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Related Experiment Video

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Nutritional Strategies To Improve VRE Control.

Enrico Morello1, Sara Roversi2, Giulia Brambilla1

  • 1Department of Clinical and Experimental Sciences, University of Brescia, Bone Marrow Transplant Unit, ASST-Spedali Civili di Brescia, Brescia, Italy.

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Summary

Implementing a lactose-free diet significantly reduced Vancomycin-resistant enterococci (VRE) colonization in cellular therapy patients. This nutritional intervention shows promise for high-risk units, potentially lowering VRE rates and associated complications.

Keywords:
GVHDLactose-free dietVRE

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Area of Science:

  • Infectious Diseases
  • Nutrition Science
  • Hematology

Background:

  • Vancomycin-resistant enterococci (VRE) pose significant risks, including increased morbidity, mortality, and costs, especially for cellular therapy recipients.
  • Lactose consumption has been linked to Enterococcus growth and graft-versus-host disease (GVHD), highlighting a need for dietary modifications.
  • Elevated VRE positivity rates were observed in rectal swabs within a Bone Marrow Transplant (BMT) Unit.

Purpose of the Study:

  • To evaluate the impact of a lactose-free diet on reducing VRE colonization in patients undergoing cellular therapy.
  • To assess the feasibility and effectiveness of a nutritional strategy targeting lactose intake in high-risk patient populations.

Main Methods:

  • A nutritional intervention was implemented, involving the introduction of lactose-free milk and strict adherence to lactose-free diets.
  • Patients were divided into a Lactose Group and a Lactose-Free Group for comparison.
  • VRE positivity rates in rectal swabs were monitored up to June 2023.

Main Results:

  • The Lactose-Free Group exhibited a significantly lower VRE positivity rate (3.6%) compared to the Lactose Group (16%).
  • The nutritional strategy demonstrated a substantial reduction in VRE carriers within the BMT Unit.

Conclusions:

  • A lactose-free dietary strategy is effective in reducing VRE colonization in cellular therapy recipients.
  • This intervention shows potential for application in high-risk settings like BMT and Intensive Care Units.
  • Implementing lactose-free diets may help decrease VRE isolation and reduce unnecessary antibiotic use for VRE colonization.