Probiotic treatment of vancomycin-resistant enterococci: a randomised controlled trial

Area of Science:

• Microbiology
• Gastroenterology
• Clinical Medicine

Background:

• Vancomycin-resistant enterococci (VRE) pose a significant challenge in healthcare settings, particularly for immunocompromised patients.
• Gastrointestinal carriage of VRE is a major reservoir for transmission and subsequent infection.
• Current strategies for VRE decolonization are limited and often associated with antibiotic resistance.

Purpose of the Study:

• To investigate the efficacy of Lactobacillus rhamnosus GG (LGG) in commercially available yogurt for clearing VRE colonization.
• To evaluate LGG as a potential probiotic therapy for VRE gastrointestinal carriage in renal patients.

Main Methods:

• A double-blind, randomized, placebo-controlled trial was conducted with 27 VRE-positive renal patients.
• Participants received either LGG-yogurt or standard yogurt daily for 4 weeks.
• Faecal samples were analyzed weekly, with follow-up testing at 8 weeks.

Main Results:

• All 11 patients in the LGG treatment group who completed the study cleared VRE.
• In the control group, only 1 out of 12 patients cleared VRE.
• Upon crossover, 8 of 11 VRE-positive control patients cleared VRE after receiving LGG-yogurt.

Conclusions:

• Lactobacillus rhamnosus GG (LGG) in yogurt demonstrated significant success in clearing VRE gastrointestinal carriage.
• This is the first study to report successful probiotic therapy for VRE in renal patients.
• Further research is warranted to explore LGG's role in managing VRE colonization.