Lacticaseibacillus rhamnosus GG Versus Placebo for Eradication of Vancomycin-Resistant Enterococcus faecium in Intestinal Carriers: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Protocol
2.2. Search Strategy
2.3. Data Collection and Analysis
2.4. Inclusion/Exclusion of Studies
2.5. Quality Assessment
2.6. Statistical Analyses
3. Results
3.1. Study Design and Selection
3.2. Description of the Studies
3.3. Primary Outcome
Meta-Analysis and Efficacy of LGG on Eradication of VREfm from the GI-Tract
3.4. Secondary Outcomes
3.4.1. Health-Related Change in the Quality of Life
3.4.2. LGG Colonization at the End of Intervention
3.4.3. Tolerability and Safety
3.4.4. Heading
3.5. Risk of Bias
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Paper | Study Design | Intervention and Duration | Number of Individuals (LGG:Placebo) | Male:Female Ratio | Mean Age in Years (Range) | Follow-Up | Dose and Formulation of LGG | Number of Cleared Individuals at the End of Intervention | Number of Cleared Individuals at the End of Follow-Up | Adverse Events | Conclusion |
---|---|---|---|---|---|---|---|---|---|---|---|
Manley et al. Australia (2007) [29] | Double-blinded, randomized and placebo-controlled trial with two arms. | 1. LGG yoghurt 2. Placebo; 4 weeks | 23 (11:12) | 10:4 | 68 (46–84) | 8 weeks | 100 g of yoghurt, unknown LGG dose | 11/11 in treatment group and 1/12 in placebo group | 8/11 in treatment group and 0/8 in placebo group | Not reported | Significant effect of VRE eradication |
Vidal et al. France (2010) [39] | Double-blinded, randomized and placebo-controlled pilot trial with two arms. | 1. LGG 2. Placebo; 5 weeks | 8 (6:2) | not reported | 77 (66–92) | 11 weeks or until negative VRE culture | 1 × 109 CFU of LGG daily as capsules | 3/6 in treatment arm and 2/2 in placebo arm | 2/4 in treatment group | Not reported | No effect on VRE clearance |
Szachta et al. Poland (2011) [30] | Double-blinded, randomized and placebo-controlled trial with two arms. | 1. LGG 2. Placebo; 3 weeks | 61 (32:29) | 40:21 | 2.5 (unknown) | 4 weeks | 3 × 109 CFU of LGG daily as a sachet dissolved in water or milk | 20/32 in treatment arm and 7/29 in placebo group | 10/19 in treatment arm and 9/20 in placebo group | Not reported | Temporary effect of VRE eradication |
Doron et al. USA (2015) [31] | Double-blinded, randomized and placebo-controlled trial with two arms. | 1. LGG 2. Placebo; 2 weeks | 11 (5:6) | 7:4 | 70 (53–90) | 2 weeks | 2 × 1010 CFU of LGG as capsules daily | 0/5 in treatment arm and 0/6 in placebo arm | 0/4 in treatment arm and 0/5 in placebo arm | No adverse events related to LGG were seen | No effect on VRE clearance |
Rauseo et al. USA (2021) [38] | Double-blinded, randomized, and controlled pilot trial with two arms. (VRE clearance = secondary outcome) | 1. LGG 2. Placebo; median duration of intervention was 5.8 and 6.5 days for LGG and placebo respectively | 16 (7:9) | Not reported for the subgroup of VREfm carriers | Not reported for the subgroup of VREfm carriers | Every 3 days after enrollment and at discharge | 2 × 1010 CFU of LGG as capsules or nasogastric administration | 2/7 in treatment arm and 1/9 in placebo arm | Same as end of intervention | No safety concerns and no difference in Bristol stool types between arms | No effect on VRE clearance |
Rubin et al. Denmark (2022) [25] | Double-blinded, randomized and placebo-controlled trial with two arms. | 1. LGG 2. Placebo; 4 weeks | 48 (21:27) | 18:30 | 75 (64.5–82.5) | 24 weeks | 6 × 1010 CFU of LGG as capsules daily | 12/21 in treatment group and 15/27 in placebo group | 7/8 in treatment group and 9/10 in placebo group | No adverse events related to LGG were seen | No effect on VRE clearance |
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Rubin, I.M.C.; Knudsen, M.J.S.; Halkjær, S.I.; Ilsby, C.S.; Pinholt, M.; Petersen, A.M. Lacticaseibacillus rhamnosus GG Versus Placebo for Eradication of Vancomycin-Resistant Enterococcus faecium in Intestinal Carriers: A Systematic Review and Meta-Analysis. Microorganisms 2023, 11, 2804. https://doi.org/10.3390/microorganisms11112804
Rubin IMC, Knudsen MJS, Halkjær SI, Ilsby CS, Pinholt M, Petersen AM. Lacticaseibacillus rhamnosus GG Versus Placebo for Eradication of Vancomycin-Resistant Enterococcus faecium in Intestinal Carriers: A Systematic Review and Meta-Analysis. Microorganisms. 2023; 11(11):2804. https://doi.org/10.3390/microorganisms11112804
Chicago/Turabian StyleRubin, Ingrid Maria Cecilia, Maja Johanne Søndergaard Knudsen, Sofie Ingdam Halkjær, Christian Schaadt Ilsby, Mette Pinholt, and Andreas Munk Petersen. 2023. "Lacticaseibacillus rhamnosus GG Versus Placebo for Eradication of Vancomycin-Resistant Enterococcus faecium in Intestinal Carriers: A Systematic Review and Meta-Analysis" Microorganisms 11, no. 11: 2804. https://doi.org/10.3390/microorganisms11112804