Cargando…
Do Probiotics During In-Hospital Antibiotic Treatment Prevent Colonization of Gut Microbiota With Multi-Drug-Resistant Bacteria? A Randomized Placebo-Controlled Trial Comparing Saccharomyces to a Mixture of Lactobacillus, Bifidobacterium, and Saccharomyces
Objective: Most infections with Enterobacteriaceae producing AmpC β-lactamase (AmpC)-, extended-spectrum β-lactamase (ESBL)-, and carbapenemase-producing bacteria, vancomycin-resistant Enterococcus as well as naturally resistant non-fermenting bacteria such as Pseudomonas aeruginosa, are related to...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7982943/ https://www.ncbi.nlm.nih.gov/pubmed/33763399 http://dx.doi.org/10.3389/fpubh.2020.578089 |
_version_ | 1783667829248098304 |
---|---|
author | Wieërs, Grégoire Verbelen, Valérie Van Den Driessche, Mieke Melnik, Ekaterina Vanheule, Greet Marot, Jean-Christophe Cani, Patrice D. |
author_facet | Wieërs, Grégoire Verbelen, Valérie Van Den Driessche, Mieke Melnik, Ekaterina Vanheule, Greet Marot, Jean-Christophe Cani, Patrice D. |
author_sort | Wieërs, Grégoire |
collection | PubMed |
description | Objective: Most infections with Enterobacteriaceae producing AmpC β-lactamase (AmpC)-, extended-spectrum β-lactamase (ESBL)-, and carbapenemase-producing bacteria, vancomycin-resistant Enterococcus as well as naturally resistant non-fermenting bacteria such as Pseudomonas aeruginosa, are related to a prior colonization of the gut microbiota. The objective of this study was to determine whether treatment with probiotics during an antibiotic treatment could prevent the colonization of the gut microbiota with multi-drug resistant bacteria. Method: In total, 120 patients treated for 10 days with amoxicillin-clavulanate antibiotics were included in a randomized, placebo-controlled, double-blinded trial, comparing the effects of a 30 days treatment with placebo Saccharomyces boulardii CNCM I-745® and a probiotic mixture containing Saccharomyces boulardii, Lactobacillus acidophilus NCFM, Lactobacillus paracasei Lpc-37, Bifidobacterium lactis Bl-04, and Bifidobacterium lactis Bi-07 (Bactiol duo®). Study treatment was initiated within 48 h of the antibiotic being initiated. Most of the patients included were elderly with a mean age of 78 years old with multiple comorbidities. Stools were collected at the time of inclusion in the trial, at the end of the antibiotic treatment, and the end of the study treatment. These were cultured on selective antibiotic media. Results: Treatment with the probiotic mixture led to a significant decline in colonization with Pseudomonas after antibiotic treatment from 25 to 8.3% (p = 0.041). Colonization with AmpC-producing enterobacteria was transiently increased after the antibiotic treatment (p = 0.027) and declined after the probiotic intervention (p= 0.041). No significant changes were observed in the placebo and Saccharomyces groups. Up to 2 years after the trial, no infection with ESBL-producing bacteria was observed in the probiotic mixture group. Conclusion: The association of Saccharomyces boulardii with specific strains of Lactobacillus and Bifidobacterium influences antibiotic treatment by counteracting the colonization of the colon microbiota with antibiotic-resistant pathogens. |
format | Online Article Text |
id | pubmed-7982943 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79829432021-03-23 Do Probiotics During In-Hospital Antibiotic Treatment Prevent Colonization of Gut Microbiota With Multi-Drug-Resistant Bacteria? A Randomized Placebo-Controlled Trial Comparing Saccharomyces to a Mixture of Lactobacillus, Bifidobacterium, and Saccharomyces Wieërs, Grégoire Verbelen, Valérie Van Den Driessche, Mieke Melnik, Ekaterina Vanheule, Greet Marot, Jean-Christophe Cani, Patrice D. Front Public Health Public Health Objective: Most infections with Enterobacteriaceae producing AmpC β-lactamase (AmpC)-, extended-spectrum β-lactamase (ESBL)-, and carbapenemase-producing bacteria, vancomycin-resistant Enterococcus as well as naturally resistant non-fermenting bacteria such as Pseudomonas aeruginosa, are related to a prior colonization of the gut microbiota. The objective of this study was to determine whether treatment with probiotics during an antibiotic treatment could prevent the colonization of the gut microbiota with multi-drug resistant bacteria. Method: In total, 120 patients treated for 10 days with amoxicillin-clavulanate antibiotics were included in a randomized, placebo-controlled, double-blinded trial, comparing the effects of a 30 days treatment with placebo Saccharomyces boulardii CNCM I-745® and a probiotic mixture containing Saccharomyces boulardii, Lactobacillus acidophilus NCFM, Lactobacillus paracasei Lpc-37, Bifidobacterium lactis Bl-04, and Bifidobacterium lactis Bi-07 (Bactiol duo®). Study treatment was initiated within 48 h of the antibiotic being initiated. Most of the patients included were elderly with a mean age of 78 years old with multiple comorbidities. Stools were collected at the time of inclusion in the trial, at the end of the antibiotic treatment, and the end of the study treatment. These were cultured on selective antibiotic media. Results: Treatment with the probiotic mixture led to a significant decline in colonization with Pseudomonas after antibiotic treatment from 25 to 8.3% (p = 0.041). Colonization with AmpC-producing enterobacteria was transiently increased after the antibiotic treatment (p = 0.027) and declined after the probiotic intervention (p= 0.041). No significant changes were observed in the placebo and Saccharomyces groups. Up to 2 years after the trial, no infection with ESBL-producing bacteria was observed in the probiotic mixture group. Conclusion: The association of Saccharomyces boulardii with specific strains of Lactobacillus and Bifidobacterium influences antibiotic treatment by counteracting the colonization of the colon microbiota with antibiotic-resistant pathogens. Frontiers Media S.A. 2021-03-08 /pmc/articles/PMC7982943/ /pubmed/33763399 http://dx.doi.org/10.3389/fpubh.2020.578089 Text en Copyright © 2021 Wieërs, Verbelen, Van Den Driessche, Melnik, Vanheule, Marot and Cani. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Public Health Wieërs, Grégoire Verbelen, Valérie Van Den Driessche, Mieke Melnik, Ekaterina Vanheule, Greet Marot, Jean-Christophe Cani, Patrice D. Do Probiotics During In-Hospital Antibiotic Treatment Prevent Colonization of Gut Microbiota With Multi-Drug-Resistant Bacteria? A Randomized Placebo-Controlled Trial Comparing Saccharomyces to a Mixture of Lactobacillus, Bifidobacterium, and Saccharomyces |
title | Do Probiotics During In-Hospital Antibiotic Treatment Prevent Colonization of Gut Microbiota With Multi-Drug-Resistant Bacteria? A Randomized Placebo-Controlled Trial Comparing Saccharomyces to a Mixture of Lactobacillus, Bifidobacterium, and Saccharomyces |
title_full | Do Probiotics During In-Hospital Antibiotic Treatment Prevent Colonization of Gut Microbiota With Multi-Drug-Resistant Bacteria? A Randomized Placebo-Controlled Trial Comparing Saccharomyces to a Mixture of Lactobacillus, Bifidobacterium, and Saccharomyces |
title_fullStr | Do Probiotics During In-Hospital Antibiotic Treatment Prevent Colonization of Gut Microbiota With Multi-Drug-Resistant Bacteria? A Randomized Placebo-Controlled Trial Comparing Saccharomyces to a Mixture of Lactobacillus, Bifidobacterium, and Saccharomyces |
title_full_unstemmed | Do Probiotics During In-Hospital Antibiotic Treatment Prevent Colonization of Gut Microbiota With Multi-Drug-Resistant Bacteria? A Randomized Placebo-Controlled Trial Comparing Saccharomyces to a Mixture of Lactobacillus, Bifidobacterium, and Saccharomyces |
title_short | Do Probiotics During In-Hospital Antibiotic Treatment Prevent Colonization of Gut Microbiota With Multi-Drug-Resistant Bacteria? A Randomized Placebo-Controlled Trial Comparing Saccharomyces to a Mixture of Lactobacillus, Bifidobacterium, and Saccharomyces |
title_sort | do probiotics during in-hospital antibiotic treatment prevent colonization of gut microbiota with multi-drug-resistant bacteria? a randomized placebo-controlled trial comparing saccharomyces to a mixture of lactobacillus, bifidobacterium, and saccharomyces |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7982943/ https://www.ncbi.nlm.nih.gov/pubmed/33763399 http://dx.doi.org/10.3389/fpubh.2020.578089 |
work_keys_str_mv | AT wieersgregoire doprobioticsduringinhospitalantibiotictreatmentpreventcolonizationofgutmicrobiotawithmultidrugresistantbacteriaarandomizedplacebocontrolledtrialcomparingsaccharomycestoamixtureoflactobacillusbifidobacteriumandsaccharomyces AT verbelenvalerie doprobioticsduringinhospitalantibiotictreatmentpreventcolonizationofgutmicrobiotawithmultidrugresistantbacteriaarandomizedplacebocontrolledtrialcomparingsaccharomycestoamixtureoflactobacillusbifidobacteriumandsaccharomyces AT vandendriesschemieke doprobioticsduringinhospitalantibiotictreatmentpreventcolonizationofgutmicrobiotawithmultidrugresistantbacteriaarandomizedplacebocontrolledtrialcomparingsaccharomycestoamixtureoflactobacillusbifidobacteriumandsaccharomyces AT melnikekaterina doprobioticsduringinhospitalantibiotictreatmentpreventcolonizationofgutmicrobiotawithmultidrugresistantbacteriaarandomizedplacebocontrolledtrialcomparingsaccharomycestoamixtureoflactobacillusbifidobacteriumandsaccharomyces AT vanheulegreet doprobioticsduringinhospitalantibiotictreatmentpreventcolonizationofgutmicrobiotawithmultidrugresistantbacteriaarandomizedplacebocontrolledtrialcomparingsaccharomycestoamixtureoflactobacillusbifidobacteriumandsaccharomyces AT marotjeanchristophe doprobioticsduringinhospitalantibiotictreatmentpreventcolonizationofgutmicrobiotawithmultidrugresistantbacteriaarandomizedplacebocontrolledtrialcomparingsaccharomycestoamixtureoflactobacillusbifidobacteriumandsaccharomyces AT canipatriced doprobioticsduringinhospitalantibiotictreatmentpreventcolonizationofgutmicrobiotawithmultidrugresistantbacteriaarandomizedplacebocontrolledtrialcomparingsaccharomycestoamixtureoflactobacillusbifidobacteriumandsaccharomyces |