Efficacy of probiotics in vancomycin-resistant enterococci decolonization: A meta-analysis of randomized clinical trials.

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology Pub Date : 2026-04-21 DOI:10.1016/j.pedneo.2026.03.002

Fei-Hsia Fan, Yi-Jyuan Lin, Jin-Hua Chen, Shiuh-Bin Fang

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引用次数: 0

Abstract

Objective: This meta-analysis investigated whether probiotics can decolonize vancomycin-resistant enterococci (VRE) and examined the effects of probiotics through subgroup analyses stratified by treatment duration, probiotic strain, and patient age.

Methods: We searched PubMed, Embase, and MEDLINE for human trials evaluating probiotics for VRE decolonization. The primary outcome was overall probiotic effectiveness in decolonizing VRE; subgroup analyses stratified by treatment duration (<12 vs. ≥12 weeks), probiotic strain (Lactobacillus rhamnosus GG [LGG] vs. non-LGG), and age group (<18 vs. ≥18 years) were also conducted. Odds ratios (ORs) with 95% confidence intervals (CIs) and p values were derived from a random-effects model using the Z test in Review Manager version 5.4.1.

Results: Five trials involving 189 patients (95 probiotic, 94 control) were included. Probiotics statistically decreased VRE colonization compared with control treatments with small sample sizes, wide CIs, and heterogeneity across studies (OR: 5.70, 95% CI: 1.29-25.07, I² = 68%, p = 0.02). Neither short-duration (OR: 4.26, 95% CI: 0.81-22.43, I² = 70%, p = 0.09) nor long-duration (OR: 4.89, 95% CI: 0.27-89.78, I² = 65%, p = 0.28) treatments were significantly effective. LGG statistically decreased colonized VRE (OR: 7.22, 95% CI: 1.34-39.02, I² = 76%, p = 0.02) more than Lactobacillus rhamnosus Lcr35 (OR: 1.50, 95% CI: 0.06-40.63, I² not applicable, p = 0.81). Probiotics statistically decreased colonized VRE in pediatric patients (OR: 7.17, 95% CI: 2.37-21.71, I² = 11%, p = 0.0005) but not in adults (OR: 5.07, 95% CI: 0.24-105.69, I² = 76%, p = 0.29).

Conclusions: Probiotics, particularly LGG, may facilitate decolonizing VRE from the human gut, especially in pediatric patients. Inconsistent effect was observed in adults or with Lactobacillus rhamnosus Lcr35.

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益生菌对万古霉素耐药肠球菌去菌落的疗效：随机临床试验的荟萃分析。

目的：本荟萃分析研究了益生菌是否可以去定植万古霉素耐药肠球菌（VRE），并通过治疗时间、益生菌菌株和患者年龄分层的亚组分析来检验益生菌的作用。方法：我们检索PubMed， Embase和MEDLINE，以评估益生菌对VRE去定殖的人体试验。主要结局是益生菌在VRE去菌落中的总体有效性；按治疗时间分层的亚组分析(结果：纳入5项试验，涉及189例患者（益生菌95例，对照组94例）。与小样本量、宽CI和研究异质性的对照处理相比，益生菌在统计学上降低了VRE定殖（OR: 5.70, 95% CI: 1.29-25.07, I2 = 68%, p = 0.02）。短期治疗（OR: 4.26, 95% CI: 0.81-22.43, I2 = 70%, p = 0.09）和长期治疗（OR: 4.89, 95% CI: 0.27-89.78, I2 = 65%, p = 0.28）均无显著疗效。LGG显著降低鼠李糖乳杆菌Lcr35的定殖VRE (OR: 7.22, 95% CI: 1.34 ~ 39.02, I2 = 76%, p = 0.02) （OR: 1.50, 95% CI: 0.06 ~ 40.63， I2不适用，p = 0.81）。从统计学上看，益生菌降低了儿科患者的VRE定植（OR: 7.17, 95% CI: 2.37-21.71, I2 = 11%, p = 0.0005），但对成人没有影响（OR: 5.07, 95% CI: 0.24-105.69, I2 = 76%, p = 0.29）。结论：益生菌，特别是LGG，可以促进VRE从人类肠道脱菌，特别是在儿科患者中。在成人或鼠李糖乳杆菌Lcr35中观察到不一致的效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatrics and Neonatology PEDIATRICS-

CiteScore

3.10

自引率

0.00%

发文量

170

审稿时长

48 days

期刊介绍： Pediatrics and Neonatology is the official peer-reviewed publication of the Taiwan Pediatric Association and The Society of Neonatology ROC, and is indexed in EMBASE and SCOPUS. Articles on clinical and laboratory research in pediatrics and related fields are eligible for consideration.