Bacteriemia por Bacillus clausii asociada a manejo con probioticos en paciente inmunocompetente
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Se describe un caso clinico de bacteriemia por Bacillus clausii en una lactante de 3 meses previamente sana, quien recibio probioticos que contenian este microorganismo. Se destaca la importancia de evaluar la seguridad de los probioticos en pediatria, especialmente en pacientes sin inmunodeficiencias aparentes. Aunque los probioticos son generalmente seguros, existen riesgos de infeccion invasiva, incluso en pacientes sin inmunodeficiencias conocidas. Bacillus clausii ha sido reportado en casos de bacteriemia y sepsis en lactantes y adultos, por lo que su uso en pediatria debe ser considerado con cautela. Es esencial realizar una evaluacion rigurosa de la seguridad de los probioticos en cada paciente antes de su indicacion. Este caso subraya la necesidad de estudios adicionales sobre la seguridad de Bacillus clausii en poblacion pediatrica y refuerza la importancia de una prescripcion basada en evidencia cientifica.
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Diaz-Madriz JP, Zavaleta-Monestel E, Rojas-Chinchilla C, Arguedas Chacon S, Serrano-Arias B, Ferreto-Meza MA, et al. Bacteremia Following Alkalihalobacillus clausii (Formerly Bacillus clausii) Administration in Immunosuppressed Adults: A Case Series. Bacteria. 2023 Dec 12;2(4):185-95. https://doi.org/10.7759/cureus.57853
Erbass IC, Nissanci B, Guur B, Makay BB, Ince OT, Belet N. Bacillus clausii Bacteremia After Probiotic Usage in a Pediatric Patient. Clin Pediatr (Phila). 2024 Feb 18;63(2):183- 6. https://doi.org/10.1177/00099228231207306
Muñoz M, Castaño G. E, Esquivel Suman R, Alvarado M. Septicemia por Bacillus clausii posterior al uso de probioticos. Una complicacion para tener presente. Andes Pediatrica. 2023 Jun 15;94(3):379. https://doi.org/10.32641/andespediatr.v94i3.4417
Swanson KS, Gibson GR, Hutkins R, Reimer RA, Reid G, Verbeke K, et al. The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of synbiotics. Vol. 17, Nature Reviews Gastroenterology and Hepatology. NatureResearch; 2020. p. 687-701. https://doi.org/10.1038/s41575-020-0344-2
Szajewska H, Berni R, Domelloof M, Guarino A, Hojsak I, Indrio F, et al. Probiotics for the management of pediatric gastrointestinal disorders: Position Paper of the ESPGHAN Special Interest Group on Gut Microbiota and Modifications. J Pediatr Gastroenterol Nutr. 2023;24(4):272. https://doi.org/10.1097/MPG.0000000000003633
Guarner F, Sanders ME, Szajewska H, Cohen H, Eliakim R, HerreraDeguise C, et al. World Gastroenterology Organisation Global Guidelines: Probiotics and Prebiotics. J Clin Gastroenterol. 2024 Jun 13;58(6):533-53. https://doi.org/10.1097/MCG.0000000000002002
Monroy FAM, Angel AFG, Carrillo MH, Lopez JPR, Camacho JFG, Calderon Guerrero OG, et al. Colombian Guideline for the Use of Probiotics in Pediatric Diseases. Acta Gastroenterol Latinoam. 2024;54(2):160-91. https://doi.org/10.52787/agl.v54i2.395
Schnadower D, Tarr PI, Casper TC, Gorelick MH, Dean JM, O'Connell KJ, et al. Lactobacillus rhamnosus GG versus Placebo for Acute Gastroenteritis in Children. New England Journal of Medicine. 2018 Nov 22;379(21):2002-14. https://doi.org/10.1056/NEJMoa1802598
Freedman SB, Williamson-Urquhart S, Farion KJ, Gouin S, Willan AR, Poonai N, et al. Multicenter Trial of a Combination Probiotic for Children with Gastroenteritis. New England Journal of Medicine. 2018 Nov 22;379(21):2015-26. https://doi.org/10.1056/NEJMoa1802597
Sharif S, Meader N, Oddie SJ, Rojas-Reyes MX, McGuire W. Probiotics to prevent necrotising enterocolitis in very preterm or very low birth weight infants. Cochrane Database of Systematic Reviews. 2020 Oct 15;2020(10). https://doi.org/10.1002/14651858.CD005496.pub5
Xu R, Yu Y, Chen T. Exploring the dark side of probiotics to pursue light: Intrinsic and extrinsic risks to be opportunistic pathogens. Curr Res Food Sci. 2025;10:101044. https://doi.org/10.1016/j.crfs.2025.101044
D'Agostin M, Squillaci D, Lazzerini M, Barbi E, Wijers L, Da Lozzo P. Invasive Infections Associated with the Use of Probiotics in Children: A Systematic Review. Children. 2021 Oct 16;8(10):924. https://doi.org/10.3390/children8100924
Cook DJ, Johnstone J, Marshall JC, Lauzier F, Thabane L, Mehta S, et al. Probiotics: Prevention of Severe Pneumonia and Endotracheal Colonization Trial-PROSPECT: a pilot trial. Trials. 2016 Dec 2;17(1):377. https://doi.org/10.1186/s13063-016-1495-x
Liu X, Zhao H, Wong A. Accounting for the health risk of probiotics. Heliyon. 2024 Mar;10(6):e27908. https://doi.org/10.1016/j.heliyon.2024.e27908
Chiang MC, Chen CL, Feng Y, Chen CC, Lien R, Chiu CH. Lactobacillus rhamnosus sepsis associated with probiotic therapy in an extremely preterm infant: Pathogenesis and a review for clinicians. Journal of Microbiology, Immunology and Infection. 2021 Aug;54(4):575-80. https://doi.org/10.1016/j.jmii.2020.03.029
Aydogan S, Dilli D, OOzyazici A, Aydin N, Simsek H, Orun UA, et al. Lactobacillus rhamnosus Sepsis Associated with Probiotic Therapy in a Term Infant with Congenital Heart Disease. Fetal Pediatr Pathol. 2022 Sep 3;41(5):823-7. https://doi.org/10.1080/15513815.2021.1966144
Katkowska M, Garbacz K, Kusiak A. Probiotics: Should All Patients Take Them? Microorganisms. 2021 Dec 18;9(12):2620. https://doi.org/10.3390/microorganisms9122620
Roy U, Jessani LG, Rudramurthy SM, Gopalakrishnan R, Dutta S, Chakravarty C, et al. Seven cases of Saccharomyces fungaemia related to use of probiotics. Mycoses. 2017 Jun 30;60(6):375-80. https://doi.org/10.1111/myc.12604
Celis L, Morales W, Duran N. Sepsis por Lactobacillus reuteri en un recien nacido pretermino: reporte de un caso. Arch Argent Pediatr. 2019 Oct 1;117(5). https://doi.org/10.5546/aap.2019.e509
Mohamed R, Sharma A, Al Maslamani E, Shurab N, Perez-Lopez A, Suleiman M. Bacillus clausii Bacteremia After Probiotic Usage in a Preterm Neonate With Short Bowel Syndrome. Pediatric Infectious Disease Journal. 2025 May 3;44(5):e191-2. https://doi.org/10.1097/INF.0000000000004722