<i>Lactobacillus acidophilus</i> bacteraemia after use of a probiotic in a patient with AIDS and Hodgkin's disease

Ledoux, Didier; LaBombardi, Vincent J.; Karter, Dennis

doi:10.1258/095646206776253507

Cited by 72 publications

(47 citation statements)

References 9 publications

(17 reference statements)

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“…This finding is in accordance with those of other studies performed in various medical fields [29][30][31]. However, it should be noted that Lactobacillus bacteremia has been associated with probiotic therapy [32][33][34][35][36], and it is possible that patients undergoing major abdominal surgery, such as liver transplantation, may be susceptible to Lactobacillus bacteremia. This may be attributed to the fact that such patients are often immunosuppressed, suffer from malnutrition, and have a protein deficit.…”

Section: Study or Subgroupsupporting

confidence: 91%

Does the use of probiotics/synbiotics prevent postoperative infections in patients undergoing abdominal surgery? A meta-analysis of randomized controlled trials

Pitsouni

Alexiou

Saridakis

et al. 2009

Eur J Clin Pharmacol

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Background Advances in surgery have considerably lowered postoperative morbidity. However, infection remains a considerable morbidity factor. The aim of this review is to identify the potential benefit(s) of the perioperative administration of probiotics/synbiotics to patients undergoing abdominal surgery. Methods We searched PubMed, Scopus, Web of Science, and Cochrane library to identify randomized controlled trials (RCTs) that studied the perioperative administration of probiotics/synbiotics to patients undergoing abdominal surgery. Results Nine RCTs studying 733 patients were included in our review. The incidence of postoperative pneumonia, cholangitis, and any infections as well as the duration of postoperative hospital stay and length of antibiotic therapy were lower among patients receiving probiotics than in the control group [six RCTs, 355 patients, odds ratio (OR) 0.24, 95% confidence interval (CI) 0.09-0.68; three RCTs, 209 patients, OR0.18, 95% CI0.05-0.57; seven RCTs, 514 patients, OR 0.26, 95% CI 0.12-0.55; five RCTs, 313 patients, OR −2.70, 95% CI−5.15 to −0.25; four RCTs, 250 patients, OR −4.01, 95% CI−5.11 to −2.92, respectively], while the incidence of postoperative wound infection, urinary tract infection, intra-abdominal abscess, and mortality was not different between patients of the compared groups (six RCTs, 355 patients, OR0.52, 95% CI0.23-1.18; five RCTs, 313 patients, OR0.44, 95% CI0. four RCTs, 226 patients, OR0.44, nine RCTs, 685 patients, OR0.98, respectively). Conclusion The use of probiotics/synbiotics may reduce postoperative infections after abdominal surgery. This is a promising infection-preventive measure that may decrease morbidity, length of antibiotic therapy, duration of hospital stay, and pressure for emergence of antimicrobial resistance. However, the results of this meta-analysis should be interpreted with caution due to the significant heterogeneity of the studies included.

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Section: Study or Subgroupsupporting

confidence: 91%

Does the use of probiotics/synbiotics prevent postoperative infections in patients undergoing abdominal surgery? A meta-analysis of randomized controlled trials

Pitsouni

Alexiou

Saridakis

et al. 2009

Eur J Clin Pharmacol

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“…However, isolated case reports of sepsis following Lactobacillus sp. feeding have been described in both pediatric and adult populations following probiotic therapy (108,109). Hence, until further studies of efficacy and safety are available, routine use of probiotic therapy in premature newborns cannot be recommended (Fig.…”

mentioning

confidence: 99%

Understanding the Susceptibility of the Premature Infant to Necrotizing Enterocolitis (NEC)

et al. 2008

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Necrotizing enterocolitis (NEC) is the most common life-threatening gastrointestinal emergency encountered in the neonatal intensive care unit. Despite advances in neonatal care, NEC remains a leading cause of morbidity and mortality among premature infants. Epidemiologic studies have identified multiple factors that increase an infant's risk for the development of NEC, although premature birth, bacterial colonization, and enteral feeding are thought to play central roles in disease pathogenesis. Appreciating factors that underlie the susceptibility of prematurely born infants to NEC is important for the development of new strategies aimed at the prevention and treatment of disease. In this review, we discuss defense mechanisms in the intestine and discuss how these systems may be insufficient in the prematurely born infant and thereby further contribute to initiation of NEC. In addition, based on a review of the literature, we suggest that, although numerous bacterial and viral pathogens have been associated with NEC, no individual organism is known to be responsible for disease. Finally, we comment on the possible role for probiotics in promoting maturation of intestinal defense mechanisms thereby attenuating or preventing the sequence of events that lead to NEC. (Pediatr Res 63: 117-123, 2008)

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“…Some case reports even seem to indicate that probiotics, including E. coli strain Nissle 1917, might promote sepsis (6,24), and severe adverse effects of probiotics have been observed in patients suffering from acute pancreatitis (3,5).…”

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confidence: 99%

Safety of ProbioticEscherichia coliStrain Nissle 1917 Depends on Intestinal Microbiota and Adaptive Immunity of the Host

et al. 2010

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Probiotics are viable microorganisms that are increasingly used for treatment of a variety of diseases. Occasionally, however, probiotics may have adverse clinical effects, including septicemia. Here we examined the role of the intestinal microbiota and the adaptive immune system in preventing translocation of probiotics (e.g., Escherichia coli Nissle). We challenged C57BL/6J mice raised under germfree conditions (GF-raised C57BL/6J mice) and Rag1 ؊/؊ mice raised under germfree conditions (GF-raised Rag1 ؊/؊ mice) and under specific-pathogen-free conditions (SPF-raised Rag1 ؊/؊ mice) with probiotic E. coli strain Nissle 1917, strain Nissle 1917 mutants, the commensal strain E. coli mpk, or Bacteroides vulgatus mpk. Additionally, we reconstituted Rag1 ؊/؊ mice with CD4 ؉ T cells. E. coli translocation and dissemination and the mortality of mice were assessed. In GF-raised Rag1 ؊/؊ mice, but not in SPF-raised Rag1 ؊/؊ mice or GF-raised C57BL/6J mice, oral challenge with E. coli strain Nissle 1917, but not oral challenge with E. coli mpk, resulted in translocation and dissemination. The mortality rate was significantly higher for E. coli strain Nissle 1917-challenged GF-raised Rag1 ؊/؊ mice (100%; P < 0. 001) than for E. coli strain Nissle 1917-challenged SPF-raised Rag1 ؊/؊ mice (0%) and GF-raised C57BL/6J mice (0%). Translocation of and mortality due to strain E. coli Nissle 1917 in GF-raised Rag1؊/؊ mice were prevented when mice were reconstituted with T cells prior to strain E. coli Nissle 1917 challenge, but not when mice were reconstituted with T cells after E. coli strain Nissle 1917 challenge. Cocolonization experiments revealed that E. coli mpk could not prevent translocation of strain E. coli Nissle 1917. Moreover, we demonstrated that neither lipopolysaccharide structure nor flagella play a role in E. coli strain Nissle 1917 translocation and dissemination. Our results suggest that if both the microbiota and adaptive immunity are defective, translocation across the intestinal epithelium and dissemination of the probiotic E. coli strain Nissle 1917 may occur and have potentially severe adverse effects. Future work should define the possibly related molecular factors that promote probiotic functions, fitness, and facultative pathogenicity.

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Lactobacillus acidophilus bacteraemia after use of a probiotic in a patient with AIDS and Hodgkin's disease

Abstract: We report the case of a patient who developed bacteraemia and septic pulmonary emboli with Lactobacillus acidophilus after taking a probiotic containing this organism.

Cited by 72 publications

References 9 publications

Does the use of probiotics/synbiotics prevent postoperative infections in patients undergoing abdominal surgery? A meta-analysis of randomized controlled trials

Does the use of probiotics/synbiotics prevent postoperative infections in patients undergoing abdominal surgery? A meta-analysis of randomized controlled trials

Understanding the Susceptibility of the Premature Infant to Necrotizing Enterocolitis (NEC)

Safety of ProbioticEscherichia coliStrain Nissle 1917 Depends on Intestinal Microbiota and Adaptive Immunity of the Host

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