No Impact of Probiotics to Reduce Clostridium difficile Infection in Hospitalized Patients: A Real-world Experience

Box, Maggie; Ortwine, Kristine; Goicoechea, Miguel

doi:10.1093/ofid/ofy192

Cited by 18 publications

(28 citation statements)

References 8 publications

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“…For example, probiotics that were not according to a doctor's recommended dosage. There were some patients who had not only received probiotics but they had also received a high dosage of antibiotics so the probiotics given at the time no longer have an effect (Box, Ortwine, & Goicoechea, 2016). Another thing to consider is that the number of study participants was 80.5% for those not eligible and the patients who were eligible may have been relatively healthy.…”

Section: Discussionmentioning

confidence: 99%

Lactobacillus sp as a Probiotic for the Prevention of Clostridium difficile Associated Diarrhea

Rohmah

Andini

Luawo

et al. 2020

J. Ners

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Background: Antibiotic treatment can disturb the resistance of the gastrointestinal flora to colonization. This may result in complications, the most serious of which is Clostridium difficile associated diarrhea (CDAD). The aim of this study was to determine the effectiveness of probiotics for the prevention of CDAD.Method: The databases used were Scopus, Proquest, CINAHL, Medline, Pubmed and ScienceDirect, limited to having been published in the last 5 years. A literature review followed the keyword search. The keywords used were probiotics, Clostridium difficile, associated, diarrhea, randomized, control and trial using "AND" and “OR”. Twelve trials with 5102 participants were included. Eight trials reported a preventive effect for CDAD using a mixture of 2 strains of lactobacillus, a mixture of 4 combination strains, a mixture of lactobacillus and Saccharomyces or a mixture of Biﬁdobacterium, Lactobacillus and Saccharomyces.Result: Our findings indicate that probiotics may prevent CDAD. Most probiotics contain a singular strain. The combination with lactobacillus sp was the most effective at preventing CDAD.Conclusion: In addition, 6 out of 8 trials had an in relation to preventing CDAD containing lactobacillus sp. Four studies said that there were some factors that meant that the probiotic could not reduce or prevent the CDAD.

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Section: Discussionmentioning

confidence: 99%

Lactobacillus sp as a Probiotic for the Prevention of Clostridium difficile Associated Diarrhea

Rohmah

Andini

Luawo

et al. 2020

J. Ners

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“…Nor did the use of probiotics appear to affect usage of CDI treatment antibacterials. Recently, other researchers failed to find lower rates of CDI with the Bio-K+ probiotic (Allen et al, 2013; Box et al, 2018). These findings do not necessarily mean that the probiotics did not help some individuals.…”

Section: Discussionmentioning

confidence: 99%

“…The inclusion of low-risk patients was suggested as a limitation in other studies not showing a preventive effect. The best examples can be seen in the PLACIDE study conducted in the UK and in many of the small studies included in the various meta-analyses (Allen et al, 2013; Box et al, 2018; Johnston et al, 2018). In addition to having a large proportion of low-risk patients, the PLACIDE study also allowed patients to start probiotics up to a week after the start of antibacterials (Allen et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Impact of an automatic hospital probiotic protocol on Clostridioides (Clostridium) difficile infection (CDI) rates and CDI antibiotic usage in a community hospital setting

Slain

Georgulis²,

Dermitt³

et al. 2019

Journal of Infection Prevention

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The aim of the present study was to see how widespread preventative use of the probiotic Saccharomyces boulardii via automatic protocol in hospitalised patients receiving antibacterials affected rates of hospital-associated Clostridioides ( Clostridium) difficile infection (HA-CDI). Rates of HA-CDI appeared to be similar between the pre-protocol and protocol periods. Use of CDI treatment antibiotics (oral metronidazole and oral vancomycin) was also similar. Laboratory-confirmed isolation of S. boulardii from sterile body sites was identified in five patients during the protocol versus only one case in the pre-protocol years.

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“…The concept of promoting human health through consumption of beneficial microorganisms has evolved during the last century ( George Kerry et al., 2018 ). Numerous studies have been published under this broad definition, attempting to demonstrate beneficial effects of probiotics to CDI, however, with highly mixed results ( Na and Kelly, 2011 ; Shen et al., 2017 ; Box et al., 2018 ). The considerable variation in outcomes between clinical trials may be attributed to multiple factors, including differences in the bacterial strains used among researchers and the survivability of the studied microorganisms in different individuals' gut microenvironment.…”

Section: Introductionmentioning

confidence: 99%

Lemon Exosome-like Nanoparticles-Manipulated Probiotics Protect Mice from C. diff Infection

Teng

et al. 2020

iScience

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Summary Clostridioides difficile (C. diff) is the leading cause of antibiotic-associated colitis. Here, we report that lemon exosome-like nanoparticles (LELNs) manipulated probiotics to inhibit C. diff infection (CDI). LELN-manipulated Lactobacillus rhamnosus GG (LGG) and Streptococcus thermophilus ST-21 ( S TH) (LELN-LS) decrease CDI mortality via an LELN-mediated increase in bile resistance and gut survivability. LELN-LS treatment increases the AhR ligands indole-3-lactic acid (I3LA) and indole-3-carboxaldehyde (I3Ald), leading to induction of IL-22, and increases lactic acid leading to a decrease of C. diff fecal shedding by inhibiting C. diff growth and indole biosynthesis. A synergistic effect between STH and LGG was identified. The STH metabolites inhibit gluconeogenesis of LGG and allow fructose-1,6-bisphosphate (FBP) to accumulate in LGG; accumulated FBP then activates lactate dehydrogenase of LGG (LGG-LDH) and enhances production of lactic acid and the AhR ligand. Our findings provide a new strategy for CDI prevention and treatment with a new type of prebiotics.

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No Impact of Probiotics to Reduce Clostridium difficile Infection in Hospitalized Patients: A Real-world Experience

Cited by 18 publications

References 8 publications

Lactobacillus sp as a Probiotic for the Prevention of Clostridium difficile Associated Diarrhea

Lactobacillus sp as a Probiotic for the Prevention of Clostridium difficile Associated Diarrhea

Impact of an automatic hospital probiotic protocol on Clostridioides (Clostridium) difficile infection (CDI) rates and CDI antibiotic usage in a community hospital setting

Lemon Exosome-like Nanoparticles-Manipulated Probiotics Protect Mice from C. diff Infection

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