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Lactobacillus rhamnosus GG clears Vancomycin resistant enterococci.

Manley K, Fraenkel M, Mayall B, Power D. Probiotic treatment of vancomycin-resistant enterococci: a randomised controlled trial. Medical Journal of Australia 2007;186(9):454-457. Free access available at http://www.mja.com.au.

Vancomycin resistant enterococci (VRE) are associated with persistent nosocomial infections that may have poor outcomes. VRE can also transfer their antibiotic resistance to other micro-organisms increasing the threat of infection.

Almost all strains of lactobilli however are already resistant to vancomycin. Thus these researchers tested whether Lactobacillus rhamnosus GG (LGG) might be able to clear VRE infections.

Twenty seven in-patients of the renal ward at Austin Health, a tertiary hospital, were randomly assigned to receive either a yoghurt containing LGG, or a yoghurt which did not contain LGG. Both yoghurts are commercially available, and the patients ate 100 g of their respective yoghurt each day for, initially, 3 weeks.

Fourteen patients were assigned to receive the LGG yoghurt. After 1 week, 6 patients had become VRE negative. After 2 weeks 3 of the patients had left the trail (including one death). Of the remaining 11 patients, 8 were now VRE negative. After 3 weeks all 11 patients were VRE negative. At follow up after 8 weeks 8 of all these 11 patients remained clear of VRE. The other 3 patients had been prescribed an antibiotic which affects LGG.

Of the control group only 1 of the eligible 11 patients had cleared VRE by week 4. These patients were then offered the LGG yoghurt. Sadly another 2 patients died, while a third refused to continue with the trial. Seven of the remaining patients were VRE negative after 1 week, while the remaining patient had cleared VRE within 4 weeks.

The authors suggest several possible mechanisms for the effectiveness of LGG in clearing VRE. LGG may out compete VRE in binding to the bowel wall and thus prevent VRE becoming established in pathological numbers. LGG may also compete with VRE for monosaccharides, thus restricting the food available to VRE and slowing VRE growth. LGG also produces fatty acids that lower the pH of the bowel to a level which does not favour pathogens. Finally, and although still to be proven, LGG may act as an antibiotic against VRE.

Comments: This study was situated in a palliative care hospital and was concerned with identifying ways to reduce nosocomial infections. To that extent it is of limited clinical relevance to natural health practitioners.

It has been presented here however as another example of the potential effectiveness of probiotics in clearing gut infections. It is also interesting to note that benefits may be obtained from some commercially available yoghurts, although there may be other factors, such as sugar content, which might make such products less desirable for patients.
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Article Details
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Title Annotation:RESEARCH BRIEFS
Author:Boylan, Matthew
Publication:Journal of the Australian Traditional-Medicine Society
Article Type:Clinical report
Geographic Code:8AUST
Date:Jun 1, 2007
Words:457
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