{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:20:37Z","timestamp":1791840037536,"version":"4.3.4"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T00:00:00Z","timestamp":1615161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    Most infections with\n                    <jats:italic>Enterobacteriaceae<\/jats:italic>\n                    producing AmpC \u03b2-lactamase (AmpC)-, extended-spectrum \u03b2-lactamase (ESBL)-, and carbapenemase-producing bacteria, vancomycin-resistant\n                    <jats:italic>Enterococcus<\/jats:italic>\n                    as well as naturally resistant non-fermenting bacteria such as\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    , are related to a prior colonization of the gut microbiota. The objective of this study was to determine whether treatment with probiotics during an antibiotic treatment could prevent the colonization of the gut microbiota with multi-drug resistant bacteria.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Method:<\/jats:bold>\n                    In total, 120 patients treated for 10 days with amoxicillin-clavulanate antibiotics were included in a randomized, placebo-controlled, double-blinded trial, comparing the effects of a 30 days treatment with placebo\n                    <jats:italic>Saccharomyces boulardii<\/jats:italic>\n                    CNCM I-745\u00ae and a probiotic mixture containing\n                    <jats:italic>Saccharomyces boulardii, Lactobacillus acidophilus<\/jats:italic>\n                    NCFM,\n                    <jats:italic>Lactobacillus paracasei<\/jats:italic>\n                    Lpc-37,\n                    <jats:italic>Bifidobacterium lactis<\/jats:italic>\n                    Bl-04, and\n                    <jats:italic>Bifidobacterium lactis<\/jats:italic>\n                    Bi-07 (Bactiol duo\u00ae). Study treatment was initiated within 48 h of the antibiotic being initiated. Most of the patients included were elderly with a mean age of 78 years old with multiple comorbidities. Stools were collected at the time of inclusion in the trial, at the end of the antibiotic treatment, and the end of the study treatment. These were cultured on selective antibiotic media.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Treatment with the probiotic mixture led to a significant decline in colonization with\n                    <jats:italic>Pseudomonas<\/jats:italic>\n                    after antibiotic treatment from 25 to 8.3% (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.041). Colonization with AmpC-producing enterobacteria was transiently increased after the antibiotic treatment (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.027) and declined after the probiotic intervention (p= 0.041). No significant changes were observed in the placebo and\n                    <jats:italic>Saccharomyces<\/jats:italic>\n                    groups. Up to 2 years after the trial, no infection with ESBL-producing bacteria was observed in the probiotic mixture group.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    The association of\n                    <jats:italic>Saccharomyces boulardii<\/jats:italic>\n                    with specific strains of\n                    <jats:italic>Lactobacillus<\/jats:italic>\n                    and\n                    <jats:italic>Bifidobacterium<\/jats:italic>\n                    influences antibiotic treatment by counteracting the colonization of the colon microbiota with antibiotic-resistant pathogens.\n                  <\/jats:p>","DOI":"10.3389\/fpubh.2020.578089","type":"journal-article","created":{"date-parts":[[2021,3,7]],"date-time":"2021-03-07T23:47:05Z","timestamp":1615160825000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":58,"title":["Do Probiotics During In-Hospital Antibiotic Treatment Prevent Colonization of Gut Microbiota With Multi-Drug-Resistant Bacteria? A Randomized Placebo-Controlled Trial Comparing Saccharomyces to a Mixture of Lactobacillus, Bifidobacterium, and Saccharomyces"],"prefix":"10.3389","volume":"8","author":[{"given":"Gr\u00e9goire","family":"Wie\u00ebrs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Verbelen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mieke","family":"Van Den Driessche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina","family":"Melnik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greet","family":"Vanheule","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Christophe","family":"Marot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice D.","family":"Cani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,3,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e02671","DOI":"10.1128\/AAC.02671-16","article-title":"Results from a 13-year prospective cohort study show increased mortality associated with bloodstream infections caused by Pseudomonas aeruginosa compared to other bacteria","volume":"61","author":"Thaden","year":"2017","journal-title":"Antimicrob Agents Chemother"},{"key":"B2","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/s00277-011-1247-7","article-title":"Risk factors for infection and treatment outcome of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae bacteremia in patients with hematologic malignancy","volume":"91","author":"Kang","year":"2012","journal-title":"Ann Hematol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e030266","DOI":"10.1136\/bmjopen-2019-030266","article-title":"Variation of effect estimates in the analysis of mortality and length of hospital stay in patients with infections caused by bacteria-producing extended-spectrum beta-lactamases: a systematic review and meta-analysis","volume":"10","author":"Shamsrizi","year":"2020","journal-title":"BMJ Open"},{"key":"B4","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1016\/j.ajic.2019.01.020","article-title":"Colonization by fecal extended-spectrum beta-lactamase-producing Enterobacteriaceae and surgical site infections in patients with cancer undergoing gastrointestinal and gynecologic surgery","volume":"47","author":"Golzarri","year":"2019","journal-title":"Am J Infect Control"},{"key":"B5","doi-asserted-by":"publisher","first-page":"4512","DOI":"10.1128\/AAC.00238-13","article-title":"Relative fecal abundance of extended-spectrum-beta-lactamase-producing Escherichia coli strains and their occurrence in urinary tract infections in women","volume":"57","author":"Ruppe","year":"2013","journal-title":"Antimicrob Agents Chemother"},{"key":"B6","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1097\/CCM.0000000000002253","article-title":"ICU Acquisition rate, risk factors, and clinical significance of digestive tract colonization with extended-spectrum beta-lactamase-producing enterobacteriaceae: a systematic review and meta-analysis","volume":"45","author":"Detsis","year":"2017","journal-title":"Crit Care Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"50","DOI":"10.3389\/fmicb.2020.00050","article-title":"Potential elimination of human gut resistome by exploiting the benefits of functional foods","volume":"11","author":"Tsigalou","year":"2020","journal-title":"Front Microbiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"454","DOI":"10.3389\/fcimb.2019.00454","article-title":"How probiotics affect the microbiota","volume":"9","author":"Wieers","year":"2019","journal-title":"Front Cell Infect Microbiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"F1000","DOI":"10.12688\/f1000research.7630.1","article-title":"Probiotics in critically ill children","volume":"5","author":"Singhi","year":"2016","journal-title":"F1000Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.nmni.2016.09.003","article-title":"Inhibitory effect of Lactobacillus plantarum and Lb. fermentum isolated from the faeces of healthy infants against nonfermentative bacteria causing nosocomial infections","volume":"15","author":"Soltan Dallal","year":"2017","journal-title":"New Microbes New Infect"},{"key":"B11","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1016\/j.cmi.2019.08.019","article-title":"Probiotics for intestinal decolonization of ESBL-producing Enterobacteriaceae: a randomized, placebo-controlled clinical trial","volume":"26","author":"Ljungquist","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"B12","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1128\/IAI.01197-12","article-title":"Intestinal microbiota containing Barnesiella species cures vancomycin-resistant Enterococcus faecium colonization","volume":"81","author":"Ubeda","year":"2013","journal-title":"Infect Immun"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2578","DOI":"10.1128\/AEM.66.6.2578-2588.2000","article-title":"Analysis of the fecal microflora of human subjects consuming a probiotic product containing Lactobacillus rhamnosus DR20","volume":"66","author":"Tannock","year":"2000","journal-title":"Appl Environ Microbiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"5098","DOI":"10.1038\/s41598-018-23437-9","article-title":"Lactobacillus paracasei CNCM I-3689 reduces vancomycin-resistant Enterococcus persistence and promotes Bacteroidetes resilience in the gut following antibiotic challenge","volume":"8","author":"Crouzet","year":"2018","journal-title":"Sci Rep"},{"key":"B15","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.ijantimicag.2005.04.004","article-title":"Effects of probiotics on the composition of the intestinal microbiota following antibiotic therapy","volume":"26","author":"Plummer","year":"2005","journal-title":"Int J Antimicrob Agents"},{"key":"B16","doi-asserted-by":"publisher","first-page":"202","DOI":"10.3389\/fmicb.2020.00202","article-title":"Full transcriptomic response of Pseudomonas aeruginosa to an inulin-derived fructooligosaccharide","volume":"11","author":"Rubio-Gomez","year":"2020","journal-title":"Front Microbiol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1128\/CMR.00036-08","article-title":"AmpC beta-lactamases","volume":"22","author":"Jacoby","year":"2009","journal-title":"Clin Microbiol Rev"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1128\/mSphereDirect.00588-18","article-title":"Impact of amoxicillin-clavulanate followed by autologous fecal microbiota transplantation on fecal microbiome structure and metabolic potential","volume":"3","author":"Bulow","year":"2018","journal-title":"mSphere"},{"key":"B19","doi-asserted-by":"publisher","first-page":"500","DOI":"10.3389\/fmicb.2019.00500","article-title":"Peptidoglycan muropeptides: release, perception, and functions as signaling molecules","volume":"10","author":"Irazoki","year":"2019","journal-title":"Front Microbiol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1111\/j.1469-0691.2005.01142.x","article-title":"Interference of Lactobacillus plantarum with Pseudomonas aeruginosa in vitro and in infected burns: the potential use of probiotics in wound treatment","volume":"11","author":"Valdez","year":"2005","journal-title":"Clin Microbiol Infect"},{"key":"B21","doi-asserted-by":"publisher","first-page":"R69","DOI":"10.1186\/cc6907","article-title":"Oral probiotic and prevention of Pseudomonas aeruginosa infections: a randomized, double-blind, placebo-controlled pilot study in intensive care unit patients","volume":"12","author":"Forestier","year":"2008","journal-title":"Crit Care"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/microorganisms8020269","article-title":"Gut microbiota, antibiotic therapy and antimicrobial resistance: a narrative review","volume":"8","author":"Pilmis","year":"2020","journal-title":"Microorganisms"},{"key":"B23","doi-asserted-by":"publisher","first-page":"246","DOI":"10.3109\/07853890.2016.1161232","article-title":"Probiotic approach to prevent antibiotic resistance","volume":"48","author":"Ouwehand","year":"2016","journal-title":"Ann Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1093\/cid\/ciw426","article-title":"Predominance of Lactobacillus spp. among patients who do not acquire multidrug-resistant organisms","volume":"63","author":"Araos","year":"2016","journal-title":"Clin Infect Dis"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2020.578089\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,7]],"date-time":"2021-03-07T23:47:08Z","timestamp":1615160828000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2020.578089\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,8]]},"references-count":24,"alternative-id":["10.3389\/fpubh.2020.578089"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2020.578089","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,8]]},"article-number":"578089"}}