Yakult: a role in combating multi-drug resistant Pseudomonas aeruginosa?

Presence of extremely drug resistant metallo-beta-lactamase (MBL VIM) Pseudomonas aeruginosa in a patient presenting with 54% deep-dermal and full-thickness flame burns to her neck, chest, upper abdomen and upper limbs, appeared to coincide with wound breakdown and non-healing. This organism was also seen to colonise the patient's gastrointestinal tract, which was thought to act as a reservoir for re-infection of her wounds. Oral treatment with a probiotic drink (Yakult yoghurt) was commenced in order to alter gut flora. Two weeks after this regimen began, P. aeruginosa grown from wound swabs was seen to change from multi-drug resistant to multi-drug sensitive strains. This change persisted through to patient discharge home from hospital. The temporal relationship seen between commencement of once-daily probiotic and change of the organism from multi-drug resistant to multi-drug sensitive suggests that this may have been an effective intervention.