Preliminary pediatric clinical evaluation of the oral probiotic Streptococcus salivarius K12 in preventing recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes and recurrent acute otitis media

Abstract

BackgroundThe oral probiotic Streptococcus salivarius K12 has been shown clearly to antagonize the growth of Streptococcus pyogenes, the most important bacterial cause of pharyngeal infections in humans, by releasing two bacteriocins named salivaricin A2 and salivaricin B. Unpublished observations indicate that it can also antagonize the growth of other bacteria involved in acute otitis media. Because of its ability to colonize the oral cavity and its safety profile, we have tested its efficacy in reducing the incidence of streptococcal pharyngitis and/or tonsillitis and episodes of acute otitis media.MethodsWe enrolled 82 children, including 65 with and 17 without a recent diagnosis of recurrent oral streptococcal pathology. Of those with recurrent pathology, 45 were treated daily for 90 days with an oral slow-release tablet containing five billion colony-forming units of S. salivarius K12 (Bactoblis®), and the remaining 20 served as an untreated control group. The 17 children without a recent diagnosis of recurrent oral pathology were used as an additional control group. After 90 days of treatment, a 6-month follow-up period without treatment was included to evaluate a possible persistent protective role for the previously administered product.ResultsThe 41 children who completed the 90-day course of Bactoblis showed a reduction in their episodes of streptococcal pharyngeal infection (about 90%) and/or acute otitis media (about 40%), calculated by comparing infection rates in the previous year. The 90-day treatment also reduced the reported incidence of pharyngeal and ear infections by about 65% in the 6-month follow-up period during which the product was not administered. Subjects tolerated the product well, with no side effects or dropouts reported.ConclusionProphylactic administration of S. salivarius K12 to children with a history of recurrent oral streptococcal pathology reduced episodes of streptococcal pharyngeal infections and/or tonsillitis as well as episodes of acute otitis media.

Investigating the Effects of Probiotics on Pneumococcal Colonization Using an <em>In Vitro</em> Adherence Assay

“…In addition to LGG and other lactic acid bacteria, Streptococcus salivarius, a common resident of the oral cavity, has been investigated as a potential probiotic for the respiratory tract due to its colonization potential and ability to inhibit pneumococci and other respiratory pathogens in vitro [11][12][13] . The protocol presented here describes an adherence assay used to investigate the effects of S. salivarius K12 on pneumococcal adherence to the human epithelial cell line CCL-23.…”

Analysis of the Inhibitory Potential of Clinical Streptococcus Salivarius Isolates From Saliva and Dorsal of Tongue of Adults on Enterococcal Faecalis Growth

“…Quorum sensing AGR-system is a system that is found on the mechanisms of Staphylococcus that cause the bacteria to enlarge their communities by destroying the cells around them [17]. If the mechanism for quorum sensing has occurred, S. salivarius would itself produce lantibiotics through autoregulation processes using a two-component regulatory system [4,5,[18][19][20].…”

“…Based on the previous studies of probiotics, Lactobacillus bacteria can be used as both a treatment and prevention of infections causing acute diarrhea of children. Lactococcus lactis could be used to deliver vaccine proteins and the DNA vaccines, and Streptococcus salivarius K12 can treat throat infections [2][3][4]. The bacteria listed above are probiotic agents that eliminate pathogens and produce similar proteins types.…”

The new first-line defense: the potential of nasopharyngeal colonization in vaccine strategies

“…95 This observation perhaps suggests that AHS have inhibitory effect on H. influenzae growth, similar to the ability of Streptococcus oralis to inhibit S. pneumoniae growth. 96 This potential effect has been exploited by the oral administration of another AHS species S. salivarius, which was associated with a reduction in S. pyogenes infections in humans 97,98 and inhibition of S. pneumoniae infection in mouse models. 99,100 Furthermore, nasal spray administration of five strains of AHS from three species (Streptococcus sanguis, Streptococcus mitis, and S. oralis) reduced the incidence of recurrent OM and secretory OM in children.…”