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Lactobacillus plantarum 299v reduces colonisation of Clostridium difficile in critically ill patients treated with antibiotics

Klarin, Bengt LU ; Wullt, Marlene LU ; Palmquist, Ingrid LU ; Molin, Göran LU ; Larsson, Anders and Jeppsson, Bengt LU (2008) In Acta Anaesthesiologica Scandinavica 52(8). p.1096-1102
Abstract
Background: The incidence of Clostridium difficile-associated disease (CDAD) in hospitalised patients is increasing. Critically ill patients are often treated with antibiotics and are at high risk of developing CDAD. Lactobacillus plantarum 299v (Lp299v) has been found to reduce recurrence of CDAD. We investigated intensive care unit (ICU) patients regarding the impact of Lp299v on C. difficile colonisation and on gut permeability and parameters of inflammation and infection in that context.

Methods: Twenty-two ICU patients were given a fermented oatmeal gruel containing Lp299v, and 22 received an equivalent product without the bacteria. Faecal samples for analyses of C. difficile and Lp299v were taken at inclusion and then twice... (More)
Background: The incidence of Clostridium difficile-associated disease (CDAD) in hospitalised patients is increasing. Critically ill patients are often treated with antibiotics and are at high risk of developing CDAD. Lactobacillus plantarum 299v (Lp299v) has been found to reduce recurrence of CDAD. We investigated intensive care unit (ICU) patients regarding the impact of Lp299v on C. difficile colonisation and on gut permeability and parameters of inflammation and infection in that context.

Methods: Twenty-two ICU patients were given a fermented oatmeal gruel containing Lp299v, and 22 received an equivalent product without the bacteria. Faecal samples for analyses of C. difficile and Lp299v were taken at inclusion and then twice a week during the ICU stay. Other cultures were performed on clinical indication. Infection and inflammation parameters were analysed daily. Gut permeability was assessed using a sugar probe technique.

Main Results: Colonisation with C. difficile was detected in 19% (4/21) of controls but in none of the Lp299v-treated patients (p < 0.05).

Conclusions: Enteral administration of the probiotic bacterium Lp299v to critically ill patients treated with antibiotics reduced colonisation with C. difficile.

Trial registration: Current Controlled Trials ISRCTN85655545 (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
gut permeability, critical illness, Clostridium difficile, ICU, Lactobacillus plantarum 299v, Clostridium difficile-associated disease, probiotics, CDAD, immune function.
in
Acta Anaesthesiologica Scandinavica
volume
52
issue
8
pages
1096 - 1102
publisher
Wiley-Blackwell
external identifiers
  • wos:000258593200011
  • scopus:49849086927
ISSN
0001-5172
DOI
10.1111/j.1399-6576.2008.01748.x
language
English
LU publication?
yes
id
b6f521a4-1935-4e36-a47c-068fef820d4e (old id 1243812)
alternative location
http://www3.interscience.wiley.com.ludwig.lub.lu.se/cgi-bin/fulltext/121382357/PDFSTART
date added to LUP
2009-06-22 14:00:34
date last changed
2017-08-27 04:12:55
@article{b6f521a4-1935-4e36-a47c-068fef820d4e,
  abstract     = {Background: The incidence of Clostridium difficile-associated disease (CDAD) in hospitalised patients is increasing. Critically ill patients are often treated with antibiotics and are at high risk of developing CDAD. Lactobacillus plantarum 299v (Lp299v) has been found to reduce recurrence of CDAD. We investigated intensive care unit (ICU) patients regarding the impact of Lp299v on C. difficile colonisation and on gut permeability and parameters of inflammation and infection in that context.<br/><br>
Methods: Twenty-two ICU patients were given a fermented oatmeal gruel containing Lp299v, and 22 received an equivalent product without the bacteria. Faecal samples for analyses of C. difficile and Lp299v were taken at inclusion and then twice a week during the ICU stay. Other cultures were performed on clinical indication. Infection and inflammation parameters were analysed daily. Gut permeability was assessed using a sugar probe technique.<br/><br>
Main Results: Colonisation with C. difficile was detected in 19% (4/21) of controls but in none of the Lp299v-treated patients (p &lt; 0.05).<br/><br>
Conclusions: Enteral administration of the probiotic bacterium Lp299v to critically ill patients treated with antibiotics reduced colonisation with C. difficile.<br/><br>
Trial registration: Current Controlled Trials ISRCTN85655545},
  author       = {Klarin, Bengt and Wullt, Marlene and Palmquist, Ingrid and Molin, Göran and Larsson, Anders and Jeppsson, Bengt},
  issn         = {0001-5172},
  keyword      = {gut permeability,critical illness,Clostridium difficile,ICU,Lactobacillus plantarum 299v,Clostridium difficile-associated disease,probiotics,CDAD,immune function.},
  language     = {eng},
  number       = {8},
  pages        = {1096--1102},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Lactobacillus plantarum 299v reduces colonisation of Clostridium difficile in critically ill patients treated with antibiotics},
  url          = {http://dx.doi.org/10.1111/j.1399-6576.2008.01748.x},
  volume       = {52},
  year         = {2008},
}