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A cautionary tale for probiotic use in hematopoietic SCT patients–Lactobacillus acidophilus sepsis in a patient with mantle cell lymphoma undergoing hematopoietic SCT

Bone Marrow Transplantation volume 48, pages 461–462 (2013)Cite this article

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Probiotics include food or drugs containing viable microorganisms that on ingestion confer beneficial physiologic effects on the host.1 Commonly used genera of probiotic strains include lactobacillus, lactococcus, bifidobacterium and saccharomyces (yeast). Probiotics are commonly consumed as a part of fermented foods with added active live cultures such as yogurt or soy yogurt or as dietary supplements. They confer beneficial effects by means of restoration of intestinal permeability, balancing of the gut microbiota, prevention of bacterial translocation and possibly immunomodulation, thereby ensuring a healthy intestinal environment. A randomized control study in children has shown that the consumption of probiotic microbial strains reduces the incidence of acute infectious, nosocomial and antibiotic-associated diarrhea in various general pediatric settings.1 However, in some patients with immunocompromised states there have been rare instances where consumption of probiotics has resulted in sepsis.2, 3, 4, 5 We report one such unusual case of a mantle-cell lymphoma patient undergoing an autologous hematopoietic SCT who developed Lactobacillus acidophilus sepsis secondary to the excessive consumption of probiotic-enriched yogurt.

The use of probiotics containing live bacterial cultures has increased significantly in the last few years, with advertised immune enhancement and anti-inflammatory health benefits. Yogurt products in the United States must contain two-specific live and active cultures of Lactobacillus bulgaricus and Streptococcus thermophilus. The addition of Lactobacillus acidophilus, Lactobacillus casei or Bifidobacterium seen in some yogurt products is not a mandatory requirement. The requirement of a voluntary seal of ‘Live active Culture’ by the National Yogurt Association requires at least 100 million cultures per gram at the time of manufacture in refrigerated yogurt and at least 10 million live culture in frozen yogurt at the time of manufacture. (http://www.aboutyogurt.com/Live-Culture (accessed on 26th June 2012).)

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Authors and Affiliations

  1. Department of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL, USA

    A Mehta & U Borate

  2. Department of Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA

    S Rangarajan

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  1. A Mehta
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  2. S Rangarajan
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  3. U Borate
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Correspondence to A Mehta.

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Mehta, A., Rangarajan, S. & Borate, U. A cautionary tale for probiotic use in hematopoietic SCT patients–Lactobacillus acidophilus sepsis in a patient with mantle cell lymphoma undergoing hematopoietic SCT. Bone Marrow Transplant 48, 461–462 (2013). https://doi.org/10.1038/bmt.2012.153

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