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BMC Complement Altern Med. 2018 Dec 12;18(1):329. doi: 10.1186/s12906-018-2394-3.

Infectious complications following probiotic ingestion: a potentially underestimated problem? A systematic review of reports and case series.

Author information

1
Intensive Care Unit of Unimed-Rio Hospital, Av. Ayrton Senna, 2550, Rio de Janeiro/RJ, CEP 22775-003, Brazil. lessa.med@gmail.com.
2
Cardiointensive Unit of Americas Medical City, Rio de Janeiro/RJ, Brazil. lessa.med@gmail.com.
3
National Institute of Cardiology, Rio de Janeiro/RJ, Brazil. lessa.med@gmail.com.
4
National Institute of Cardiology, Rio de Janeiro/RJ, Brazil.
5
National Institute of Infectology Evandro Chagas, Fiocruz, Rio de Janeiro/RJ, Brazil.
6
Unigranrio University, Rio de Janeiro/RJ, Brazil.

Abstract

BACKGROUND:

Little is studied about complications related to probiotic ingestion. This study proposes to present a synthesis and critical evaluation of the reports and series of cases on the infectious complications related to the ingestion of probiotics, which can raise awareness for the prescribing and use of probiotics for certain groups of patients.

METHODS:

Systematic review of reports and series of cases researched in the PubMed, SciELO and Scopus databases published until August 2018. The references of the articles were investigated manually for the search of cross references. SPSS version 23.0 was used for descriptive statistics and univariate analysis.

RESULTS:

We found 60 case reports and 7 case series, making up a total of 93 patients. Fungemia was the most common infectious complications with 35 (37.6%) cases. The genus Saccharomyces was the most frequent with 47 (50.6%) cases, followed by Lactobacillus, Bifidobacterium, Bacillus, Pedioccocus and Escherichia with 26 (27.9%), 12 (12.8%), 5 (5.4%), 2 (2.2%) and 1 (1.1%) case, respectively. Adults over 60 years of age, Clostridium difficile colitis, antibiotic use and Saccharomyces infections were associated with overall mortality. HIV infections, immunosuppressive drugs, solid organ transplantation, deep intravenous lines, enteral or parenteral nutrition were not associated with death.

CONCLUSION:

The use of probiotics cannot be considered risk-free and should be carefully evaluated for some patient groups.

TRIAL REGISTRATION:

CRD42016042289.

KEYWORDS:

Fungemia; Infection; Lactobacillus; Probiotics; Saccharomyces; Sepsis

PMID:
30541524
PMCID:
PMC6292120
DOI:
10.1186/s12906-018-2394-3
[Indexed for MEDLINE]
Free PMC Article

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