Complicações infecciosas após a ingestão de probióticos: revisão sistemática de relatos e séries de casos.
Complicações infecciosas após a ingestão de probióticos: revisão sistemática de relatos e séries de casos.
Data
2016
Autores
Costa, Rafael Lessa da
Journal Title
Journal ISSN
Volume Title
Publisher
Instituto Nacional de Cardiologia
Resumo
Introdução: O consumo de probióticos tem aumentado nas últimas décadas e estudos clínicos sobre seu potencial terapêutico em diversas doenças é cada vez mais comum na literatura. Porém, pouco se estuda ou se conhece sobre as complicações graves comprovadamente ou possivelmente relacionadas ao uso desses produtos. Objetivo: apresentar uma síntese e avaliação crítica dos relatos ou séries de casos sobre as complicações infecciosas comprovadamente ou possivelmente relacionadas ao uso de probióticos. Método: Revisão sistemática de relatos e séries de casos pesquisados nas bases PubMed, SciELO e Scopus publicados até julho de 2016. As referências dos artigos foram investigadas manualmente para a busca de referências cruzadas. O pacote estatístico SPSS versão 23.0 foi usada para estatística descritiva e análise univariada. Resultados: Foram encontrados 54 relatos de caso e 6 séries de casos, compondo um total de 81 pacientes. Fungemia e sepse foram as complicações infecciosas mais comuns com 27 (33,3%) casos cada uma. O gênero Saccharomyces foi o mais frequente com 38 (46,9%) casos, seguido de Lactobacillus, Bifidobacterium, Bacillus, Pedioccocus e Escherichia com 23 (28,4%), 12 (14,6%), 5 (6,5%), 2 (2,4%) e 1 (1,2%) caso, respectivamente. Idade maior que 60 anos, colite por Clostridium difficile, uso de antibiótico e infecções por Saccharomyces estavam associados à maior mortalidade geral. Infecção por HIV, drogas imunossupressoras, transplante de órgãos sólidos, acesso venoso central, nutrição enteral e parenteral não apresentaram associação com o óbito. Conclusão: O uso de probióticos não pode ser considerado isento de riscos e deve ser criteriosamente avaliado para determinados grupos de pacientes.
Introduction: Probiotics consumption has increased in recent decades and clinical studies on their therapeutic potential in various disease states is increasingly common in the literature. However, little is studied or known about the serious complications definitely or possibly related to the use of these products. Objective: To present a synthesis and critical evaluation of the reports or series of cases on the infectious complications, definitely or possibly related to the use of probiotics. Method: Systematic review of reports and series of cases researched in the PubMed, SciELO and Scopus databases published until July 2016. The references of the articles were investigated manually for the search of cross references. SPSS version 23.0 was used for descriptive statistics and univariate analysis. Results: We found 54 case reports and 6 case series, making up a total of 81 patients. Fungemia and sepsis were the most common infectious complications with 27 (33,3%) cases each. The genus Saccharomyces was the most frequent with 38 (46,9%) cases, followed by Lactobacillus, Bifidobacterium, Bacillus, Pedioccocus and Escherichia with 23 (28,4%), 12 (14,6%), 5 6,5%), 2 (2,4%) and 1 (1,2%) case, respectively. Adults over 60 years of age, Clostridium difficile colitis, antibiotic use and Saccharomyces infections were associated with overall mortality. HIV infections, immunosuppressive drugs, solid organ transplantation, deep intravenous lines, enteral or parenteral nutrition were not associated with death. Conclusion: The use of probiotics cannot be considered risk-free and should be carefully evaluated for some patient group
Introduction: Probiotics consumption has increased in recent decades and clinical studies on their therapeutic potential in various disease states is increasingly common in the literature. However, little is studied or known about the serious complications definitely or possibly related to the use of these products. Objective: To present a synthesis and critical evaluation of the reports or series of cases on the infectious complications, definitely or possibly related to the use of probiotics. Method: Systematic review of reports and series of cases researched in the PubMed, SciELO and Scopus databases published until July 2016. The references of the articles were investigated manually for the search of cross references. SPSS version 23.0 was used for descriptive statistics and univariate analysis. Results: We found 54 case reports and 6 case series, making up a total of 81 patients. Fungemia and sepsis were the most common infectious complications with 27 (33,3%) cases each. The genus Saccharomyces was the most frequent with 38 (46,9%) cases, followed by Lactobacillus, Bifidobacterium, Bacillus, Pedioccocus and Escherichia with 23 (28,4%), 12 (14,6%), 5 6,5%), 2 (2,4%) and 1 (1,2%) case, respectively. Adults over 60 years of age, Clostridium difficile colitis, antibiotic use and Saccharomyces infections were associated with overall mortality. HIV infections, immunosuppressive drugs, solid organ transplantation, deep intravenous lines, enteral or parenteral nutrition were not associated with death. Conclusion: The use of probiotics cannot be considered risk-free and should be carefully evaluated for some patient group
Description
Palavras-chave
Probióticos, Infecção, Fungemia, Sepse, Fungemia, Probiotics, Infection, Sepsis, Saccharomyces, Lactobacillus
Citação
Costa RL. Complicações infecciosas após a ingestão de probióticos: revisão sistemática de relatos e séries de casos. Rio de Janeiro. Dissertação [Mestrado Profissional em Ciências Cardiovasculares] - Instituto Nacional de Cardiologia; 2016.