Lactobacillus rhamnosus sepsis associated with probiotic therapy in an extremely preterm infant: Pathogenesis and a review for clinicians

Chiang, Ming-Chou; Chen, Chyi‐Liang; Feng, Ye; Chen, Chien‐Chang; Lien, Reyin; Chiu, Cheng-Hsun

doi:10.1016/j.jmii.2020.03.029

Cited by 48 publications

(52 citation statements)

References 13 publications

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“…The difference in the gut microbiome of preterm infants compared to the one of term infants could be considered an important factor in NEC development [ 118 ]. Since concerns over the development of sepsis in infants after probiotic administration are raised, the use of postbiotics instead of probiotics in this vulnerable group might be a useful strategy in shaping their gut microbiome and thus preventing or treating NEC [ 119 , 120 , 121 ]. However, it is essential to add that specific probiotics with documented efficacy are recommended for preventing NEC by both the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) and the American Gastroenterological Association (AGA) [ 122 , 123 ].…”

Section: Potential Mechanisms Of Actionmentioning

confidence: 99%

Postbiotics against Pathogens Commonly Involved in Pediatric Infectious Diseases

et al. 2020

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The Sustainable Development goals for 2020 included reducing all causes associated with infant and perinatal mortality in their priorities. The use of compounds with bioactive properties has been proposed as a therapeutic strategy due to their stimulating effect on the host’s immune system. Additionally, biotherapeutic products such as postbiotics, tentatively defined as compounds produced during a fermentation process that support health and well-being, promote intestinal barrier integrity without posing considerable risks to children’s health. Although this is a concept in development, there are increasing studies in the field of nutrition, chemistry, and health that aim to understand how postbiotics can help prevent different types of infections in priority populations such as minors under the age of five. The present review aims to describe the main mechanisms of action of postbiotics. In addition, it presents the available current evidence regarding the effects of postbiotics against pathogens commonly involved in pediatric infections. Postbiotics may constitute a safe alternative capable of modulating the cellular response and stimulating the host’s humoral response.

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Section: Potential Mechanisms Of Actionmentioning

confidence: 99%

Postbiotics against Pathogens Commonly Involved in Pediatric Infectious Diseases

et al. 2020

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“…As a consequence, daily practice differs substantially in different centers, resulting in a discrepancy in administration from 0 to 100% according to over 150 different neonatal intensive care units [ 103 ]. Many trials do not report any adverse event, but some cases of Lactobacillus or Bifidobacterium sepsis have been reported in infants receiving probiotics [ 104 , 105 , 106 , 107 ]. Most affected infants had severe diseases, such as short-bowel syndrome or immunodeficiency [ 103 ].…”

Section: Results: Evidence Of Efficacy Of Probioticsmentioning

confidence: 99%

Probiotics in Pediatrics. A Review and Practical Guide

Depoorter

Vandenplas

2021

Nutrients

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The potential benefit of the administration of probiotics in children has been studied in many settings globally. Probiotics products contain viable micro-organisms that confer a health benefit on the host. Beneficial effects of selected probiotic strains for the management or prevention of selected pediatric conditions have been demonstrated. The purpose of this paper is to provide an overview of current available evidence on the efficacy of specific probiotics in selected conditions to guide pediatricians in decision-making on the therapeutic or prophylactic use of probiotic strains in children. Evidence to support the use of certain probiotics in selected pediatric conditions is often available. In addition, the administration of probiotics is associated with a low risk of adverse events and is generally well tolerated. The best documented efficacy of certain probiotics is for treatment of infectious gastroenteritis, and prevention of antibiotic-associated, Clostridioides difficile-associated and nosocomial diarrhea. Unfortunately, due to study heterogeneity and in some cases high risk of bias in published studies, a broad consensus is lacking for specific probiotic strains, doses and treatment regimens for some pediatric indications. The current available evidence thus limits the systematic administration of probiotics. The most recent meta-analyses and reviews highlight the need for more well-designed, properly powered, strain-specific and dedicated-dose response studies.

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“…Of note, Lactobacillus infection after taking probiotics products contain Lactobacillus spp. had been reported in some relatively immunocompromised patients [ 63 , 64 , 65 ]. These immunocompromised patients were at higher risk of developing CDI, and the use of probiotics to prevent CDI in these group of patients should be approached more carefully.…”

Section: Probiotics Supply To Restore the Disturbed Microbiota In CDImentioning

confidence: 99%

Application of Microbiome Management in Therapy for Clostridioides difficile Infections: From Fecal Microbiota Transplantation to Probiotics to Microbiota-Preserving Antimicrobial Agents

et al. 2021

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Oral vancomycin and metronidazole, though they are the therapeutic choice for Clostridioides difficile infections (CDIs), also markedly disturb microbiota, leading to a prolonged loss of colonization resistance to C. difficile after therapy; as a result, their use is associated with a high treatment failure rate and high recurrent rate. An alternative for CDIs therapy contains the delivery of beneficial (probiotic) microorganisms into the intestinal tract to restore the microbial balance. Recently, mixture regimens containing Lactobacillus species, Saccharomyces boulardii, or Clostridium butyricum have been extensively studied for the prophylaxis of CDIs. Fecal microbiota transplantation (FMT), the transfer of (processed) fecal material from healthy donors to patients for treating CDIs, combined with vancomycin was recommended as the primary therapy for multiple recurrent CDIs (rCDIs). Either probiotics or FMT have been utilized extensively in preventing or treating CDIs, aiming at less disturbance in the microbiota to prevent rCDIs after therapy cessation. Otherwise, many newly developed therapeutic agents have been developed and aim to preserve microbiota during CDI treatment to prevent disease recurrence and might be useful in clinical patients with rCDIs in the future.

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Lactobacillus rhamnosus sepsis associated with probiotic therapy in an extremely preterm infant: Pathogenesis and a review for clinicians

Cited by 48 publications

References 13 publications

Postbiotics against Pathogens Commonly Involved in Pediatric Infectious Diseases

Postbiotics against Pathogens Commonly Involved in Pediatric Infectious Diseases

Probiotics in Pediatrics. A Review and Practical Guide

Application of Microbiome Management in Therapy for Clostridioides difficile Infections: From Fecal Microbiota Transplantation to Probiotics to Microbiota-Preserving Antimicrobial Agents

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