Probiotic treatment of vancomycin-resistant enterococci: a randomised controlled trial
Probiotic treatment of vancomycin-resistant enterococci: a randomised controlled trial
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DOI：
10.5694/j.1326-5377.2007.tb00995.x
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发表时间：
2007-05-07
影响因子：
11.4
通讯作者：
Power, David A.
中科院分区：
文献类型：
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作者：
Manley, Karen J.;Fraenkel, Margaret B.;Power, David A.
目的：为了确定以市售酸奶的形式食用鼠李糖乳杆菌GG（LGG）是否能改善万古霉素耐药肠球菌（VRE）的清除率。设计：双盲、随机、安慰剂对照试验。设置：三级医院奥斯汀健康中心的肾脏病房，2005年2月至10月。参与者：27名VRE阳性患者，14名接受积极治疗，13名对照。干预措施：受试者被随机分配到治疗组（每天接受100 g含有LGG的酸奶，持续4周）或对照组（接受标准巴氏杀菌酸奶）。粪便样本采集三次，间隔约为一周。治疗患者在第8周再次进行VRE测试。在对照组中的患者谁没有明确VRE后4周，然后给予含LGG酸奶4周，作为一个开放continuation.Main结果measure：粪便标本清除VRE.Results的数量：在27例患者入组，23完成了研究。2例患者失访，1例死亡，1例退出。治疗组中完成研究的所有11例患者均清除了VRE。3例受试者在使用LGG敏感的抗生素后恢复为VRE阳性，而所有其他受试者在试验完成后至少4周内保持阴性。12名对照受试者完成了研究，其中1名清除了VRE，11名保持VRE阳性。这11例患者中的8例随后交叉接受LGG酸奶，并清除VRE在4 weeks.Conclusion：据我们所知，这是第一次描述的益生菌疗法，成功地治疗胃肠道运载VRE肾脏患者。需要进一步研究LGG在VRE阳性患者中的应用。
Objective: To determine whether eating Lactobacillus rhamnosus GG (LGG) in the form of commercially available yogurt improves clearance of vancomycin-resistant enterococci (VRE).Design: Double-blind, randomised, placebo-controlled trial.Setting: Renal ward of Austin Health, a tertiary hospital, Feb-Oct 2005.Participants: 27 VRE-positive patients, 14 receiving active treatment and 13 controls.Interventions: Subjects were randomly assigned to either a treatment group (receiving 100 g daily of yoghurt containing LGG for 4 weeks) or a control group (receiving standard pasteurised yoghurt). Faecal samples were obtained three times at about weekly intervals. Treated patients were tested for VRE again at 8 weeks. Patients in the control group who had failed to clear VRE after 4 weeks were then given LGG-containing yoghurt for 4 weeks, as an open continuation.Main outcome measure: Number of faecal specimens clear of VRE.Results: Of the 27 patients enrolled, 23 completed the study. Two patients were lost to follow-up, one died and one withdrew. All 11 patients in the treatment group who completed the study cleared VRE. Three subjects reverted to VRE positivity after using antibiotics to which LGG is sensitive, while all others remained negative for at least 4 weeks after trial completion. Twelve control subjects completed the study, of whom one cleared VRE and 11 remained VRE-positive. Eight of these 11 patients were subsequently crossed over to receive LGG yoghurt, and all cleared VRE within 4 weeks.Conclusion: To our knowledge, this is the first description of a probiotic therapy to successfully treat gastrointestinal carriage of VRE in renal patients. Further investigation of the use of LGG in VRE-positive patients is warranted.