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Clinical and Bacteriologic Characteristics of Six Cases of Bifidobacterium breve Bacteremia Due to Probiotic Administration in the Neonatal Intensive Care Unit

  • 2021-06-22
  • Pediatric Infectious Disease Journal 41(1)
    • Yoshie Sakurai
    • Tatsuya Watanabe
    • Yuichiro Miura
    • Toshihiko Uchida
    • Natsumi Suda
    • M. Yoshida
    • Tatsuro Nawa

Abstract

Background: Bifidobacterium breve is widely used as a probiotic in preterm infants and children with congenital surgical conditions, however, some cases of probiotics-induced bacteremia have been reported recently.

Objectives: To examine the clinical and bacteriologic features of Bifidobacterium breve bacteremia caused by a probiotic (BBG-01) in term and preterm infants.

Methods: We included 298 patients who were admitted to the neonatal intensive care unit of Miyagi Children's Hospital and were given BBG-01 as a probiotic within the period June 2014 to February 2019. We experienced six cases of B. breve bacteremia and assessed their features retrospectively.

Results: The incidence rate of B. breve bacteremia in our hospital was 2% (6/298), higher than reported previously. The median age at onset, corrected age, and weight of the patients was 8 days (range: 5-27 days), 35 weeks (range: 26-39 weeks), and 1,940 g (range: 369-2734 g), respectively. The bacteremia triggers were gastrointestinal perforations in two cases, food protein-induced enterocolitis syndrome in two cases, adhesive ileus in one case, ileal volvulus in one case, and aspiration pneumonia following esophageal atresia repair in one case. B. breve was detected on blood cultures after a median of 5 days 13 hours (range: 4 days 18 hours-9 days 13 hours). No patient demonstrated serious symptoms, such as septic shock. All patients received antibiotics and recovered without any sequelae.

Conclusions: Ileus and intestinal mucosal damage, such as enteritis, can cause B. breve bacteremia. The incidence of B. breve bacteremia may be higher than reported previously and detection via culture may require a longer time than typically needed for more common bacteria. It is associated with a good prognosis.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Bifidobacterium breveAsymptomatic or Mild SymptomsNeutral
Moderate
Bifidobacterium breveComplete Recovery Without SequelaeBeneficial
Large
Bifidobacterium breveIncreased Detection Time in Blood CulturesNeutral
Moderate
Bifidobacterium breveReduced Blood Bacterial IncidenceHarmful
Moderate
Bifidobacterium breve Bb-03Complete Recovery Without SequelaeBeneficial
Large
Bifidobacterium breve Bb-03Increased Detection Time in Blood CulturesNeutral
Moderate
Bifidobacterium breve Bb-03Reduced Bacteremia IncidenceHarmful
Moderate
Bifidobacterium breve BBr60Increased BacteremiaHarmful
Moderate
Bifidobacterium breve BBr60Recovered Without Further ComplicationsNeutral
Moderate
Bifidobacterium breve Bbr8Complete Recovery Without SequelaeBeneficial
Large
Bifidobacterium breve Bbr8Reduced Blood Bacterial IncidenceHarmful
Moderate
Bifidobacterium breve BR-03Bifidobacterium Breve BacteremiaHarmful
Moderate
Bifidobacterium breve BR-03Recovered from Bacteremia without SequelaeNeutral
Moderate
Bifidobacterium breve BR03Bifidobacterium Breve BacteremiaHarmful
Moderate
Bifidobacterium breve BR03Improved Prognosis After Bacteremia RecoveryBeneficial
Moderate
Bifidobacterium breve HA-129Reduced Bacteremia IncidenceHarmful
Moderate
Bifidobacterium breve MAK40B22BImproved Prognosis Post-RecoveryBeneficial
Moderate
Bifidobacterium breve MAK40B22BIncreased Bacteremia IncidenceHarmful
Moderate
Bifidobacterium breve R0070Absence of Serious Symptoms such as Septic ShockNeutral
Small
Bifidobacterium breve R0070Bifidobacterium Breve BacteremiaHarmful
Moderate
Bifidobacterium breve SD5206Blood Bacteremia Due to Probiotic AdministrationHarmful
Moderate
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