amphotericin-b and Enterocolitis--Pseudomembranous

Saccharomyces cerevisiae, known as baker's yeast, is normally considered a non-pathogenic yeast. A genetically very similar subtype, S boulardii, is used in a probioticum (Sacchaflor) to prevent antibiotic-associated diarrhoea and in the treatment of recurrent Clostridium difficile associated diarrhoea. The authors present a case report of a 79-year-old woman with rheumatoid arthritis, who after a bowel resection developed S boulardii fungemia. Her postoperative course was complicated by nutritional problems, anaemia and several nosocomial infections including recurrent C difficile associated diarrhoea. The diarrhoea was treated with metronidazole, vancomycin and Sacchaflor. After 13 days of treatment, the patient developed fungemia with S boulardii. Treatment with Sacchaflor was immediately discontinued and the patient was successfully treated with amphotericin B. Fungemia is a rare, but a serious complication to treatment with probiotics. Accordingly, the authors find it important to remind the clinicians of this risk when prescribing probiotics especially to immunocompromised patients.

Topics: Aged; Amphotericin B; Antifungal Agents; Enterocolitis, Pseudomembranous; Female; Fungemia; Humans; Probiotics; Saccharomyces

The ability of viable and nonviable Saccharomyces boulardii to protect gnotobiotic mice from Clostridium difficile induced mortality was tested. With the exception of irradiated S. boulardii, which retained some activity, only viable yeast protected the mice from lethality. The survival of C. difficile infected mice was dependent on the dose of the yeast provided in the drinking water.

Topics: Amphotericin B; Animals; Bacterial Proteins; Bacterial Toxins; Cecum; Clostridioides difficile; Cytotoxins; Diarrhea; Disease Models, Animal; Enterocolitis, Pseudomembranous; Germ-Free Life; Mice; Saccharomyces

Topics: Amphotericin B; Animals; Anti-Bacterial Agents; Antitoxins; Cells, Cultured; Clostridium; Colitis, Ulcerative; Cricetinae; Cytotoxicity, Immunologic; Diarrhea; Enterocolitis, Pseudomembranous; Haplorhini; Humans; Infant, Newborn; Mice; Neomycin; Penicillins; Polymyxins; Rabbits; Streptomycin; Toxins, Biological

Topics: Acute Kidney Injury; Aged; Amphotericin B; Candidiasis; Carcinoma, Squamous Cell; Enterocolitis, Pseudomembranous; Female; Humans; Parenteral Nutrition; Radiotherapy; Sepsis; Uterine Cervical Neoplasms