title: Saccharomyces boulardii probiotic-associated fungemia: questioning the safety of this preventive probiotic's use.
abstract: We report a case of fungemia in an immunocompetent patient after administration of probiotic containing Saccharomyces boulardii. We demonstrated the strain relatedness of the yeast from the probiotic capsule and the yeast causing fungal infection using genomic and proteomic typing methods. Our study questions the safety of this preventative biotherapy.
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Isabella W
authors.initials: IW
authors.lastname: Martin
authors.affiliation: Hospital Epidemiology and Infection Control, Suburban Hospital, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Rita
authors.initials: R
authors.lastname: Tonner
authors.affiliation: Hospital Epidemiology and Infection Control, Suburban Hospital, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Trivedi
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Miller
authors.affiliation: Microbiology Laboratory, The Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Lee
authors.affiliation: Department of Geriatrics, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China.
authors.forename: Xinglun
authors.initials: X
authors.lastname: Liang
authors.affiliation: Suburban Hospital, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Leo
authors.initials: L
authors.lastname: Rotello
authors.affiliation: Suburban Hospital, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Elena
authors.initials: E
authors.lastname: Isenbergh
authors.affiliation: Suburban Hospital, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Anderson
authors.affiliation: Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: tperl@jhmi.edu.
authors.forename: Trish
authors.initials: T
authors.lastname: Perl
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Microbiology Laboratory, The Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Baltimore, MD, USA. Electronic address: szhang28@jhmi.edu.
authors.forename: Sean X
authors.initials: SX
authors.lastname: Zhang
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D003967:Diarrhea / Q000188:drug therapy / Q000517:prevention & control; D015725:Fluconazole / Q000627:therapeutic use; D016469:Fungemia / Q000188:drug therapy* / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016533:Mycological Typing Techniques; D019936:Probiotics / Q000009:adverse effects* / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D000069983:Saccharomyces boulardii / Q000302:isolation & purification*; D013449:Sulfonamides / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D013449:Sulfonamides; C413390:florasulam; D015725:Fluconazole
keywords: Fungal infection; Fungemia; Probiotic; Saccharomyces boulardii; Strain typing