Probiotics and intestinal decolonization of antibiotic-resistant microorganisms; A reality or fantasy?

Keikha, Masoud

doi:10.1016/j.amsu.2022.104269

Cited by 9 publications

(7 citation statements)

References 25 publications

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“…Most probiotics derive from fermented foods (e.g., yogurt, cheese) that contain a large quantity of Lactobacillales able to replace the initial high concentration of Ent in these nutrients thanks to the production of lactic acid. Moreover, probiotic organisms can compete with intestinal pathogens by excreting toxins, antimicrobial compounds (e.g., short-chain fatty acids, microcins) and adherence factors, potentiating the immune system and reinforcing mucosa production [ 235 , 236 ]. Therefore, probiotics could be implemented as food additives to eradicate the pathogenic and/or MDR- Ent colonizing the intestinal tract in humans and animals.…”

Section: Strategies To Decolonize Carriersmentioning

confidence: 99%

Intestinal colonization with multidrug-resistant Enterobacterales: screening, epidemiology, clinical impact, and strategies to decolonize carriers

Campos-Madueno

Moradi

Eddoubaji

et al. 2023

Eur J Clin Microbiol Infect Dis

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The clinical impact of infections due to extended-spectrum β-lactamase (ESBL)- and/or carbapenemase-producing Enterobacterales (Ent) has reached dramatic levels worldwide. Infections due to these multidrug-resistant (MDR) pathogens—especially Escherichia coli and Klebsiella pneumoniae—may originate from a prior asymptomatic intestinal colonization that could also favor transmission to other subjects. It is therefore desirable that gut carriers are rapidly identified to try preventing both the occurrence of serious endogenous infections and potential transmission. Together with the infection prevention and control countermeasures, any strategy capable of effectively eradicating the MDR-Ent from the intestinal tract would be desirable. In this narrative review, we present a summary of the different aspects linked to the intestinal colonization due to MDR-Ent. In particular, culture- and molecular-based screening techniques to identify carriers, data on prevalence and risk factors in different populations, clinical impact, length of colonization, and contribution to transmission in various settings will be overviewed. We will also discuss the standard strategies (selective digestive decontamination, fecal microbiota transplant) and those still in development (bacteriophages, probiotics, microcins, and CRISPR-Cas-based) that might be used to decolonize MDR-Ent carriers.

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Section: Strategies To Decolonize Carriersmentioning

confidence: 99%

Intestinal colonization with multidrug-resistant Enterobacterales: screening, epidemiology, clinical impact, and strategies to decolonize carriers

Campos-Madueno

Moradi

Eddoubaji

et al. 2023

Eur J Clin Microbiol Infect Dis

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“…In vitro and in vivo data demonstrate certain probiotics can reduce the abundance of Enterobacterales in the gut [ 34 ] and can have inhibitory activity against them [ 35 , 36 ], including ESBL-E [ 37 ]. A recent analysis of 14 clinical studies investigating the efficacy of probiotics to restore the microbiota in those with ARO (including nine studies targeting antimicrobial-resistant Enterobacterales) did not find any advantage of these products [ 38 ]. Many of the clinical studies investigating probiotics have used the eradication of ARO as the primary end-point (usually using culture-based techniques).…”

Section: Strategies To Reduce Expansion Of the Gut Resistome By Modul...mentioning

confidence: 99%

Modulation of the Gut Microbiota to Control Antimicrobial Resistance (AMR)—A Narrative Review with a Focus on Faecal Microbiota Transplantation (FMT)

Merrick,

Sergaki,

Edwards

et al. 2023

Infectious Disease Reports

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Antimicrobial resistance (AMR) is one of the greatest challenges facing humanity, causing a substantial burden to the global healthcare system. AMR in Gram-negative organisms is particularly concerning due to a dramatic rise in infections caused by extended-spectrum beta-lactamase and carbapenemase-producing Enterobacterales (ESBL and CPE). These pathogens have limited treatment options and are associated with poor clinical outcomes, including high mortality rates. The microbiota of the gastrointestinal tract acts as a major reservoir of antibiotic resistance genes (the resistome), and the environment facilitates intra and inter-species transfer of mobile genetic elements carrying these resistance genes. As colonisation often precedes infection, strategies to manipulate the resistome to limit endogenous infections with AMR organisms, as well as prevent transmission to others, is a worthwhile pursuit. This narrative review presents existing evidence on how manipulation of the gut microbiota can be exploited to therapeutically restore colonisation resistance using a number of methods, including diet, probiotics, bacteriophages and faecal microbiota transplantation (FMT).

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“…However, in adults, opposing person-specific and antibiotic-dependent effects of probiotics on ARG burden were observed, which were related to the permissiveness to probiotic colonization [ 127 ]. The analysis of fourteen clinical studies regarding the efficacy of probiotics in the eradication of the intestinal possession of multidrug-resistant organisms (MDROs) concluded no significant effect of probiotics with respect to the placebo [ 128 ]. Further studies will be necessary to understand the role of probiotics on the infant resistome.…”

Section: Impact Of Increased Levels Of Args On Health and Mitigation ...mentioning

confidence: 99%

Old Folks, Bad Boon: Antimicrobial Resistance in the Infant Gut Microbiome

et al. 2023

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The development of the intestinal microbiome in the neonate starts, mainly, at birth, when the infant receives its founding microbial inoculum from the mother. This microbiome contains genes conferring resistance to antibiotics since these are found in some of the microorganisms present in the intestine. Similarly to microbiota composition, the possession of antibiotic resistance genes is affected by different perinatal factors. Moreover, antibiotics are the most used drugs in early life, and the use of antibiotics in pediatrics covers a wide variety of possibilities and treatment options. The disruption in the early microbiota caused by antibiotics may be of great relevance, not just because it may limit colonization by beneficial microorganisms and increase that of potential pathogens, but also because it may increase the levels of antibiotic resistance genes. The increase in antibiotic-resistant microorganisms is one of the major public health threats that humanity has to face and, therefore, understanding the factors that determine the development of the resistome in early life is of relevance. Recent advancements in sequencing technologies have enabled the study of the microbiota and the resistome at unprecedent levels. These aspects are discussed in this review as well as some potential interventions aimed at reducing the possession of resistance genes.

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Probiotics and intestinal decolonization of antibiotic-resistant microorganisms; A reality or fantasy?

Cited by 9 publications

References 25 publications

Intestinal colonization with multidrug-resistant Enterobacterales: screening, epidemiology, clinical impact, and strategies to decolonize carriers

Intestinal colonization with multidrug-resistant Enterobacterales: screening, epidemiology, clinical impact, and strategies to decolonize carriers

Modulation of the Gut Microbiota to Control Antimicrobial Resistance (AMR)—A Narrative Review with a Focus on Faecal Microbiota Transplantation (FMT)

Old Folks, Bad Boon: Antimicrobial Resistance in the Infant Gut Microbiome

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