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Among critically ill, study finds probiotics useless against 'superbugs'

by Gus Iversen, Editor in Chief | August 27, 2015
Infection Control Population Health Risk Management
The probiotic Lactobacillus
rhamnosus
GG
Courtesy:
Washington University
in St. Louis
As health care providers look for ways to curb the risk of antibiotic resistant bacteria infecting their patients, the use of probiotics to restore intestinal balance has been an intriguing prospect.

Unfortunately, at least among the sickest patients, new research suggests there is little value in that approach.

"With fewer therapies available to treat multidrug-resistant organisms, innovative methods to prevent or eliminate gastrointestinal colonization are necessary," said Jennie H. Kwon, clinical researcher in the Washington University School of Medicine in St. Louis' Division of Infectious Diseases, and lead study author.

Probiotics are microorganisms that that can help replenish the microbiome of healthy bacteria which may become depleted through an infection, or the use of antibiotics. Superbugs, such as Clostridium difficile (C. diff), vancomycin-resistant Enterococcus (VRE) and Pseudomonas aeruginosa, are all resistant to multiple forms of antibiotics and pose a mounting threat to health care providers.

In their study, published August 27 in Infection Control & Hospital Epidemiology, Kwon and her team followed 70 patients admitted to ICUs at Barnes-Jewish Hospital in St. Louis to determine if a probiotic called Lactobacillus rhamnosus GG could hamper superbug colonization.

The researchers monitored the intestinal tracks of those patients, having divided them into one group receiving routine care and another receiving routine care plus probiotics.

After administering the probiotic twice daily for as many as two weeks, the researchers reported no statistically significant reduction in the frequency of microbe colonization — 10 percent versus 15 percent for the control group.

In her statement, Kwon acknowledged and emphasized the limitations of the study: small patient sample size, brief length of patient follow-up, and use of a single type and dose of probiotic. The researchers also did not assess the possible impact of probiotics on preventing the colonization of superbugs in other bodily regions, such as the stomach or upper airway.

Next, she and her colleagues intend to assess how superbugs hold up against probiotics in a non-ICU population of hospital patients.

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