Saccharomyces boulardii probiotic-associated fungemia: questioning the safety of this preventive probiotic's use

Isabella W Martin; Rita Tonner; Julie Trivedi; Heather Miller; Richard Lee; Xinglun Liang; Leo Rotello; Elena Isenbergh; Jennifer Anderson; Trish Perl; Sean X Zhang

doi:10.1016/j.diagmicrobio.2016.12.004

Saccharomyces boulardii probiotic-associated fungemia: questioning the safety of this preventive probiotic's use

Diagn Microbiol Infect Dis. 2017 Mar;87(3):286-288. doi: 10.1016/j.diagmicrobio.2016.12.004. Epub 2016 Dec 16.

Authors

Affiliations

¹ Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² Hospital Epidemiology and Infection Control, Suburban Hospital, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
³ Microbiology Laboratory, The Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
⁴ Department of Geriatrics, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China.
⁵ Suburban Hospital, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
⁶ Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: tperl@jhmi.edu.
⁷ Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Microbiology Laboratory, The Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Baltimore, MD, USA. Electronic address: szhang28@jhmi.edu.

PMID: 28024866
DOI: 10.1016/j.diagmicrobio.2016.12.004

Abstract

We report a case of fungemia in an immunocompetent patient after administration of probiotic containing Saccharomyces boulardii. We demonstrated the strain relatedness of the yeast from the probiotic capsule and the yeast causing fungal infection using genomic and proteomic typing methods. Our study questions the safety of this preventative biotherapy.

Keywords: Fungal infection; Fungemia; Probiotic; Saccharomyces boulardii; Strain typing.

Publication types

Case Reports

MeSH terms

Antifungal Agents / therapeutic use
Diarrhea / drug therapy
Diarrhea / prevention & control
Fluconazole / therapeutic use
Fungemia / drug therapy*
Fungemia / microbiology*
Humans
Male
Middle Aged
Mycological Typing Techniques
Probiotics / adverse effects*
Probiotics / therapeutic use
Pyrimidines / therapeutic use
Saccharomyces boulardii / isolation & purification*
Sulfonamides / therapeutic use

Substances

Antifungal Agents
Pyrimidines
Sulfonamides
florasulam
Fluconazole