Assuntos
Bacteriemia/diagnóstico , Infecções por Bifidobacteriales/diagnóstico , Bifidobacterium/isolamento & purificação , Leucemia-Linfoma Linfoblástico de Células Precursoras , Probióticos/efeitos adversos , Bacteriemia/etiologia , Infecções por Bifidobacteriales/etiologia , Pré-Escolar , Diagnóstico Diferencial , Humanos , Intestinos/microbiologia , Masculino , MicrobiotaRESUMO
BACKGROUND: The use of probiotics as prophylaxis for necrotizing enterocolitis (NEC) in preterm infants is being increasingly practised. OBJECTIVE: We report, for the first time, a case series of 3 preterm, very-low-birth-weight (VLBW) infants who developed bacteremia with Bifidobacterium longum on probiotic therapy with Infloran® containing viable B. longum. METHODS: We retrospectively reviewed data of 3 infants (of gestational age <30 weeks and birth weight <1,230 g). They were admitted to the neonatal intensive care unit. Clinical data were retrieved from their medical records. RESULTS: In infants 1 and 2, B. longum was isolated from the blood cultures when they were on probiotic therapy with Infloran or shortly after, respectively, and was interpreted as transient bacteremia. The clinical presentation of these infants did not require antibiotic treatment after the isolation of B. longum. Infant 3 developed an NEC despite probiotic therapy with Infloran and the blood cultures showed B. longum growth. This infant required explorative laparotomy and antibiotic treatment. The clinical isolates of B. longum and the strain of the Infloran capsule showed an identical profile on biochemical, mass-spectrometric and molecular analyses, suggesting a direct correlation between the administration of probiotics and bacteremia with B. longum in all 3 infants. CONCLUSIONS: The occurrence of bacteremia with bifidobacteria after its prophylactic administration in VLBW infants and its possible clinical consequences are a matter of concern. In the interests of safety, the use of probiotics in such a population should be indicated with caution and requires further investigation.
Assuntos
Bacteriemia , Infecções por Bifidobacteriales , Bifidobacterium/isolamento & purificação , Enterocolite Necrosante/prevenção & controle , Probióticos , Bacteriemia/diagnóstico , Bacteriemia/etiologia , Bacteriemia/fisiopatologia , Infecções por Bifidobacteriales/diagnóstico , Infecções por Bifidobacteriales/etiologia , Infecções por Bifidobacteriales/fisiopatologia , Suplementos Nutricionais/efeitos adversos , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Recém-Nascido de muito Baixo Peso , Masculino , Probióticos/administração & dosagem , Probióticos/efeitos adversos , Resultado do TratamentoRESUMO
We report the one case of sepsis caused by Bifidobacterium breve administered as probiotic therapy. Probiotics can be a potential cause of an invasive disease and should be used with care in vulnerable patients.
Assuntos
Infecções por Bifidobacteriales/etiologia , Bifidobacterium/isolamento & purificação , Hérnia Umbilical/cirurgia , Cuidados Pós-Operatórios/efeitos adversos , Probióticos/efeitos adversos , Sepse/etiologia , Antibacterianos/uso terapêutico , Infecções por Bifidobacteriales/tratamento farmacológico , Infecções por Bifidobacteriales/microbiologia , Feminino , Humanos , Recém-Nascido , Cuidados Pós-Operatórios/métodos , Gravidez , Probióticos/uso terapêutico , Sepse/tratamento farmacológico , Sepse/microbiologia , Infecção da Ferida Cirúrgica/prevenção & controleRESUMO
Lactobacilli and bifidobacteria are extremely rare causes of infection in humans, as are probiotics based on these organisms. This lack of pathogenicity extends across all age groups and to immunocompromised individuals. Strains used for new probiotics should be chosen from the commensal flora of humans and should not carry intrinsic resistance to antibiotics that would prevent treatment of a rare probiotic infection. Vigilance regarding the detection of possible rare cases of infection due to probiotics should be maintained, and isolates should be sent to reference centers for molecular characterization and confirmation.