Neonatal sepsis associated with Lactobacillus supplementation

Cavicchiolo, Maria Elena; Magnani, Margherita; Calgaro, Serena; Bonadies, Luca; Castagliulo, Ignazio; Morelli, L.; Verlato, Giovanna; Baraldi, Eugenio

doi:10.1515/jpm-2019-0268

Cited by 17 publications

(18 citation statements)

References 9 publications

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“…The paper from Cavicchiolo et al. () describes bacteraemia in three premature babies due to L. rhamnosus . One of them, a girl born at 31 weeks gestation and weighing 770 g at birth, had been fed with a probiotic supplement from her third day onwards.…”

Section: Assessmentmentioning

confidence: 99%

“…Full paper review allowed the recognition of three articles dealing with safety concerns. Two of them dealt with L. rhamnosus infections linked to probiotic consumption (Cavicchiolo et al, 2019;Yelin et al, 2019) while the third described a prosthetic aortic valve endocarditis that was associated with L. paracasei in a patient with no history of probiotic intake (Ajam et al, 2019). The ascription of this last case is doubtful; the organism was isolated from blood and identified 'by culture' with no further specification.…”

Section: Lactobacillus Sppmentioning

confidence: 99%

“…In addition, she had suffered an aortic stenosis 9 years previously that needed to be replaced by the prosthetic valve that became colonised. The paper from Cavicchiolo et al (2019) describes bacteraemia in three premature babies due to L. rhamnosus. One of them, a girl born at 31 weeks gestation and weighing 770 g at birth, had been fed with a probiotic supplement from her third day onwards.…”

Section: Lactobacillus Sppmentioning

confidence: 99%

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Update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA 12: suitability of taxonomic units notified to EFSA until March 2020

Koutsoumanis¹,

Allende²,

Álvarez‐Ordóñez³

et al. 2020

EFS2

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The qualified presumption of safety (QPS) was developed to provide a generic safety evaluation for biological agents to support EFSA's Scientific Panels. It is based on an assessment of the taxonomic identity, the body of knowledge, safety concerns and antimicrobial resistance. Safety concerns identified for a taxonomic unit (TU) are where possible to be confirmed at strain or product level, reflected by ‘qualifications’. No new information was found that would change the previously recommended QPS TUs of the 39 microorganisms notified to EFSA between October 2019 and March 2020, 33 were excluded, including five filamentous fungi, five Escherichia coli, two Enterococcus faecium, two Streptomyces spp. and 19 TUs already evaluated. Six TUs were evaluated. Akkermansia muciniphila was not recommended for QPS status due to safety concerns. Clostridium butyricum was not recommended because some strains contain pathogenicity factors. This TU was excluded for further QPS evaluation. Galdieria sulphuraria and Pseudomonas chlororaphis were also rejected due to a lack of body of knowledge. The QPS status of Corynebacterium ammoniagenes (with the qualification ‘for production purposes only’) and of Komagataella pastoris (with the qualification ‘for enzyme production’) was confirmed. In relation to the taxonomic revision of the Lactobacillus genus, previously designated Lactobacillus species will be reassigned to the new species and both the old and new names will be retained in the QPS list.

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Section: Assessmentmentioning

confidence: 99%

Section: Lactobacillus Sppmentioning

confidence: 99%

Section: Lactobacillus Sppmentioning

confidence: 99%

See 1 more Smart Citation

Update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA 12: suitability of taxonomic units notified to EFSA until March 2020

Koutsoumanis¹,

Allende²,

Álvarez‐Ordóñez³

et al. 2020

EFS2

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“…In this case, the probiotic supplement yielded growth of Rhizopus species on microbial culture, and the same species was identified upon DNA sequencing of a resected intestinal tissue specimen from the infant [ 65 ]. Adverse effects of probiotics, namely probiotic-associated bacteremia or sepsis, have been reported in case reports [ 66 , 67 , 68 , 69 ] as well as in a recent analysis of Lactobacillus bacteremia in intensive care units (ICUs) [ 70 ]. In this analysis, 522 critically ill neonatal and pediatric patients treated with L. rhamnosus strain GG probiotics demonstrated a higher risk of developing Lactobacillus bacteremia than patients receiving no probiotic supplementation [ 70 ].…”

Section: Probiotics and The Preterm Infant Microbiomementioning

confidence: 99%

The Role of Human Milk Oligosaccharides and Probiotics on the Neonatal Microbiome and Risk of Necrotizing Enterocolitis: A Narrative Review

2020

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Preterm infants are a vulnerable population at risk of intestinal dysbiosis. The newborn microbiome is dominated by Bifidobacterium species, though abnormal microbial colonization can occur by exogenous factors such as mode of delivery, formula feeding, and exposure to antibiotics. Therefore, preterm infants are predisposed to sepsis and necrotizing enterocolitis (NEC), a fatal gastrointestinal disorder, due to an impaired intestinal barrier, immature immunity, and a dysbiotic gut microbiome. Properties of human milk serve as protection in the prevention of NEC. Human milk oligosaccharides (HMOs) and the microbiome of breast milk are immunomodulatory components that provide intestinal homeostasis through regulation of the microbiome and protection of the intestinal barrier. Enteral probiotic supplements have been trialed to evaluate their impact on establishing intestinal homeostasis. Here, we review the protective role of HMOs, probiotics, and synbiotic combinations in protecting a vulnerable population from the pathogenic features associated with necrotizing enterocolitis.

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“…Probiotics were administered as enteral supplementation in all cases: orally or via a nasogastric tube or through gastrostomy, according to patients' clinical conditions. In most reports, the etiological agents were identified both by blood cultures and strain-specific polymerase chain reaction (PCR) (61%) [27][28][29][30][31][32][33]35,42,[50][51][52][53][54]56,58,59,62]; in 17 cases (34%), causative microorganisms were isolated from cultures [27,[37][38][39][40][41][43][44][45]48,55,57,60,61], and in 3 of these (6%), the causative microorganisms were isolated both from blood culture and from central venous catheter (CVC) tip culture [46,47,49]. The pathogen was isolated from bronchoalveolar lavage (BAL) culture in the patient with pneumonia and confirmed with PCR analysis [36].…”

Section: Resultsmentioning

confidence: 99%

Invasive Infections Associated with the Use of Probiotics in Children: A Systematic Review

et al. 2021

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Although the effectiveness of probiotics has only been proven in specific conditions, their use in children is massively widespread because of their perception as harmless products. Recent evidence raises concerns about probiotics’ safety, especially but not only in the paediatric population due to severe opportunistic infections after their use. This review aimed at summarising available case reports on invasive infections related to probiotics’ use in children. For this purpose, we assessed three electronic databases to identify papers describing paediatric patients with documented probiotic-derived invasive infections, with no language restrictions. A total of 49 case reports from 1995 to June 2021 were identified. The infections were caused by Lactobacillus spp. (35%), Saccharomyces spp. (29%), Bifidobacterium spp. (31%), Bacillus clausii (4%), and Escherichia coli (2%). Most (80%) patients were younger than 2 years old and sepsis was the most observed condition (69.4%). All the patients except one had at least one condition facilitating the development of invasive infection, with prematurity (55%) and intravenous catheter use (51%) being the most frequent. Three (6%) children died. Given the large use of probiotics, further studies aiming at evaluating the real incidence of probiotic-associated systemic infections are warranted.

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Neonatal sepsis associated with Lactobacillus supplementation

Cited by 17 publications

References 9 publications

Update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA 12: suitability of taxonomic units notified to EFSA until March 2020

Update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA 12: suitability of taxonomic units notified to EFSA until March 2020

The Role of Human Milk Oligosaccharides and Probiotics on the Neonatal Microbiome and Risk of Necrotizing Enterocolitis: A Narrative Review

Invasive Infections Associated with the Use of Probiotics in Children: A Systematic Review

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