<i>Lactobacillus</i>Bacteremia during a Rapid Increase in Probiotic Use of<i>Lactobacillus rhamnosus</i>GG in Finland

Salminen, Minna; Tynkkynen, Soile; Rautelin, Hilpi; Saxelin, Maija; Vaara, Martti; Ruutu, Petri; Sarna, Seppo; Valtonen, Ville; Järvinen, Asko

doi:10.1086/342912

Cited by 363 publications

(251 citation statements)

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“…rhamnosus GG, originally cultured from a healthy human intestinal source, has been thoroughly studied and used safely as a probiotic strain in a variety of functional foods for nearly 20 years (2,3,(17)(18)(19)(20). In our efforts to decipher the molecular mechanisms involved in the interaction between strain GG and the human host, we determined the complete genome sequences for L. rhamnosus GG and L. rhamnosus LC705, an industrial strain used routinely as an adjunct starter culture in dairy products (21).…”

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confidence: 99%

Comparative genomic analysis of Lactobacillus rhamnosus GG reveals pili containing a human- mucus binding protein

Kankainen

Paulín

Tynkkynen

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

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To unravel the biological function of the widely used probiotic bacterium Lactobacillus rhamnosus GG, we compared its 3.0-Mbp genome sequence with the similarly sized genome of L. rhamnosus LC705, an adjunct starter culture exhibiting reduced binding to mucus. Both genomes demonstrated high sequence identity and synteny. However, for both strains, genomic islands, 5 in GG and 4 in LC705, punctuated the colinearity. A significant number of strain-specific genes were predicted in these islands (80 in GG and 72 in LC705). The GG-specific islands included genes coding for bacteriophage components, sugar metabolism and transport, and exopolysaccharide biosynthesis. One island only found in L. rhamnosus GG contained genes for 3 secreted LPXTG-like pilins (spaCBA) and a pilin-dedicated sortase. Using anti-SpaC antibodies, the physical presence of cell wall-bound pili was confirmed by immunoblotting. Immunogold electron microscopy showed that the SpaC pilin is located at the pilus tip but also sporadically throughout the structure. Moreover, the adherence of strain GG to human intestinal mucus was blocked by SpaC antiserum and abolished in a mutant carrying an inactivated spaC gene. Similarly, binding to mucus was demonstrated for the purified SpaC protein. We conclude that the presence of SpaC is essential for the mucus interaction of L. rhamnosus GG and likely explains its ability to persist in the human intestinal tract longer than LC705 during an intervention trial. The presence of mucus-binding pili on the surface of a nonpathogenic Gram-positive bacterial strain reveals a previously undescribed mechanism for the interaction of selected probiotic lactobacilli with host tissues.genome ͉ probiotics ͉ adhesion ͉ pilus ͉ lactic acid bacteria

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confidence: 99%

Comparative genomic analysis of Lactobacillus rhamnosus GG reveals pili containing a human- mucus binding protein

Kankainen

Paulín

Tynkkynen

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

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901

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“…endocarditis, sepsis, or liver abscesses) [19]. More frequent Lactobacillus GG bacteremia has not been observed in connection with an increased use of this probiotic in Finland [186]. Prolonged administration of S. boulardii to immunosuppressed, polymorbid, and critically ill subjects deserves increased attention [187][188][189].…”

Section: Dosagementioning

confidence: 99%

Probiotics and prebiotics — renaissance of a therapeutic principle

Frič

2007

Open Medicine

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AbstractProbiotics are nonpathogenic microorganisms mostly of human origin which, when administered in adequate amounts, confer a health benefit on the host and enable to prevent or improve some diseases. Probiotics may be a natural temporary constituent of the resident intestinal microflora, but their concentration is not sufficient for therapeutic purposes. The microbiota, the intestinal epithelium, and the mucosal immune system constitute the gastrointestinal ecosystem. All three components are essential for complete functional and developmental maturity of the system. The viability of intestinal microflora (including probiotic strains) requires the availability of nutritional substrates (prebiotics), i.e. various types of fiber and oligosaccharides. Prebiotics are cleaved by microbial enzymes to numerous substances (short-chain fatty acids, aminoacids, polyamines, growth factors, vitamins and antioxidants) indispensable for metabolic and functional activities of the intestinal mucosa. The principal probiotics in use include lactobacilli, bifidobacteria, some nonpathogenic strains of Escherichia coli, and Saccharomyces boulardii. These microbiota display favourable effects which qualify them for therapeutic use. For this purpose, probiotics have to fulfill a series of requirements verifying their efficacy and safety. Experimental and clinical studies examine the prerequisites for the administration of probiotics in digestive diseases, allergic and atopic affections, as well as in some extraintestinal conditions. Future goals of probiotic application include genomic analysis, controlled postnatal colonisation of the digestive tract, the use of probiotics as carriers of peroral vaccines, and recombinant probiotics with in-situ production and targeted application of therapeutic molecules.

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“…Infections rates for lactobacilli have been estimated at 0.1-0.4% (Gasser, 1994;Saxelin et al, 1996;Salminen et al, 2004) of all blood infections. For bifidobacteria these number appear to be at least a factor of 10 lower (Salminen et al, 2002). What groups of patients may contract Lactobacillus infections?…”

Section: The Role Of the Hostmentioning

confidence: 99%

“…In a survey of blood culture isolates in Finland (see also below), 89 cases of Lactobacillus bacteraemia were identified. Of these, 11 were indistinguishable from Lactobacillus GG based on PFGE analysis with 4 different restriction enzymes (Salminen et al, 2002;2004). However, analysis of the phenotypic properties of these Lactobacillus GG-like isolates indicated they differed in one or more properties (Ouwehand et al, 2004b).…”

Section: The Role Of the Hostmentioning

confidence: 99%

Assuring the continued safety of lactic acid bacteria used as probiotics

Gueimonde

Frías

Ouwehand³

2006

Biologia

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Lactic acid bacteria have long been used to improve the safety of foods through fermentation. Some fermented products were also early used for their perceived health benefits, which lead to the development of probiotics as we now know them. Probiotics mainly belong to the genera Lactobacillus and Bifidobacterium. Most members of these genera are not considered pathogens or even opportunistic pathogens. Nevertheless, rare cases of Lactobacillus and Bifidobacterium infection have been reported, possibly even associated with the consumption of probiotic products. Such cases are extremely rare and the subjects always had severe underlying conditions most often affecting the immune system. There does not seem to be any risk for the general population. Safety assessments can be performed and many possible tests exist. It is, however, not certain these tests will prevent rare case of Lactobacillus infection in certain high-risk patients. The benefits of probiotic use should be weighed against the possible small risk. Such an evaluation will, in most cases, be favourable and should therefore not discourage consumption of probiotics.

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LactobacillusBacteremia during a Rapid Increase in Probiotic Use ofLactobacillus rhamnosusGG in Finland

Cited by 363 publications

References 21 publications

Comparative genomic analysis of Lactobacillus rhamnosus GG reveals pili containing a human- mucus binding protein

Comparative genomic analysis of Lactobacillus rhamnosus GG reveals pili containing a human- mucus binding protein

Probiotics and prebiotics — renaissance of a therapeutic principle

Assuring the continued safety of lactic acid bacteria used as probiotics

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