Tolerability of a probiotic in subjects with a history of methicillin-resistant Staphylococcus aureus colonisation

Benef Microbes. 2014 Dec;5(4):389-95. doi: 10.3920/BM2013.0062.

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen of major public health importance. Colonisation precedes infection; thus reducing MRSA carriage may be of benefit for reducing infection. Probiotics represent a novel approach to reducing MRSA carriage. We undertook a pilot feasibility randomised controlled trial of the tolerability and acceptability of probiotics for reducing nasal and intestinal carriage of MRSA. In addition, subjects were screened for vancomycin-resistant enterocococci (VRE). Subjects with a history of MRSA were recruited from a large, academic medical center and randomised to take either a placebo or probiotic (Lactobacillus rhamnosus HN001). Subjects returned to the clinic after four weeks for further testing to determine adherence to the probiotic regimen and colonisation of MRSA. 48 subjects were enrolled and randomised. Nearly 25% were transplant recipients and 30% had diabetes. The probiotic was well tolerated in the study population though minor side effects, such as nausea and bloating, were observed. A majority of the subjects randomised to HN001 had good adherence to the regimen. At the four week time point among subjects randomised to the probiotic, MRSA was detected in 67 and 50% of subjects colonised in the nares and the gastrointestinal tract, respectively. Three subjects who initially tested positive for VRE were negative after four weeks of probiotic exposure. Probiotics were well tolerated in our study population of largely immunocompromised subjects with multiple comorbidities. Adherence to the intervention was good. Probiotics should be studied further for their potential to reduce colonisation by multidrug resistant bacteria.

Keywords: HN001; Lactobacillus rhamnosus; MRSA; probiotics.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carrier State / microbiology*
  • Enterococcus / isolation & purification
  • Female
  • Gastrointestinal Tract / microbiology
  • Humans
  • Lactobacillus rhamnosus / growth & development*
  • Male
  • Medication Adherence
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Middle Aged
  • Nasal Cavity / microbiology
  • Patient Acceptance of Health Care
  • Placebos / administration & dosage
  • Probiotics / administration & dosage*
  • Probiotics / adverse effects*
  • Staphylococcal Infections / microbiology*
  • Vancomycin Resistance
  • Young Adult

Substances

  • Placebos