| Lactobacillus and bifidobacteria combinations: a strategy to reduce hospital-acquired Clostridium difficile diarrhea incidence and mortality. | |
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MedLine Citation:
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PMID: 19359104 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Incidence and virulence of Clostridium difficile-associated disease (CDAD) is increasing, particularly in institutional settings. Morbidity, mortality, and costs associated with this condition are high. Broad-spectrum antibiotics have long been recognized as the primary risk factor for CDAD due to disruption of protective normal gastrointestinal flora. We suggest that administration of appropriate lactobacilli and bifidobacteria probiotics could be employed as a strategy to protect hospitalized patients from CDAD by normalizing disrupted gastrointestinal flora, resulting in fewer cases per admission. Routine use of probiotics within institutional settings may substantially decrease healthcare costs. To date, relatively little is known about the role of probiotics as a means of preventing initial CDAD diagnosis. Although two reports suggestive of benefits have been published, these studies have been either too under-powered to draw definitive conclusions or have employed such restrictive inclusion criteria that results are not generalizable to most hospitalized adults. Since CDAD is an opportunistic infection associated with disrupted gut flora, it is logical to employ a strategy that modulates gut flora as a preventative approach. Herein, we report pilot data that is strongly suggestive that bifidobacteria and lactobacilli combinations may be effective in preventing this hospital-acquired infection and possibly reducing severity when diagnosed. These data are generalizable to all hospital patients since few exclusion criteria were employed. Limitations to these data are acknowledged since the pilot was not conducted in a placebo-controlled manner. Although generalizable, lack of a placebo precludes a definitive answer in terms of efficacy that lactobacilli and bifidobacteria may provide in CDAD prevention. Given substantial morbidity, mortality, and healthcare costs associated with CDAD, appropriately-designed clinical trials are warranted. |
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Authors:
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Terry Graul; Alisha M Cain; Kelly D Karpa |
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Publication Detail:
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Type: Journal Article Date: 2009-04-08 |
Journal Detail:
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Title: Medical hypotheses Volume: 73 ISSN: 1532-2777 ISO Abbreviation: Med. Hypotheses Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-05-27 Completed Date: 2009-08-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7505668 Medline TA: Med Hypotheses Country: United States |
Other Details:
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Languages: eng Pagination: 194-8 Citation Subset: IM |
Affiliation:
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American Board Certified Clin-Path Associates, PC, 1255 West Washington Street, Tempe, AZ 85281-1201, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Bifidobacterium* Clostridium Infections / microbiology, prevention & control* Clostridium difficile / isolation & purification* Diarrhea / microbiology, prevention & control* Humans Incidence Lactobacillus* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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