Experience with Saccharomyces boulardii Probiotic in Oncohaematological Patients

Beata Sulik-Tyszka,Jadwiga Dwilewicz-Trojaczek,Ewa Swoboda-Kopeć,Marta Wróblewska,Wiesław Wiktor Jędrzejczak,Emilian Snarski,Małgorzata Augustyniak,Thorvald Nilsen Myhre,Marta Roszkowska,Anna Kacprzyk,Magda Niedźwiedzka

doi:10.1007/s12602-017-9332-4

Beata Sulik-Tyszka, Jadwiga Dwilewicz-Trojaczek + Show 9 more

Open Access

https://doi.org/10.1007/s12602-017-9332-4

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Abstract

Very few reports have been published to date on the bloodstream infections caused by Saccharomyces spp. in oncohaematological patients, and there are no guidelines on the use of this probiotic microorganism in this population. We describe the use of probiotic preparation containing Saccharomyces boulardii in a large group of oncohaematological patients. We retrospectively analysed the data from 32,000 patient hospitalisations at the haematological centre during 2011–2013 (including 196 haematopoietic stem cell transplant recipients) in a tertiary care university-affiliated hospital. During the study period, 2270 doses of Saccharomyces boulardii probiotic were administered to the oncohaematological patients. In total, 2816 mycological cultures were performed, out of which 772 (27.4%) were positive, with 52 indicating digestive tract colonisation by Saccharomyces spp., mainly in patients with acute myeloid leukaemia (AML), myelodysplastic syndrome (MDS) or multiple myeloma (MM). While colonised, they were hospitalised for 1683 days and 416 microbiological cultures of their clinical samples were performed. In the studied group of patients, there were six blood cultures positive for fungi; however, they comprised Candida species: two C. glabrata, one C. albicans, one C. krusei, one C. tropicalis and one C. parapsilosis. There was no blood culture positive for Saccharomyces spp. Our study indicates that despite colonisation of many oncohaematological patients with Saccharomyces spp., there were no cases of fungal sepsis caused by this species.

Highlights

Saccharomyces boulardii is a fungus classified as a yeast, which routinely cannot be distinguished from Saccharomyces cerevisiae and at present is regarded as a subtype of S. cerevisiae [1,2,3,4,5,6]
Since the 1990s, an increasing number of publications of fungemia and invasive infections caused by Saccharomyces cerevisiae, among intensive care unit (ICU) patients and individuals with multiple co-morbidities, have been reported in literature in patients treated with a probiotic preparation containing this yeast [1, 2, 5, 6, 11, 17,18,19,20,21]
Diarrhoea and colonisation of the gastrointestinal tract by potentially pathogenic bacteria including Clostridium difficile are important problems in care of oncohaematological patients treated for leukaemia and lymphoma [25]

Summary

Introduction

Saccharomyces boulardii is a fungus classified as a yeast, which routinely cannot be distinguished from Saccharomyces cerevisiae and at present is regarded as a subtype of S. cerevisiae [1,2,3,4,5,6] These yeasts are widespread in nature and can be found on plants, fruit and in soil, being used in the baking and brewing industry [1, 2]. Since the 1990s, an increasing number of publications of fungemia and invasive infections caused by Saccharomyces cerevisiae (boulardii), among intensive care unit (ICU) patients and individuals with multiple co-morbidities, have been reported in literature in patients treated with a probiotic preparation containing this yeast [1, 2, 5, 6, 11, 17,18,19,20,21].

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