associated with a Rhizopus oryzae –contaminated probiotic product, attention has been drawn to the need for improved quality of probiotic products administered to neonates. In 2021, the Committee on Fetus and Newborn of the American Academy of Pediatrics determined, “Current evidence does not support the routine, universal administration of probiotics to preterm infants, particularly those with a birth weight of <1000 g,” justified in part by the lack of pharmaceutical-grade probiotic products of sufficient microbiological quality to meet the needs of this population.…”

mentioning

confidence: 99%