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What is the Role of Probiotics in Preventing Hospital Infections?

Yıl 2018, Cilt: 10 Sayı: 5, 14 - 18, 07.09.2018

Öz

Abstract

Probiotics are defined as live microorganisms of human origin that are able totolerate the hostile gastrointestinal environment such that they persist in the loweralimentary tract to confer a health benefit to the host. Metaanalysis of RCT sho-wed that LGG at a dose of 109 CFU/day is effective in prevention of nosocomial diarrhea in children. In 2014 metaanalysis the use of probiotics decreased the incidence of VAP from 29 to 21 percent. However no significant differences in mortality, length of ICU stay, or duration of mechanical ventilation were detected. However quality of evidence is low.  Available results do not provide sufficient evidence to draw conclusions regarding the efficacy or safety of probiotics for the prevention of VAP.

Kaynakça

  • 1.Shimizu K, Ogura H, Goto M, et al. Altered gut flora and en-vironment in patients with severe SIRS. J Trauma 2006; 60:126-33.
  • 2.Sanders ME. Probiotics: definition, sources, selection, and uses.Clin Infect Dis 2008; 46: S58-S61.
  • 3.Goldin BR, Gorbach SL. Clinical indications for probiotics:an overview. Clin Infect Dis 2008; 46: S96-100.
  • 4.Mazmanian SK, Liu CH, Tzianabos AO, Kasper DL. An im-munomodulatory molecule of symbiotic bacteria directs ma-turation of the host immune system. Cell 2005; 122: 107-18.
  • 5.Eckburg PB, Relman DA. The role of microbes in Crohn’s di-sease. Clin Infect Dis 2007; 44: 256-62.
  • 6.Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial eco-logy: human gut microbes associated with obesity. Nature 2006;444: 1022-23.
  • 7.Walker WA. Mechanisms of action of probiotics. Clin InfectDis 2008; 46: S87-S91.
  • 8.Jacobsen CN, Rosenfeldt Nielsen V, Hayford AE, et al.Screening of probiotic activities of forty seven strains of Lac-tobacillus spp. by in vitro techniques and evaluation of colo-nization ability of five selected strains in humans. Appl En-viron Microbiol 1999; 65: 4949-56.
  • 9.Gänzle MG. Reutericyclin: biological activity, mode of acti-on, and potential applications. Appl Microbiol Biotechnol 2004;64: 326–32.
  • 10.Szajewska H, Koodziej M. Systematic review with meta-analy-sis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2015Oct;42(7):793–801).
  • 11.Saavedra JM, Bauman NA, Qung I, Perman JA, Yolken RH.Feeding of Bifidobacterium bifidum and Streptococcus ther-mophilus to infants in hospital for prevention of diarrhea andshedding of rotavirus. Lancet Lond Engl 1994;344:1046-9.
  • 12.Siempos II, Ntaidou TK, Falagas ME. Impact of the adminis-tration of probiotics on the incidence of ventilator-associatedpneumonia: A meta-analysis of randomized controlled trials.Crit Care Med 2010; 38: 954–62.
  • 13.Wang J, Liu K, Ariani F, Tao LL, Zhang J, Qu JM. Probio-tics for preventing ventilator-associated pneumonia: A syste-matic review and meta-analysis of high-quality randomizedcontrolled trials. PLOS One 2013; 8: e83934
  • 14.Forestier C, Guelon D, Cluytens V, Gillart T, Sirot J, DeChamps C. Oral probiotic and prevention of Pseudomonas ae-ruginosa infections: a randomized,double-blind, placebo-con-trolled pilot study in intensive care unit patients. Crit Care2008; 12: R69.
  • 15.Petrof EO, Dhaliwal R, Manzaranes W, Johnstone J, Cook D,Heyland DK. Probiotics in the critically ill: a systematic re-view of the randomized trial evidence. Critical Care Med 2012;40: 3290–302.
  • 16.Gu WJ, Wei CY, Yin RX. Lack of efficacy of probiotics in pre-venting ventilator-associated pneumonia: a systematic revi-ew and meta-analysis of randomized controlled trials. Chest2012; 142: 859–968.
  • 17.Bo L, Li J, Tao T, Bai Y, Ye X, Hotchkiss RS, et al. Probio-tics for preventing ventilator-associated pneumonia. Cochra-ne Database Syst Rev. 2014 Oct 25;(10):CD009066).
  • 18.Kotzampassi K, Giamarellos-Bourboulis EJ, Voudouris A, Ka-zamias P, Eleftheriadis E. Benefits of a synbiotic formula(Synbiotic 2000Forte) in critically ill trauma patients: resultsof a randomized controlled trial. World J Surg2006;30:1848–55.
  • 19.Gu WJ, Deng T, Gong YZ, Jing R, Liu JC. The effects of pro-biotics in early enteral nutrition on the outcomes of trauma:a meta-analysis of randomized controlled trials. JPEN J Pa-renter Enteral Nutr 2013;37: 310-317.
  • 20.Mcnaught CE, Woodcock NP, Anderson AD, MacFie J. A pros-pective randomized trial of probiotics in critically ill patients.Clin Nutr 2005; 24: 211–19
  • 21.Rayes N, Seehofer D, Theruvath T, et al. Supply of pre- andprobiotics reduces bacterial infection rates after liver transp-lantation: a randomized double blind trial. Am J Transplant2005; 5: 125–30
  • 22.Honeycutt TC, El Khashab M, Wardrop RM, et al. Probioticadministration and the incidence of nosocomial infection inpediatric intensive care: a randomized placebo-controlled tri-al. Pediatr Crit Care Med 2007; 8: 452-64.
  • 23.Hojsak I, Abdovi S, Szajewska H, Milosevi M, Krznari Z, Ko-lacek S. Lactobacillus GG in the prevention of nosocomial gas-trointestinal and respiratory tract infections. Pediatrics2010; 125: e1171-77.
  • 24.Kumar S, Singhi S, Chakrabarti A, Bansal A, Jayashree M.Probiotic use and prevalence of candidemia and candiduriain a PICU. Pediatr Crit Care Med 2013; 14: e409-415.
  • 25.Manzoni P, De Luca D, Stronati M, et al. Prevention of no-socomial infections in neonatal intensive care units. Am J Pe-rinatol 2013; 30: 81-88.
  • 26.Manzoni P, Mostert M, Leonessa ML, et al. Oral supplemen-tation with Lactobacillus casei subspecies rhamnosus preventsenteric colonization by Candida species in preterm neonates:a randomized study. Clin Infect Dis 2006; 42: 1735–42.
  • 27.Athalye-Jape G, Rao S, Patole S. Lactobacillus reuteriiDSM 17938 as a probiotic for preterm neonates: A strain spe-cific systematic review. JPEN J Parenter Enteral Nutr2016;40:738-94.
  • 28.Alfaleh K, Anabrees J, Bassler D, Al-Kharfi T. Probiotics forprevention of necrotizing enterocolitis in preterm infants. Coch-rane Database Syst Rev 2011; (3): CD005496.
  • 29.Rao SC, Athalye-Jape GK, Deshpande GC, Simmer KN, Pa-tole SK. Probiotic supplementation and late onset sepsis in pre-term infants: A meta analysis. Pediatrics 2016;137:e20153684
  • 30.Costeloe K, Hardy P, Juszczak E, Wilks M, Millar MR,: Pro-biotics in preterm infants study collaborative group. Lancet2016;387: 649-60.
  • 31.Barraud D, Blard C, Hein F, et al. Probiotics in the criticallyill patient: a double blind, randomized, placebo-controlled tri-al. Intensive Care Med 2010; 36: 1540-47.
  • 32.Besseling MG, van Santvoort HC, Buskens E, et al. Probio-tic prophylaxis in predicted severe acute pancreatitis: a ran-domized, double-blind, placebo controlled trial. Lancet 2008;371: 651-59.
  • 33.Syndman DR. The safety of probiotics. Clin Infect Dis 2008;46: S104-S111.
  • 34.Rautio M, Jousimies-Somer H, Kauma H, et al. Liver abscessdue to a Lactobacillus rhamnosus strain indistinguishable fromL. Rhamnosus strain GG. Clin Infect Dis 1999; 28: 1159–60.
  • 35.Salminen MK, Rautelin H, Tynkkynen S, et al. Lactobacillusbacteremia, clinical significance, and patient outcome, withspecial focus on probiotic L.rhamnosus GG. Clin Infect Dis2004; 38: 62–69.
  • 36.Mackay AD, Taylor MB, Kibbler CC, Hamilton-Miller JM. Lac-tobacillus endocarditis caused by a probiotic organism. ClinMicrobiol Infect 1999; 5: 290–92.
  • 37.Enache-Angoulvant A, Hennequin E. Invasive Saccharomy-ces infection: a comprehensive review. Clin Infect Dis 2005;41: 1559-668.
  • 38.Manzoni P, Lista G, Gallo E, et al. Routine Lactobacillus rham-nosus GG administration in VLBW infants: a retrospective,6-year cohort study. Early Hum Dev 2011; 87: S35–S38.

Hastane Enfeksiyonlarının Önlenmesinde Probiyotiklerin Rolü Nedir?

Yıl 2018, Cilt: 10 Sayı: 5, 14 - 18, 07.09.2018

Öz

Öz

Probiyotikler yeterli miktarda alındığında konağın sindirim sisteminde yeterli sayıda kalabilen  ve konağa yarar sağlayabilen insan kaynaklı canlı mikroorganizmalardır.  Lactobacillus rhamnosus GG (LGG) en az 109 CFU/gün, hastane yatışı boyunca kullanıldığında nozokomiyal ishalin önlenmesinde etkili bulunmuştur. 2014 metaanalizinde probiyotiklerin kontrol grubıu ile karşılaştırıldığında VAP insidansını %29’dan %21’e azalttığı saptanmıştır.  Ancak yoğun bakım yatış süresinde ve mortalitede azalma bulunmamıştır. Hali hazırda probiyotiklerin VAP’ı önlemek amacıyla rutin olarak kullanımı önerilmemektedir

Kaynakça

  • 1.Shimizu K, Ogura H, Goto M, et al. Altered gut flora and en-vironment in patients with severe SIRS. J Trauma 2006; 60:126-33.
  • 2.Sanders ME. Probiotics: definition, sources, selection, and uses.Clin Infect Dis 2008; 46: S58-S61.
  • 3.Goldin BR, Gorbach SL. Clinical indications for probiotics:an overview. Clin Infect Dis 2008; 46: S96-100.
  • 4.Mazmanian SK, Liu CH, Tzianabos AO, Kasper DL. An im-munomodulatory molecule of symbiotic bacteria directs ma-turation of the host immune system. Cell 2005; 122: 107-18.
  • 5.Eckburg PB, Relman DA. The role of microbes in Crohn’s di-sease. Clin Infect Dis 2007; 44: 256-62.
  • 6.Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial eco-logy: human gut microbes associated with obesity. Nature 2006;444: 1022-23.
  • 7.Walker WA. Mechanisms of action of probiotics. Clin InfectDis 2008; 46: S87-S91.
  • 8.Jacobsen CN, Rosenfeldt Nielsen V, Hayford AE, et al.Screening of probiotic activities of forty seven strains of Lac-tobacillus spp. by in vitro techniques and evaluation of colo-nization ability of five selected strains in humans. Appl En-viron Microbiol 1999; 65: 4949-56.
  • 9.Gänzle MG. Reutericyclin: biological activity, mode of acti-on, and potential applications. Appl Microbiol Biotechnol 2004;64: 326–32.
  • 10.Szajewska H, Koodziej M. Systematic review with meta-analy-sis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2015Oct;42(7):793–801).
  • 11.Saavedra JM, Bauman NA, Qung I, Perman JA, Yolken RH.Feeding of Bifidobacterium bifidum and Streptococcus ther-mophilus to infants in hospital for prevention of diarrhea andshedding of rotavirus. Lancet Lond Engl 1994;344:1046-9.
  • 12.Siempos II, Ntaidou TK, Falagas ME. Impact of the adminis-tration of probiotics on the incidence of ventilator-associatedpneumonia: A meta-analysis of randomized controlled trials.Crit Care Med 2010; 38: 954–62.
  • 13.Wang J, Liu K, Ariani F, Tao LL, Zhang J, Qu JM. Probio-tics for preventing ventilator-associated pneumonia: A syste-matic review and meta-analysis of high-quality randomizedcontrolled trials. PLOS One 2013; 8: e83934
  • 14.Forestier C, Guelon D, Cluytens V, Gillart T, Sirot J, DeChamps C. Oral probiotic and prevention of Pseudomonas ae-ruginosa infections: a randomized,double-blind, placebo-con-trolled pilot study in intensive care unit patients. Crit Care2008; 12: R69.
  • 15.Petrof EO, Dhaliwal R, Manzaranes W, Johnstone J, Cook D,Heyland DK. Probiotics in the critically ill: a systematic re-view of the randomized trial evidence. Critical Care Med 2012;40: 3290–302.
  • 16.Gu WJ, Wei CY, Yin RX. Lack of efficacy of probiotics in pre-venting ventilator-associated pneumonia: a systematic revi-ew and meta-analysis of randomized controlled trials. Chest2012; 142: 859–968.
  • 17.Bo L, Li J, Tao T, Bai Y, Ye X, Hotchkiss RS, et al. Probio-tics for preventing ventilator-associated pneumonia. Cochra-ne Database Syst Rev. 2014 Oct 25;(10):CD009066).
  • 18.Kotzampassi K, Giamarellos-Bourboulis EJ, Voudouris A, Ka-zamias P, Eleftheriadis E. Benefits of a synbiotic formula(Synbiotic 2000Forte) in critically ill trauma patients: resultsof a randomized controlled trial. World J Surg2006;30:1848–55.
  • 19.Gu WJ, Deng T, Gong YZ, Jing R, Liu JC. The effects of pro-biotics in early enteral nutrition on the outcomes of trauma:a meta-analysis of randomized controlled trials. JPEN J Pa-renter Enteral Nutr 2013;37: 310-317.
  • 20.Mcnaught CE, Woodcock NP, Anderson AD, MacFie J. A pros-pective randomized trial of probiotics in critically ill patients.Clin Nutr 2005; 24: 211–19
  • 21.Rayes N, Seehofer D, Theruvath T, et al. Supply of pre- andprobiotics reduces bacterial infection rates after liver transp-lantation: a randomized double blind trial. Am J Transplant2005; 5: 125–30
  • 22.Honeycutt TC, El Khashab M, Wardrop RM, et al. Probioticadministration and the incidence of nosocomial infection inpediatric intensive care: a randomized placebo-controlled tri-al. Pediatr Crit Care Med 2007; 8: 452-64.
  • 23.Hojsak I, Abdovi S, Szajewska H, Milosevi M, Krznari Z, Ko-lacek S. Lactobacillus GG in the prevention of nosocomial gas-trointestinal and respiratory tract infections. Pediatrics2010; 125: e1171-77.
  • 24.Kumar S, Singhi S, Chakrabarti A, Bansal A, Jayashree M.Probiotic use and prevalence of candidemia and candiduriain a PICU. Pediatr Crit Care Med 2013; 14: e409-415.
  • 25.Manzoni P, De Luca D, Stronati M, et al. Prevention of no-socomial infections in neonatal intensive care units. Am J Pe-rinatol 2013; 30: 81-88.
  • 26.Manzoni P, Mostert M, Leonessa ML, et al. Oral supplemen-tation with Lactobacillus casei subspecies rhamnosus preventsenteric colonization by Candida species in preterm neonates:a randomized study. Clin Infect Dis 2006; 42: 1735–42.
  • 27.Athalye-Jape G, Rao S, Patole S. Lactobacillus reuteriiDSM 17938 as a probiotic for preterm neonates: A strain spe-cific systematic review. JPEN J Parenter Enteral Nutr2016;40:738-94.
  • 28.Alfaleh K, Anabrees J, Bassler D, Al-Kharfi T. Probiotics forprevention of necrotizing enterocolitis in preterm infants. Coch-rane Database Syst Rev 2011; (3): CD005496.
  • 29.Rao SC, Athalye-Jape GK, Deshpande GC, Simmer KN, Pa-tole SK. Probiotic supplementation and late onset sepsis in pre-term infants: A meta analysis. Pediatrics 2016;137:e20153684
  • 30.Costeloe K, Hardy P, Juszczak E, Wilks M, Millar MR,: Pro-biotics in preterm infants study collaborative group. Lancet2016;387: 649-60.
  • 31.Barraud D, Blard C, Hein F, et al. Probiotics in the criticallyill patient: a double blind, randomized, placebo-controlled tri-al. Intensive Care Med 2010; 36: 1540-47.
  • 32.Besseling MG, van Santvoort HC, Buskens E, et al. Probio-tic prophylaxis in predicted severe acute pancreatitis: a ran-domized, double-blind, placebo controlled trial. Lancet 2008;371: 651-59.
  • 33.Syndman DR. The safety of probiotics. Clin Infect Dis 2008;46: S104-S111.
  • 34.Rautio M, Jousimies-Somer H, Kauma H, et al. Liver abscessdue to a Lactobacillus rhamnosus strain indistinguishable fromL. Rhamnosus strain GG. Clin Infect Dis 1999; 28: 1159–60.
  • 35.Salminen MK, Rautelin H, Tynkkynen S, et al. Lactobacillusbacteremia, clinical significance, and patient outcome, withspecial focus on probiotic L.rhamnosus GG. Clin Infect Dis2004; 38: 62–69.
  • 36.Mackay AD, Taylor MB, Kibbler CC, Hamilton-Miller JM. Lac-tobacillus endocarditis caused by a probiotic organism. ClinMicrobiol Infect 1999; 5: 290–92.
  • 37.Enache-Angoulvant A, Hennequin E. Invasive Saccharomy-ces infection: a comprehensive review. Clin Infect Dis 2005;41: 1559-668.
  • 38.Manzoni P, Lista G, Gallo E, et al. Routine Lactobacillus rham-nosus GG administration in VLBW infants: a retrospective,6-year cohort study. Early Hum Dev 2011; 87: S35–S38.
Toplam 38 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm makale
Yazarlar

Doç. Dr. Özden Türel

Yayımlanma Tarihi 7 Eylül 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 10 Sayı: 5

Kaynak Göster

APA Türel, D. D. Ö. (2018). Hastane Enfeksiyonlarının Önlenmesinde Probiyotiklerin Rolü Nedir?. Klinik Tıp Pediatri Dergisi, 10(5), 14-18.
AMA Türel DDÖ. Hastane Enfeksiyonlarının Önlenmesinde Probiyotiklerin Rolü Nedir?. Pediatri. Eylül 2018;10(5):14-18.
Chicago Türel, Doç. Dr. Özden. “Hastane Enfeksiyonlarının Önlenmesinde Probiyotiklerin Rolü Nedir?”. Klinik Tıp Pediatri Dergisi 10, sy. 5 (Eylül 2018): 14-18.
EndNote Türel DDÖ (01 Eylül 2018) Hastane Enfeksiyonlarının Önlenmesinde Probiyotiklerin Rolü Nedir?. Klinik Tıp Pediatri Dergisi 10 5 14–18.
IEEE D. D. Ö. Türel, “Hastane Enfeksiyonlarının Önlenmesinde Probiyotiklerin Rolü Nedir?”, Pediatri, c. 10, sy. 5, ss. 14–18, 2018.
ISNAD Türel, Doç. Dr. Özden. “Hastane Enfeksiyonlarının Önlenmesinde Probiyotiklerin Rolü Nedir?”. Klinik Tıp Pediatri Dergisi 10/5 (Eylül 2018), 14-18.
JAMA Türel DDÖ. Hastane Enfeksiyonlarının Önlenmesinde Probiyotiklerin Rolü Nedir?. Pediatri. 2018;10:14–18.
MLA Türel, Doç. Dr. Özden. “Hastane Enfeksiyonlarının Önlenmesinde Probiyotiklerin Rolü Nedir?”. Klinik Tıp Pediatri Dergisi, c. 10, sy. 5, 2018, ss. 14-18.
Vancouver Türel DDÖ. Hastane Enfeksiyonlarının Önlenmesinde Probiyotiklerin Rolü Nedir?. Pediatri. 2018;10(5):14-8.