Probiotics do not help prevent gastrointestinal colonization with MDROs in critically ill patients

Probiotics show no benefit for preventing or eliminating gastrointestinal colonization with drug-resistant organisms in patients in the intensive care unit compared to standard care, according to new research published online today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

"Our research suggests that probiotics do not help prevent gastrointestinal colonization with multidrug-resistant organisms in critically ill patients," said Jennie H. Kwon, DO, lead author of the study.

This prospective, randomized controlled pilot study, conducted over a 21-month period, followed 70 patients admitted to intensive care units at Barnes-Jewish Hospital in St. Louis. The research team from the Washington University School of Medicine in St. Louis sought to determine if the probiotic Lactobacillus rhamnosus GG could prevent gastrointestinal colonization of multi-drug resistant organisms (MDROs), such as Clostridium difficile, vancomycin-resistant Enterococcus (VRE), and Pseudomonas aeruginosa. Each patient was followed for 14 days or until they left the unit

There was no significant difference in overall acquisition of any MRDOs between the two groups. A safety assessment of the use of probiotics in this patient population found that there were no significant differences in mortality rates between the two groups and no adverse events related to use of the probiotic.

Limitations of the study included the small sample size of patients, duration of follow-up, and inclusion of a single type of dose of probiotic.

"Further research is needed on this emerging intervention to evaluate the effectiveness in preventing intestinal colonization of drug-resistant organisms," said Dr. Kwon. Researchers also noted that their study was confined to lower intestinal bacteria and did not assess possible impact on bacteria in the stomach or upper airways.

Jennie H. Kwon, Kerry M. Bommarito, Kimberly A. Reske, Sondra M. Seiler, Tiffany Hink, Hilary M. Babcock, Marin H. Kollef, Victoria J. Fraser, Carey-Ann D. Burnham, Erik R. Dubberke. "Randomized Controlled Trial to Determine the Impact of Probiotic Administration on Colonization With Multidrug-Resistant Organisms in Critically Ill Patients." Web (August 27, 2015).