S A Cohen1,2, M C Woodfield1, N Boyle1, Z Stednick1, M Boeckh1,2, S A Pergam3,4,5. 1. Fred Hutchinson Cancer Research Center, Seattle, Washington, USA. 2. Department of Medicine, University of Washington, Seattle, Washington, USA. 3. Fred Hutchinson Cancer Research Center, Seattle, Washington, USA. spergam@fhcrc.org. 4. Department of Medicine, University of Washington, Seattle, Washington, USA. spergam@fhcrc.org. 5. Infection Prevention, Seattle Cancer Care Alliance, Seattle, Washington, USA. spergam@fhcrc.org.
Abstract
BACKGROUND: Probiotic supplementation has been promoted for numerous health conditions; however, safety in immunosuppressed patients is unknown. We evaluated bloodstream infections (BSIs) caused by common probiotic organisms in hematopoietic cell transplant recipients. METHODS: All blood culture (BC) results from a cohort of hematopoietic cell transplant recipients transplanted at Fred Hutchinson Cancer Research Center in Seattle, Washington, between 2002 and 2011 were reviewed. Patients with at least 1 positive BC for common probiotic organisms (Lactobacillus species, Bifidobacterium species, Streptococcus thermophilus, and Saccharomyces species) within 1 year post hematopoietic cell transplantation (HCT) were considered cases. Data were collected from center databases, which contain archived laboratory data, patient demographics, and clinical summaries. RESULTS: A total of 19/3796 (0.5%) patients developed a BSI from one of these organisms within 1 year post HCT; no Bifidobacterium species or S. thermophilus were identified. Cases had a median age of 49 years (interquartile range [IQR]: 39-53), and the majority were allogeneic hematopoietic cell transplant recipients (14/19, 74%). Most positive BCs were Lactobacillus species (18/19) and occurred at a median of 84 days (IQR: 34-127) post transplant. The incidence rate of Lactobacillus bacteremia was 1.62 cases per 100,000 patient-days; the highest rate occurred within 100 days post transplant (3.3 per 100,000 patient-days). Eight patients (44%) were diagnosed with acute graft-versus-host disease of the gut prior to the development of bacteremia. No mortality was attributable to any of these infections. CONCLUSION: Organisms frequently incorporated in available over-the-counter probiotics are infrequent causes of bacteremia after HCT. Studies evaluating the use of probiotics among high-risk patients are needed.
BACKGROUND: Probiotic supplementation has been promoted for numerous health conditions; however, safety in immunosuppressed patients is unknown. We evaluated bloodstream infections (BSIs) caused by common probiotic organisms in hematopoietic cell transplant recipients. METHODS: All blood culture (BC) results from a cohort of hematopoietic cell transplant recipients transplanted at Fred Hutchinson Cancer Research Center in Seattle, Washington, between 2002 and 2011 were reviewed. Patients with at least 1 positive BC for common probiotic organisms (Lactobacillus species, Bifidobacterium species, Streptococcus thermophilus, and Saccharomyces species) within 1 year post hematopoietic cell transplantation (HCT) were considered cases. Data were collected from center databases, which contain archived laboratory data, patient demographics, and clinical summaries. RESULTS: A total of 19/3796 (0.5%) patients developed a BSI from one of these organisms within 1 year post HCT; no Bifidobacterium species or S. thermophilus were identified. Cases had a median age of 49 years (interquartile range [IQR]: 39-53), and the majority were allogeneic hematopoietic cell transplant recipients (14/19, 74%). Most positive BCs were Lactobacillus species (18/19) and occurred at a median of 84 days (IQR: 34-127) post transplant. The incidence rate of Lactobacillus bacteremia was 1.62 cases per 100,000 patient-days; the highest rate occurred within 100 days post transplant (3.3 per 100,000 patient-days). Eight patients (44%) were diagnosed with acute graft-versus-host disease of the gut prior to the development of bacteremia. No mortality was attributable to any of these infections. CONCLUSION: Organisms frequently incorporated in available over-the-counter probiotics are infrequent causes of bacteremia after HCT. Studies evaluating the use of probiotics among high-risk patients are needed.
Authors: Arnoldo J Riquelme; Mario A Calvo; Ana M Guzmán; María S Depix; Patricia García; Carlos Pérez; Marco Arrese; Jaime A Labarca Journal: J Clin Gastroenterol Date: 2003-01 Impact factor: 3.062
Authors: Bradley C Johnston; Stephanie S Y Ma; Joshua Z Goldenberg; Kristian Thorlund; Per O Vandvik; Mark Loeb; Gordon H Guyatt Journal: Ann Intern Med Date: 2012-12-18 Impact factor: 25.391
Authors: E J Ladas; M Bhatia; L Chen; E Sandler; A Petrovic; D M Berman; F Hamblin; M Gates; R Hawks; L Sung; M Nieder Journal: Bone Marrow Transplant Date: 2015-11-16 Impact factor: 5.483
Authors: Mary Hickson; Aloysius L D'Souza; Nirmala Muthu; Thomas R Rogers; Susan Want; Chakravarthi Rajkumar; Christopher J Bulpitt Journal: BMJ Date: 2007-06-29
Authors: Eija Nissilä; François P Douillard; Jarmo Ritari; Lars Paulin; Hanna M Järvinen; Pia Rasinkangas; Karita Haapasalo; Seppo Meri; Hanna Jarva; Willem M de Vos Journal: PLoS One Date: 2017-05-11 Impact factor: 3.240