title: Effect of Lactobacillus rhamnosus GG Administration on Vancomycin-Resistant Enterococcus Colonization in Adults with Comorbidities.
abstract: Vancomycin-resistant enterococci (VRE) are endemic in health care settings. These organisms colonize the gastrointestinal tract and can lead to infection which is associated with increased mortality. There is no treatment for VRE colonization. We conducted a randomized, double-blind, placebo-controlled clinical trial to examine the safety and efficacy of administration of the probiotic Lactobacillus rhamnosus GG (LGG) for the reduction or elimination of intestinal colonization by VRE. Colonized adults were randomized to receive LGG or placebo for 14 days. Quantitative stool cultures for LGG and VRE were collected at baseline and days 7, 14, 21, 28, and 56. Day 14 stool samples from some subjects were analyzed by quantitative PCR (qPCR) for LGG. Patients were closely monitored for adverse events. Eleven subjects, of whom 5 received LGG and 6 received placebo, were analyzed. No differences in VRE colony counts were seen at any time points between groups. No decline in colony counts was seen over time in subjects who received LGG. LGG was detected by PCR in all samples tested from subjects who received LGG but was only isolated in culture from 2 of 5 subjects in the LGG group. No treatment-related adverse events were seen. We demonstrated that LGG could be administered safely to patients with comorbidities and is recoverable in some patients' stool cultures. Concomitant administration of antibiotics may have resulted in an inability to recover viable organisms from stool samples, but LGG DNA could still be detected by qPCR. LGG administration did not affect VRE colonization in this study. (This study was registered at Clinicaltrials.gov under registration no. NCT00756262.).
authors.affiliation: Division of Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA sdoron@tuftsmedicalcenter.org.
authors.forename: Shira
authors.initials: S
authors.lastname: Doron
authors.affiliation: Division of Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Hibberd
authors.affiliation: Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Barry
authors.initials: B
authors.lastname: Goldin
authors.affiliation: Division of Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA.
authors.forename: Cheleste
authors.initials: C
authors.lastname: Thorpe
authors.affiliation: Division of Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: McDermott
authors.affiliation: Division of Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Snydman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015169:Colony Count, Microbial; D015897:Comorbidity; D004311:Double-Blind Method; D005243:Feces / Q000382:microbiology; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans; D052201:Lacticaseibacillus rhamnosus / Q000254:growth & development*; D008297:Male; D008875:Middle Aged; D019936:Probiotics / Q000008:administration & dosage*; D014640:Vancomycin / Q000494:pharmacology*; D065507:Vancomycin-Resistant Enterococci / Q000254:growth & development*
chemical_list: D014640:Vancomycin