Saccharomyces boulardii for the Prevention of Hospital Onset Clostridium difficile Infection

Flatley, Elizabeth A; Wilde, Ashley M; Nailor, Michael D

doi:10.15403/jgld.2014.1121.fly

Cited by 23 publications

(28 citation statements)

References 10 publications

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“…24,25 In contrast, an observational study reported no difference in CDI (9.9 of 10,000 patient days vs 10.4 of 10,000 patient-days) after cessation of twice daily 250 mg dosing of Saccharomyces boulardii with antibiotics without changing other C. difficile preventive measures. 26 …”

Section: Resultsmentioning

confidence: 99%

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Clostridium DifficileInfection in Acute Care Hospitals: Systematic Review and Best Practices for Prevention

Louh

Greendyke

Hermann

et al. 2017

Infect. Control Hosp. Epidemiol.

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Objective Prevention of Clostridium difficile infection (CDI) in acute care hospitals is a priority for hospitals and clinicians. We performed a qualitative systematic review to update the evidence on interventions to prevent CDI published since 2009. Design We searched Ovid, MEDLINE, EMBASE, The Cochrane Library, CINAHL, ISI Web of Knowledge, and grey literature databases from January 1, 2009 to August 1, 2015. Setting We included studies performed in acute care hospitals. Patients or participants We included studies conducted on hospitalized patients that investigated the impact of specific interventions on CDI rates. Interventions We used the QI-Minimum Quality Criteria Set (QI-MQCS) to assess the quality of included studies. Interventions were grouped thematically: environmental disinfection, antimicrobial stewardship, hand hygiene, chlorhexidine bathing, probiotics, bundled approaches, and others. A meta-analysis was performed when possible. Results Of 3236 articles screened, 261 met the criteria for full-text review and 46 studies were ultimately included. The average quality rating was 82% on the QI-MQCS. The most effective interventions, resulting in a 45% to 85% reduction in CDI, included daily to twice daily disinfection of high-touch surfaces (including bed rails) and terminal cleaning of patient rooms with chlorine-based products. Bundled interventions and antimicrobial stewardship showed promise for reducing CDI rates. Chlorhexidine bathing and intensified hand hygiene practices were not effective for reducing CDI rates. Conclusions Daily and terminal cleaning of patient rooms using chlorine-based products were most effective in reducing CDI rates in hospitals. Further studies are needed to identify the components of bundled interventions that reduce CDI rates.

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Section: Resultsmentioning

confidence: 99%

“…In the only CHG study that showed a reduction in CDI in acute care hospitals, Rupp et al, 26 speculated that scrubbing in addition to bed bathing might reduce the overall presence of spores.…”

Section: Discussionmentioning

confidence: 99%

Clostridium DifficileInfection in Acute Care Hospitals: Systematic Review and Best Practices for Prevention

Louh

Greendyke

Hermann

et al. 2017

Infect. Control Hosp. Epidemiol.

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“…Interesting results have also been reported by Lim et al (2015) , suggesting that yeasts can enhance the growth of other probiotics under acidic conditions: Saccharomyces cerevisiae EC-1118 was found to significantly enhance the viability of the probiotic strain Lactobacillus rhamnosus HN001 at pH 2.5–4.0. The use of S. boulardii in reduction of C. difficile infection relapse is still under debate due to controversial results of clinical trials ( Flatley et al, 2015 ). Among other yeasts species, Torulaspora delbrueckii, Debaromyces hansenii, Yarrowia lipolytica, Kluyveromyces lactis, Kluyveromyces marxianus, and Kluyveromyces lodderae have shown strong antagonistic effect against pathogenic bacteria and high acid tolerance ( Kumura et al, 2004 ; Psani and Kotzekidou, 2006 ; Chen et al, 2010 ).…”

Section: Probiotic Bacteriamentioning

confidence: 99%

Probiotic-based strategies for therapeutic and prophylactic use against multiple gastrointestinal diseases

2015

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Probiotic bacteria offer a number of potential health benefits when administered in sufficient amounts that in part include reducing the number of harmful organisms in the intestine, producing antimicrobial substances and stimulating the body’s immune response. However, precisely elucidating the probiotic effect of a specific bacterium has been challenging due to the complexity of the gut’s microbial ecosystem and a lack of definitive means for its characterization. This review provides an overview of widely used and recently described probiotics, their impact on the human’s gut microflora as a preventative treatment of disease, human/animal models being used to help show efficacy, and discusses the potential use of probiotics in gastrointestinal diseases associated with antibiotic administration.

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“…S. boulardii has been extensively studied for its probiotic effects against gastrointestinal tract disorders (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). The clinical activities of S. boulardii relevant to antibiotic-associated diarrhea and recurrent Clostridium difficile intestinal infections have been reported (8,(15)(16)(17)(18). S. boulardii is also called S. cerevisiae var.…”

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confidence: 99%

A Mutation in PGM2 Causing Inefficient Galactose Metabolism in the Probiotic Yeast Saccharomyces boulardii

Liu

Zhang

Kong

et al. 2018

Appl Environ Microbiol

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The probiotic yeast has been extensively studied for the prevention and treatment of diarrheal diseases, and it is now commercially available in some countries. displays notable phenotypic characteristics, such as a high optimal growth temperature, high tolerance against acidic conditions, and the inability to form ascospores, which differentiate from The majority of prior studies stated that exhibits sluggish or halted galactose utilization. Nonetheless, the molecular mechanisms underlying inefficient galactose uptake have yet to be elucidated. When the galactose utilization of a widely used strain, ATCC MYA-796, was examined under various culture conditions, the strain could consume galactose, but at a much lower rate than that of While all genes were present in the genome, according to analysis of genomic sequencing data in a previous study, a point mutation (G1278A) in , which codes for phosphoglucomutase, was identified in the genome of the strain. As the point mutation resulted in the truncation of the Pgm2 protein, which is known to play a pivotal role in galactose utilization, we hypothesized that the truncated Pgm2 might be associated with inefficient galactose metabolism. Indeed, complementation of in restored galactose utilization. After reverting the point mutation to a full-length in by Cas9-based genome editing, the growth rates of wild-type (with a truncated gene) and mutant (with a full-length) strains with glucose or galactose as the carbon source were examined. As expected, the mutant (with a full-length ) was able to ferment galactose faster than the wild-type strain. Interestingly, the mutant showed a lower growth rate than that of the wild-type strain on glucose at 37°C. Also, the wild-type strain was enriched in the mixed culture of wild-type and mutant strains on glucose at 37°C, suggesting that the truncated might offer better growth on glucose at a higher temperature in return for inefficient galactose utilization. Our results suggest that the point mutation in might be involved in multiple phenotypes with different effects. is a probiotic yeast strain capable of preventing and treating diarrheal diseases. However, the genetics and metabolism of this yeast are largely unexplored. In particular, molecular mechanisms underlying the inefficient galactose metabolism of remain unknown. Our study reports that a point mutation in, which codes for phosphoglucomutase, is responsible for inferior galactose utilization by After correction of the mutated via genome editing, the resulting strain was able to use galactose faster than a parental strain. While the mutation made the yeast use galactose slowly, investigation of the genomic sequencing data of other strains revealed that the mutation is evolutionarily conserved. Interestingly, the mutation was beneficial for growth at a higher temperature on glucose. We speculate that the mutation was enriched due to selection of in the natural habitat (sugar-rich fruits in tropical areas).

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Saccharomyces boulardii for the Prevention of Hospital Onset Clostridium difficile Infection

Abstract: Removal of S. boulardii administration to patients receiving broad spectrum antibiotics and the hospital formulary did not impact the rate of hospital onset C. difficile infection in either the hospital population or patients receiving broad spectrum antibiotics.

Cited by 23 publications

References 10 publications

Clostridium DifficileInfection in Acute Care Hospitals: Systematic Review and Best Practices for Prevention

Clostridium DifficileInfection in Acute Care Hospitals: Systematic Review and Best Practices for Prevention

Probiotic-based strategies for therapeutic and prophylactic use against multiple gastrointestinal diseases

A Mutation in PGM2 Causing Inefficient Galactose Metabolism in the Probiotic Yeast Saccharomyces boulardii

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