Microbiota and infection prevention: making space for probiotics in healthcare

Abstract

The human microbiome plays a vital role in patients' susceptibility to infections. A change to the composition of the microbiome—be it a change in the presence or abundance of microbial species or the introduction of new pathogens—may result in dysbiosis, which has been identified in patients with acute gastroenteritis (AGE) and antibiotic-associated diarrhoea (AAD). Probiotics can ameliorate dysbiosis, and there is extensive research into their use in AGE and AAD. Recently, national and international bodies—inlcuding the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) and the National Institute for Health and Care Excellence (NICE) Clinical Knowledge Summaries (CKS)—have recommended the use of probiotics in the treatment of AGE and the prevention of AAD and Clostridium difficile infections (CDI). Also, there is emerging evidence suggesting that the perioperative use of probiotics in elective surgery can reduce rates of surgical infections (SI) and reduce the need for postoperative antibiotics. A growing body of evidence suggests that probiotics should be considered as an adjunct to standard protocols in AGE, AAD, CDI and SI, and this review summarises recent developments in probiotic research in these conditions.