In this episode, I’ll discuss probiotic-associated central venous catheter bloodstream infections in the ICU.
While probiotics are typically seen as a harmless intervention that may have benefits related to antibiotic-associated diarrhea, bloodstream infections caused by organisms contained within probiotics have been reported in ICU patients.
A group of researchers recently published in Critical Care Medicine a retrospective observational cohort study that pulled from a large healthcare database in order to determine the occurrence rate and impact on patient outcomes of probiotic-associated central venous catheter bloodstream infections in the ICU.
A cohort of just over 23,000 ICU patients that received probiotics was identified, and 86 patients had a probiotic-associated central venous catheter bloodstream infection. This translated to a number needed to harm of 270. In a cohort of ICU patients that did not receive probiotics, there were zero probiotic-associated central venous catheter bloodstream infections identified.
These probiotic-associated central venous catheter bloodstream infections were associated with an increased risk of mortality with an odds ratio of 2.23.
Furthermore, the authors were able to identify that powdered formulations of probiotics had about double the relative risk of causing a probiotic-associated central venous catheter bloodstream infection when compared to non-powdered formuations.
The authors concluded:
Probiotic administration is associated with a substantial rate of probiotic-associated bloodstream infection in ICU patients with central venous catheters in place. Probiotic-associated bloodstream infections result in significantly increased mortality. Powder formulations cause bloodstream infections more frequently than nonpowder formulations. In ICU patients with central venous catheters, the risks of probiotic-associated central venous catheter bloodstream infection and death outweigh any potential benefits of probiotic administration.
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