Abstract
BackgroundInfection by Staphylococcus aureus (S. aureus) is a major cause of morbidity and mortality. Colonization by S. aureus increases the risk of infection. Little is known about decolonization strategies for S. aureus beyond antibiotics, however probiotics represent a promising alternative. A randomized controlled trial was conducted to determine the efficacy of Lactobacillus rhamnosus (L. rhamnosus) HN001 in reducing carriage of S. aureus at multiple body sites.MethodsOne hundred thirteen subjects, positive for S. aureus carriage, were recruited from the William S. Middleton Memorial Medical Center, Madison, WI, USA, and randomized by initial site of colonization, either gastrointestinal (GI) or extra-GI, to 4-weeks of oral L. rhamnosus HN001 probiotic, or placebo. Nasal, oropharyngeal, and axillary/groin swabs were obtained, and serial blood and fecal samples were collected. Differences in prevalence of S. aureus carriage at the end of the 4-weeks of treatment were assessed.ResultsThe probiotic and placebo groups were similar in age, gender, and health history at baseline. S. aureus colonization within the stool samples of the extra-GI group was 15% lower in the probiotic than placebo group at the endpoint of the trial. Those in the probiotic group compared to the placebo group had 73% reduced odds (OR 0.27, 95% CI 0.07–0.98) of methicillin-susceptible S. aureus presence, and 83% reduced odds (OR 0.17, 95% CI 0.04–0.73) of any S. aureus presence in the stool sample at endpoint.ConclusionUse of daily oral L. rhamnosus HN001 reduced odds of carriage of S. aureus in the GI tract, however it did not eradicate S. aureus from other body sites.Trial registrationClinicalTrials.gov Identifier: NCT01321606. Registered March 21, 2011.
Highlights
Infection by Staphylococcus aureus (S. aureus) is a major cause of morbidity and mortality
Current treatment options for methicillinresistant S. aureus (MRSA) are limited to strong antibiotics that are accompanied by severe side effects and promote antibiotic resistance [8, 9]
The study groups had similar medical histories, the placebo group had a higher frequency of current liver disease than the probiotic group (Table 1)
Summary
Infection by Staphylococcus aureus (S. aureus) is a major cause of morbidity and mortality. Probiotics are cultures of live bacteria species that normally reside in the human gut They can help prevent infections by pathogens by outcompeting pathogenic bacteria for essential nutrients and mucosal binding sites, as well as enhancing immune function and promoting the production of mucosal and epithelial barriers [15]. Lactobacillus rhamnosus (L. rhamnosus) HN001, in particular has been shown to improve both innate and acquired immune function in multiple studies against a variety of bacterial infection threats [12, 13, 16,17,18,19] It has been chosen for use in this study due to its immune effects and its safety and tolerability [20,21,22]
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