Probiotic-associated central venous catheter bloodstream infection
Abstract:
Objectives: To determine the occurrence rate and impact on patient outcomes of probiotic-associated central venous catheter bloodstream infections in the ICU.
Design: Retrospective observational cohort study.
Setting: The cohort was gathered using HCA Healthcare’s data warehouse.
Patients: Adult patients with central venous catheters in the ICU.
Interventions: None.
Measurements and main results: Blood culture data were used to determine whether an infection had occurred with an organism contained in an administered probiotic. Eighty-six probiotic-associated central venous catheter bloodstream infections were identified among the 23,015 patient cohort who received probiotics (0.37%). The number needed to harm was 270. Zero infections were found in the cohort that did not receive probiotics. Patients who contracted a probiotic infection had increased mortality (odds ratio, 2.23; 1.30-3.71; p < 0.01). Powder formulations had an increased rate of infection compared with nonpowder formulations (0.76% vs 0.33%; odds ratio, 2.03; 1.05-3.95; p = 0.04).
Conclusions: 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.
Reference:
Mayer S, Bonhag C, Jenkins P, Cornett B, Watts P, Scherbak D. Probiotic-Associated Central Venous Catheter Bloodstream Infections Lead to Increased Mortality in the ICU. Crit Care Med. 2023 Jun 1. doi: 10.1097/CCM.0000000000005953. Epub ahead of print. PMID: 37260310.