Efficacy of Lactiplantibacillus plantarum 299 and 299v against nosocomial oropharyngeal pathogens in vitro and as an oral prophylactic treatment in a randomized, controlled clinical trial

• Published in: MicrobiologyOpen (Weinheim) Vol. 10; no. 1; pp. e1151 - n/a
• Main Authors: Tranberg, Anna, Klarin, Bengt, Johansson, Julia, Påhlman, Lisa I.
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.01.2021; John Wiley and Sons Inc; Wiley
• Subjects: Agar; Antibiotics; Basic Medicine; Clinical trials; Culture; Experiments; hospitalization; Hospitals; In vitro methods and tests; In vivo methods and tests; Medical and Health Sciences; Medical research; Medicin och hälsovetenskap; Medicinska och farmaceutiska grundvetenskaper; Microbiology in the medical area; Microbiomes; Microbiota; Mikrobiologi inom det medicinska området; Nosocomial infection; nosocomial pathogens; Original; oropharyngeal microbiota; Pathogens; Patients; Placebos; Probiotics; Proton pump inhibitors; Respiratory tract; Risk analysis; Risk factors; Steroids; Sweden; oropharyngeal microbiota; nosocomial pathogens; hospitalization; nosocomial infection; probiotics
• ISSN: 2045-8827; 2045-8827
• DOI: 10.1002/mbo3.1151

Background Disturbance in the oropharyngeal microbiota is common in hospitalized patients and contributes to the development of nosocomial pneumonia. Lactiplantibacillus plantarum 299 and 299v (Lp299 and Lp299v) are probiotic bacteria with beneficial effects on the human microbiome. Aim To investigate how Lp299 and Lp299v affect the growth of nosocomial oropharyngeal pathogens in vitro and to evaluate the efficacy in vivo when these probiotics are administered prophylactically in hospitalized patients. Methods The in vitro effect of Lp299 and Lp299v on nosocomial respiratory tract pathogens was evaluated using two methods, the co‐culture and agar overlay. In the clinical study, patients were randomized to orally receive either probiotics or placebo twice daily during their hospital stay. Oropharyngeal swabs were analyzed at inclusion and every fourth day throughout hospitalization. Findings All tested pathogens were completely inhibited by both Lp299 and Lp299v using the agar‐overlay method. In the co‐culture experiment, Lp299 and Lp299v significantly (p < 0.05) reduced the growth of all pathogens except for Enterococcus faecalis co‐incubated with Lp299. In the clinical study, daily oral treatment with Lp299 and Lp299v did not influence the development of disturbed oropharyngeal microbiota or nosocomial infection. Proton pump inhibitors, antibiotics, and steroid treatment were identified as risk factors for developing disturbed oropharyngeal microbiota. Conclusions Lp299 and Lp299v inhibited pathogen growth in vitro but did not affect the oropharyngeal microbiota in vivo. The ClinicalTrials.gov Identifier for this study is NCT02303301. This combined laboratory and clinical study showed that Lactiplantibacillus plantarum 299 and 299v significantly inhibited in vitro growth of nosocomial pathogens often found in the oropharynx of hospitalized patients. In the randomized controlled trial, hospitalized patients were randomized to receive either oral twice‐daily treatment with lactobacilli or placebo, and oropharyngeal swabs were performed regularly throughout hospitalization. No differences could be shown between the Lactobacilli and placebo groups regarding changes in oropharyngeal microbiota or the occurrence of nosocomial infections.