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In patients with central venous catheters in the intensive care unit (ICU), administration of probiotic medications is associated with an increased incidence of probiotic-associated central line infections (PACLIs) and a significant rise in mortality, according to study findings presented at the American College of Chest Physicians (CHEST) 2022 Annual Meeting, held October 16-19, in Nashville, Tennessee.
Although probiotics have become popular for addressing many gastrointestinal conditions, case reports have suggested that probiotics carry a risk for patients in the ICU with central venous catheters. Researchers therefore conducted a retrospective study of data from 23,015 patients in the HCA DATACLEAR health care database who received probiotics while on a central venous catheters in the ICU.
To establish the incidence of PACLI in the study cohort, researchers divided the total number of infections, which was defined as “positive blood cultures” (ie, growing organisms found in ingested probiotics), by the number of individuals at risk, which was defined as “patients taking probiotics while a central venous catheter was in place.” The researchers identified 86 PACLIs, with an incidence rate of 0.37%.
Mortality analysis was carried out with the use of logistical regression analysis, which showed a significantly increased rate of mortality among participants with a PACLI vs those without (odds ratio, 2.23; 95% CI, 1.30-3.71; P <.01).
Investigators also compared mortality rates of those with protected central venous catheters (eg, those with peripherally inserted central catheters) vs those without protected catheters. The analysis found decreased mortality in those with protected catheters vs those with nonprotected catheters. “It is likely that protected catheters are at decreased risk of PACLI and subsequent mortality due to decreased risk of external contamination,” noted the researchers.
In conclusion, study authors said that “The increased risk [for] bacteremia from probiotic medication containing organisms and the associated increase in mortality outweigh the potential benefits for patients with central venous catheters in the ICU.”
Disclosure: One of the study authors has declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of the author’s disclosures.
Reference
Mayer S, Bonhag CM, Jenkins P, Cornett BT, Scherbak D. Probiotic administration is associated with increased mortality in ICU patients with central venous catheters. Presented at: CHEST 2022 Annual Meeting; October 16-19, 2022; Nashville, TN.
