Do probiotics prevent colonization with multi-resistant Enterobacteriaceae during travel? A randomized controlled trial.
Adult
Bacterial Proteins
Diarrhea
/ prevention & control
Drug Resistance, Multiple, Bacterial
Enterobacteriaceae
/ drug effects
Enterobacteriaceae Infections
/ prevention & control
Feces
/ microbiology
Female
Humans
Incidence
Intestines
/ microbiology
Lacticaseibacillus rhamnosus
Male
Middle Aged
Probiotics
/ administration & dosage
Prospective Studies
Risk Factors
Travel
beta-Lactamases
CPE
Colonization
ESBL-E
India
Probiotic
Traveler
Journal
Travel medicine and infectious disease
ISSN: 1873-0442
Titre abrégé: Travel Med Infect Dis
Pays: Netherlands
ID NLM: 101230758
Informations de publication
Date de publication:
Historique:
received:
19
06
2018
revised:
02
11
2018
accepted:
29
11
2018
pubmed:
7
12
2018
medline:
17
4
2019
entrez:
4
12
2018
Statut:
ppublish
Résumé
Travelers to India are often colonized with extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E) or Carbapenemase-producing Enterobacteriaceae (CPE). The aim of this study was to investigate if the probiotic species Lactobacillus Rhamnosus GG (LGG) could prevent the colonization of the gut with multi-drug resistant bacteria. Adult Danish travelers traveling to India for 10-28 days were randomized to receive either LGG or no probiotics during travel. Rectal swabs and questionnaires were obtained before travel, immediately after and six months after return. Swaps were screened for the presence of ESBL-E and CPE. 31 travelers were randomized to the LGG group and 30 to the control group. Before traveling, 6/50 (12.0%) were colonized with ESBL-E. After return, 41/44 (93.2%) of those not colonized before travel were colonized and 11/36 (30.6%) were still colonized after six months. There was no statistically significant difference in the colonization rate between the group receiving LGG and the control group. No CPE was detected in any cases. The study confirms the very high incidence of colonization with ESBL-E associated with travel to India with >90% colonized upon return and one third were intestinal carriers for at least six months. Use of LGG did not have any effect on the risk of colonization with ESBL-E.
Sections du résumé
BACKGROUND
Travelers to India are often colonized with extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E) or Carbapenemase-producing Enterobacteriaceae (CPE). The aim of this study was to investigate if the probiotic species Lactobacillus Rhamnosus GG (LGG) could prevent the colonization of the gut with multi-drug resistant bacteria.
METHODS
Adult Danish travelers traveling to India for 10-28 days were randomized to receive either LGG or no probiotics during travel. Rectal swabs and questionnaires were obtained before travel, immediately after and six months after return. Swaps were screened for the presence of ESBL-E and CPE.
RESULTS
31 travelers were randomized to the LGG group and 30 to the control group. Before traveling, 6/50 (12.0%) were colonized with ESBL-E. After return, 41/44 (93.2%) of those not colonized before travel were colonized and 11/36 (30.6%) were still colonized after six months. There was no statistically significant difference in the colonization rate between the group receiving LGG and the control group. No CPE was detected in any cases.
CONCLUSIONS
The study confirms the very high incidence of colonization with ESBL-E associated with travel to India with >90% colonized upon return and one third were intestinal carriers for at least six months. Use of LGG did not have any effect on the risk of colonization with ESBL-E.
Identifiants
pubmed: 30508633
pii: S1477-8939(18)30447-2
doi: 10.1016/j.tmaid.2018.11.013
pii:
doi:
Substances chimiques
Bacterial Proteins
0
beta-Lactamases
EC 3.5.2.6
carbapenemase
EC 3.5.2.6
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
81-86Informations de copyright
Copyright © 2018 Elsevier Ltd. All rights reserved.