Do probiotics prevent colonization with multi-resistant Enterobacteriaceae during travel? A randomized controlled...

Area of Science:

• Microbiology
• Infectious Diseases
• Gastroenterology

Background:

• Travelers to India are at high risk of gut colonization with multidrug-resistant bacteria, specifically extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E) and Carbapenemase-producing Enterobacteriaceae (CPE).
• Understanding the prevalence and prevention of such colonization is crucial for public health.

Purpose of the Study:

• To investigate the efficacy of the probiotic species Lactobacillus Rhamnosus GG (LGG) in preventing gut colonization with ESBL-E and CPE in travelers to India.

Main Methods:

• A randomized controlled trial involving adult Danish travelers to India.
• Participants received either LGG or a placebo during their 10-28 day trip.
• Rectal swabs were collected before travel, immediately after return, and six months post-return for screening of ESBL-E and CPE.

Main Results:

• High incidence of ESBL-E colonization observed, with over 90% of travelers colonized upon return and approximately one-third remaining carriers after six months.
• No statistically significant difference in ESBL-E colonization rates was found between the LGG group and the control group.
• Carbapenemase-producing Enterobacteriaceae (CPE) were not detected in any participants.

Conclusions:

• Travel to India is associated with a very high rate of intestinal colonization with ESBL-E.
• The probiotic Lactobacillus Rhamnosus GG (LGG) did not demonstrate a preventive effect on ESBL-E colonization in this study population.