Sac B .... Fatal?

[trintiybella]

However, in immunocompromised individuals, S. Boulardii has been associated with (fungemia) or localized infection, which may be fatal.

[rowingmom]

http://cid.oxfordjournals.org/content/41/11/1559.long

Invasive Saccharomyces Infection: A Comprehensive Review

" S. boulardii accounted for 51.3% of fungemias and was exclusively isolated from blood. Compared with patients infected with S. cerevisiae, patients infected with S. boulardii were more frequently immunocompetent and had a better prognosis. Saccharomyces invasive infection was clinically indistinguishable from an invasive candidiasis. Overall, S. cerevisiae clinical isolates exhibited low susceptibility to amphotericin B and azole derivatives. However, global outcome was favorable in 62% of the cases. Treatment with intravenous amphotericin B and fluconazole, in combination with central vascular catheter removal, were effective therapeutic options.

Conclusion. Saccharomyces organisms should now be added to the growing list of emerging fungal pathogens. Special caution should be taken regarding the use of S. boulardii probiotic preparations ".

For these reasons we don't use it.

[searching_for_help]

Wow, that's surprising. Wonder why some labs and integrative docs aren't aware of this, since they are the ones suggesting using them? Once again, now I'm confused as to what path to take. We really need to control the clostridia while attacking the yeast... and the Sacc. Boul is used with culturelle to control the clostridia. Thanks for posting this. Good to be informed. Sure wish we had professionals helping us with this stuff...

[trintiybella]

Searching for help...have you ever used the vancomycen for the clostridia?

[nicklemama]

You needed to read the entire article. Every person with a systemic Sacc B or Sacc C infection in this paper, had two factors, IV catheter and antibiotic therapy. The mode of transmission is assumed to be nosocomial(hospital acquired) from the hands and from eating raw, unwashed fruit/veggies. The caution here is supplementing with Sacc B while you are undergoing IV antibiotic therapy and likely if you have any sort of port.

[rowingmom]

Since the 1980s, S. cerevisiae has also been isolated from persons with pathogenic conditions and has been considered to be a cause of invasive fungal infections. The incidence of Saccharomyces fungemia varied from 1% in a retrospective study of 102 nosocomial cases of fungemia [18] to 3.6% among patients at French teaching hospitals [9]. Among these cases, there is a growing number of observations regarding invasive infections with S. boulardii."

 

Nowhere in this paper does it state that all of these infections are nosocomial in origin. 1% to 3.6% incidences of nosocomial cases were found to be Sacc. fungemia in two of the papers referenced, but these were not the only papers from which data were drawn for this study.

 

"... the clinical impact of Saccharomyces infection has been clearly assessed in an immunocompetent patient whose unique predisposing factor was the ingestion of health food containing viable yeasts [25]. The patient developed recurrent fever, malaise with nausea, and night sweats. Yeasts were isolated from bone marrow and urine specimens. The patient recovered when he stopped ingesting health food containing yeasts. The occurrence of deep-site involvement with histologic documentation also underlines the pathogenicity of such yeasts. In these cases, yeasts were most often associated with necrosis [60] and granulomatous reaction."

 

The health food they are referring to here is actually brewer's yeast Saccharomyces cerevisiae, and not unwashed fruits and vegetables.

 

Jensen DP,Smith DL. Fever of unknown origin secondary to brewer's yeast ingestion. Arch Intern Med 1976;136:332-3.

 

S. boulardii was considered to be the etiologic agent in 37 cases.

Among the 37 patients with presumed S. boulardii infection, 5 did not take a probiotic containing S. boulardii at the time of diagnosis.

 

Risk factors associated with invasive Saccharomyces infections are similar to those reported elsewhere for invasive candidiasis, except for treatment with a probiotic containing S. boulardii. It is important to emphasize the role of this biotherapeutic agent, because it was responsible for 40.2% of invasive Saccharomyces infections reported in the literature. In the 5 cases in which S. boulardii was considered to be the etiologic agent, although these patients did not take a probiotic preparation, the similarity of the genotypic profile between S. boulardii isolates from patients and from probiotic preparations strongly suggested nosocomial acquisition, with catheters being a likely portal of entry because of possible contamination through hand transmission [6, 7].

 

So this nosocomial acquisition applies to only 5 of the 37 patients. Probiotic dosing with S boulardii appears to be responsible for the rest.

Edited March 7, 2014 by rowingmom

[MomWithOCDSon]

Personally, I think this is likely another instance of being both reasonable and vigilant when undertaking any therapy, be it supplements, OTC's, prescription meds, etc. There is such thing as "too much of a good thing," and just because "some" can be beneficial, doesn't mean that "more" is better.

 

We've been using sach b. for years . . . not daily since termination of abx therapy . . . but as needed. None of us . . . DS, DH or myself . . . has suffered any ill effects. But we weren't consuming copious amounts of it, either. Enough, but not more than enough.

 

When we first started our PANDAS journey, we went very heavy on probiotics, as recommended by some other forum participants and represented as having been prescribed to them by some very prestigious and leading-edge caregivers. There was a lot of detail provided in terms of dosage, timing, etc., and some first-hand accounts of how beneficial the probiotic regimen had been observed to be with these particular PANDAS children. Even at our heaviest dosage (in terms of billions of units), our regimen represented only a fraction of what these people were endorsing/suggesting. After a couple of weeks, however, we discovered that DS was experiencing more, rather than less, gastrointestinal discomfort, bloating, etc., so we stepped down and lowered his daily dose of mixed flora (including, but not exclusively sach b.). Within a few weeks, we found what his behavior and physical comfort demonstrated as his optimum level, and we stuck with that through the antibiotic therapy.

 

Meanwhile, many months later, one of the forum families who had been especially vociferous about high-dosing probiotics = positive intervention began to post about some new health discoveries with at least one child . . . gastrointestinal abnormalities and dysfunction that may or may not have been a result of, or at least exacerbated by, the hefty probiotic dosing. Their lesson learned, but at some price.

 

Caveat emptor, but all things should be kept in context and perspective, IMHO. What is good and healthy for one person may be counterproductive or even harmful for another. I'm a fan of no blanket statements. We benefit by hearing one another's stories, physician feedback, experiences, etc. But we have to make our own healthcare decisions, in the end, and hopefully make them as well-informed as possible, but not on the basis of fear or a single data point.

[3bmom]

I find it interesting the increase since the 90's. Also all patients eating the standard American diet are consuming large amount of antibiotics, since 80% of all antibiotics in US are used in food sources. Round-Up is patented as an antibiotic and it kills off intestinal flora thru their shikimate pathway. What happens when this flora gets knocked out depends on your individual innate immune system. That may be why there is such a variance of infections among our kids and the difficulty in treating them.