A Four-Probiotic Regime to Reduce Surgical Site Infections in Multi-Trauma Patients
Georgios Tzikos1, Despoina Tsalkatidou1, George Stavrou2,3
11st Propedeutic Department of Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, 54636 Thessaloniki, Greece.
Abstract:
Investigations that focused on the protective role of probiotics against Surgical Site Infections (SSI) in multiple-trauma (MT) patients are generally few, probably due to the complexity of the concept of trauma. We aimed to assess the efficacy of a four-probiotic regime to reduce the incidence of SSI in MT patients, with a brain injury included. MT patients, being intubated and expected to require mechanical ventilation for >10 days, were randomly allocated into placebo (n = 50) or probiotic treatment (n = 53) comprising Lactobacillus acidophilus LA-5 (1.75 × 109 cfu), Lactiplantibacillus plantarum UBLP-40 (0.5 × 109 cfu), Bifidobacterium animalis subsp. lactis BB-12 (1.75 × 109 cfu), and Saccharomycesboulardii Unique-28 (1.5 × 109 cfu) in sachets. All patients received two sachets of placebo or probiotics twice/day for 15 days and were followed-up for 30 days. The operations were classified as neurosurgical, thoracostomies, laparotomies, orthopedics, and others; then, the SSI and the isolated pathogen were registered. A total of 23 (46.0%) and 13 (24.5%) infectious insults in 89 (50 placebo patients) and 88 (53 probiotics-treated) operations (p = 0.022) were recorded, the majority of them relating to osteosynthesis—17 and 8, respectively. The most commonly identified pathogens were Staphylococcus aureus and Acinetobacter baumannii. Our results support published evidence that the prophylactic administration of probiotics in MT patients exerts a positive effect on the incidence of SSI.
Insights
Probiotics significantly reduced Surgical Site Infections (SSI) in multiple-trauma (MT) patients, including those with brain injuries. This study highlights the protective effect of a specific four-probiotic regimen in complex trauma cases.
Area of Science:
- Medical Microbiology
- Trauma Surgery
- Gastroenterology
Background:
- Surgical Site Infections (SSI) pose a significant risk in multiple-trauma (MT) patients.
- Limited research exists on probiotic interventions for SSI prevention in complex trauma, particularly those involving brain injuries.
Purpose of the Study:
- To evaluate the efficacy of a specific four-probiotic formulation in reducing SSI incidence among MT patients.
- To assess the impact of probiotics on SSI rates in patients with traumatic brain injuries requiring prolonged mechanical ventilation.
Main Methods:
- A randomized, placebo-controlled trial involving 103 MT patients (intubated, expected mechanical ventilation >10 days).
- Patients received either a placebo or a four-probiotic regimen (Lactobacillus acidophilus LA-5, Lactiplantibacillus plantarum UBLP-40, Bifidobacterium animalis subsp. lactis BB-12, Saccharomyces boulardii Unique-28) twice daily for 15 days.
- Follow-up for 30 days, classifying operations and registering SSI and isolated pathogens.
Main Results:
- A lower incidence of SSI was observed in the probiotic group (24.5%) compared to the placebo group (46.0%), p = 0.022.
- Osteosynthesis procedures showed the highest SSI rates in both groups (17 placebo vs. 8 probiotic).
- Staphylococcus aureus and Acinetobacter baumannii were the most frequently isolated pathogens.
Conclusions:
- Prophylactic administration of this four-probiotic regimen is effective in reducing SSI incidence in multiple-trauma patients.
- The findings support the use of probiotics as an adjunct therapy for SSI prevention in complex trauma care.
- Further research may explore specific probiotic strains and their mechanisms in preventing infections in vulnerable patient populations.
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