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Cited by 107Probiotics and Fermented FoodsAntifungal resistance and susceptibilityComplementary and Alternative Medicine Studies

Infectious complications following probiotic ingestion: a potentially underestimated problem? A systematic review of reports and case series

Open access
Costa, Rafael Lessa, Moreira, José, Lorenzo, Andrea, Lamas, Cristiane C.·2018·BMC Complementary and Alternative Medicine
DOI 10.1186/s12906-018-2394-3PMC PMC6292120
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Abstract

BACKGROUND: Little is studied about complications related to probiotic ingestion. This study proposes to present a synthesis and critical evaluation of the reports and series of cases on the infectious complications related to the ingestion of probiotics, which can raise awareness for the prescribing and use of probiotics for certain groups of patients. METHODS: Systematic review of reports and series of cases researched in the PubMed, SciELO and Scopus databases published until August 2018. The references of the articles were investigated manually for the search of cross references. SPSS version 23.0 was used for descriptive statistics and univariate analysis. RESULTS: We found 60 case reports and 7 case series, making up a total of 93 patients. Fungemia was the most common infectious complications with 35 (37.6%) cases. The genus Saccharomyces was the most frequent with 47 (50.6%) cases, followed by Lactobacillus, Bifidobacterium, Bacillus, Pedioccocus and Escherichia with 26 (27.9%), 12 (12.8%), 5 (5.4%), 2 (2.2%) and 1 (1.1%) case, respectively. Adults over 60 years of age, Clostridium difficile colitis, antibiotic use and Saccharomyces infections were associated with overall mortality. HIV infections, immunosuppressive drugs, solid organ transplantation, deep intravenous lines, enteral or parenteral nutrition were not associated with death. CONCLUSION: The use of probiotics cannot be considered risk-free and should be carefully evaluated for some patient groups. TRIAL REGISTRATION: CRD42016042289.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review of 60 case reports and 7 case series (93 patients, 1976–2018) found infectious complications after probiotic ingestion, most commonly fungemia and Saccharomyces infection. Mortality was associated with age >60 years, C. difficile colitis, antibiotic use, and Saccharomyces infection.

Key findings

  • Among 93 patients, fungemia was most common at 35 (37.6%), followed by sepsis 29 (31.2%), bacteremia 19 (20.4%), endocarditis 4, and abscess 3; pneumonia, pleural empyema, and septic arthritis each occurred in 1 case.
  • Saccharomyces was the most frequent genus with 47 (50.6%) cases, including S. cerevisiae 41 (44.1%), S. boulardii 5 (5.4%), and Saccharomyces spp. 1 (1.1%); Lactobacillus accounted for 26 (27.9%), Bifidobacterium 12 (12.8%), Bacillus 5 (5.4%), Pediococcus 2 (2.2%), and Escherichia coli 1 (1.1%).
  • All-cause mortality was 19.6% (18 cases) and was associated with age >60 years (OR 6.25, 95% CI 1.89–20.1; p=0.003), C. difficile colitis (OR 11.8, 95% CI 2.89–48.81; p<0.001), antibiotic use (OR 9.75, 95% CI 1.51–17.11; p=0.002), and Saccharomyces spp. (OR 4.9, 95% CI 1.30–15.48; p=0.03). HIV infection, immunosuppressive drugs, solid organ transplantation, deep intravenous lines, and enteral or parenteral nutrition were not associated with death.
  • Blood was the most frequent isolation site, in 87 (93.5%) cases.

Methods

  • Systematic review of case reports and case series searched in PubMed, SciELO, and Scopus from inception to August 8, 2018, with manual reference cross-checking; no language restriction; reported per PRISMA and registered at PROSPERO (CRD42016042289).
  • Included infections after probiotic ingestion, including bacteremia/fungemia, sepsis, endocarditis, and abscess; 6797 records plus 55 cross-references yielded 67 articles (60 case reports, 7 case series) corresponding to 93 patients.
  • Descriptive statistics and univariate analysis used SPSS version 23.0; categorical variables compared with chi-square and Fisher’s exact tests, continuous variables with Mann-Whitney test, two-tailed p<0.05; risk of bias assessed with a modified National Institutes of Health tool.

Limitations

  • The paper states possible publication bias, with more serious cases more likely published, but also notes that case reports are increasingly difficult to publish, so other serious cases may not have reached public knowledge.
  • The paper states that the mortality analysis did not consider other factors such as numbers and types of comorbidity, and that the review is not intended to discourage probiotic use.
  • Evident from the text: case reports and case series cannot establish causality or incidence, and there is no denominator of all probiotic users; risk of bias was mostly “fair” (7/67, 10.4%, were “good”; none “poor”).

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s12906-018-2394-3

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 2 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Adults over 60 years of age were associated with overall mortality.

    “Adults over 60 years of age, Clostridium difficile colitis, antibiotic use and Saccharomyces infections were associated with overall mortality.”
    • Also stated in: § Conclusion · plain
      “Mortality was associated with age > 60 years, C. difficile colitis, current antimicrobial use and Saccharomyces infection.”
    Quote in the paperSubstantial claim
  • Findingown data

    Enteral or parenteral nutrition were not associated with death.

    “HIV infections, immunosuppressive drugs, solid organ transplantation, deep intravenous lines, enteral or parenteral nutrition were not associated with death.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Endocarditis occurred in 4 cases.

    “followed by endocarditis and abscess, with 4 and 3 cases, respectively.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Saccharomyces infections were associated with overall mortality.

    “Adults over 60 years of age, Clostridium difficile colitis, antibiotic use and Saccharomyces infections were associated with overall mortality.”
    • Also stated in: § Conclusion · plain
      “Mortality was associated with age > 60 years, C. difficile colitis, current antimicrobial use and Saccharomyces infection.”
    Quote in the paperSubstantial claim
  • Findingown data

    Bifidobacterium accounted for 12 (12.8%) cases.

    “followed by Lactobacillus, Bifidobacterium, Bacillus, Pedioccocus and Escherichia with 26 (27.9%), 12 (12.8%), 5 (5.4%), 2 (2.2%) and 1 (1.1%) case, respectively.”
    • Also stated in: § Probiotic microorganisms involved in infectious complications · plain
      “Of the 12 patients with infectious complications due to Bifidobacterium spp.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 18
  • Classified as probably not a substantial claim. 23

  • May combine two claims.

    Findingown data

    Saccharomyces was the most frequent genus, accounting for 47 (50.6%) cases.

    “The genus Saccharomyces was the most frequent with 47 (50.6%) cases”
    • Also stated in: § Probiotic microorganisms involved in infectious complications · plain
      “Among the 93 cases, 47 (50.5%) were due to Saccharomyces, making it the most frequent genus in this review.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Pediococcus accounted for 2 (2.2%) cases.

    “followed by Lactobacillus, Bifidobacterium, Bacillus, Pedioccocus and Escherichia with 26 (27.9%), 12 (12.8%), 5 (5.4%), 2 (2.2%) and 1 (1.1%) case, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Pneumonia, pleural empyema and septic arthritis were each present in only one case.

    “Pneumonia, pleural empyema and septic arthritis were present in only one case each.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Fungemia was the most common infectious complication, occurring in 35 (37.6%) cases.

    “Fungemia was the most common infectious complications with 35 (37.6%) cases.”
    • Also stated in: § Occurrence of infectious complications · plain
      “Fungemia was most commonly observed condition, with 35 (37.6%) of the cases.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of the 67 articles included, 7 (10.4%) were classified as good and the remaining as fair; none were classified as poor.

    “Of the 67 articles included in the synthesis, 7 (10.4%) were classified as “good” and the remaining as “fair”. None were classified as “poor”.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Escherichia accounted for 1 (1.1%) case.

    “followed by Lactobacillus, Bifidobacterium, Bacillus, Pedioccocus and Escherichia with 26 (27.9%), 12 (12.8%), 5 (5.4%), 2 (2.2%) and 1 (1.1%) case, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The systematic review identified 60 case reports and 7 case series, totaling 93 patients.

    “We found 60 case reports and 7 case series, making up a total of 93 patients.”
    • Also stated in: § Database search · plain
      “We included 60 case reports and 7 case series, corresponding to 93 patients (Additional file 1).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Central venous access was present in 59 (63.5%) cases.

    “Central venous access, enteral nutrition and parenteral nutrition were present in 59 (63.5%), 52 (56%) and 14 (15%), respectively, of all cases.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Patients on immunosuppressive drugs accounted for 14 (15%) patients.

    “Patients on immunosuppressive drugs (corticosteroids, chemotherapy and immunobiologicals) accounted for 14 (15%) patients.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The genus Saccharomyces was positively associated with mortality; 3/4 of patients who died had probiotics belonging to this genus as the etiological agent.

    “The genus Saccharomyces was also positively associated with mortality, since 3/4 of patients who died had probiotics belonging to this genus as the etiological agent of the infectious complications found.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Two patients had received solid organ transplantation and 5 (5.4%) had been previously diagnosed as HIV infected.

    “Two patients had received solid organ transplantation and 5 (5.4%) had been previously diagnosed as HIV infected.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Bacteremia accounted for 20.4% of infectious complications and Lactobacillus was responsible for 42% of these.

    “Bacteremia accounted 20.4% of the infectious complications and the genus Lactobacillus was responsible for 42% of these.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In 10 patients the indication for probiotic use was to prevent necrotizing enterocolitis and at least 4 of them developed this complication despite probiotic prophylaxis.

    “In 10 patients the indication for the use of probiotic was to prevent necrotizing enterocolitis (NE) and at least 4 of them ended up developing this complication, despite probiotic prophylaxis.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    Ten preterm infants had extremely low birth weight and half had sepsis, four patients had bacteremia and only one had fungemia.

    “Ten preterm infants had extremely low birth weight and half had sepsis, four patients had bacteremia and only one had fungemia.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Between 2011 and 2017, there were 39 cases.

    “Between 2011 and 2017, there were 39 cases.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Parenteral nutrition was present in 14 (15%) cases.

    “Central venous access, enteral nutrition and parenteral nutrition were present in 59 (63.5%), 52 (56%) and 14 (15%), respectively, of all cases.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The earliest case dated back to 1976, and there was a progressive increase in cases in the 1980s, 1990s and 2000s, with 4, 16 and 33 cases, respectively.

    “The earliest case dated back to 1976, and we observed a progressive increase in the following decades of 80, 90 and 00, with 4,16 and 33 cases, respectively.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Enteral nutrition was present in 52 (56%) cases.

    “Central venous access, enteral nutrition and parenteral nutrition were present in 59 (63.5%), 52 (56%) and 14 (15%), respectively, of all cases.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In our review, 12 samples of Saccharomyces spp. had antimicrobial susceptibility testing and 10 of them were sensitive to azoles.

    “In our review, 12 samples of Saccharomyces spp. had antimicrobial susceptibility testing and 10 of them were sensitive to azoles.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Each of the five continents had at least one case.

    “Each of the five continents had at least one case.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Males had a slightly higher prevalence, corresponding to 53 (57%) of the cases.

    “Males had a slightly higher prevalence, corresponding to 53 (57%) of the cases.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Most cases were from Europe (61; 65.6%) and 17 (18.3%) from the United States and Canada.

    “Of the 60 reports and 7 series of cases involving 93 patients, most were from Europe (61; 65.6%) and 17 (18.3%) from the United States and Canada.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Elderly (adults over 60 years) were reported in 33 (35.5%) cases.

    “Elderly (defined as adults over 60 years of age) and children younger than 1 year were reported in 33 (35.5%) and 25 (26.7%) cases, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of the 8 patients with Lactobacillus bacteremia, 4 were immunosuppressed (2 with HIV infection), 3 underwent intestinal invasive procedures, and 1 had diverticular disease of the colon.

    “We observed that of the 8 patients with Lactobacillus bacteremia, 4 were immunosuppressed - 2 with HIV infection; 3 underwent intestinal invasive procedures and 1 had diverticular disease of the colon.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Of patients younger than 1 year, 17 (68%) were premature.

    “Of patients younger than 1 year, 17 (68%) were premature (Additional file 1: Table S8).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In our review, 26.7% of patients were younger than 1 year and practically two-thirds of them premature.

    “In our review, 26.7% of the patients were younger than 1 year of age and practically two-thirds of them premature.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Children younger than 1 year were reported in 25 (26.7%) cases.

    “Elderly (defined as adults over 60 years of age) and children younger than 1 year were reported in 33 (35.5%) and 25 (26.7%) cases, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Neoplasia was described in 10 (10.7%) cases, of which 4 (40%) were hematologic malignancies.

    “Neoplasia was described in 10 (10.7%) and of these, 4 (40%) were of hematologic malignancies.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The systematic review was based on PRISMA.

    “The description of this systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes – PRISMA [9].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Liberati A, Altman DG, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):1–34. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    A modified National Institutes of Health Tool was used to evaluate risk of bias in the retrieved articles.

    “A modified National Institutes of Health Tool [14] was to use to evaluate the risk of bias in the retrieved articles (see Additional file 1).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] NIH. Quality assessment tool for case series studies. In: National Heart, Lung, and Blood Institute; 2014. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools . Acessed 28 June 2016.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Potentially relevant titles and abstracts were selected and articles evaluated independently by two reviewers, with divergences resolved by consensus and a third reviewer if necessary.

    “Potentially relevant titles and abstracts were selected and their articles evaluated independently by Rafael Lessa da Costa and Jose Moreira. The divergences were resolved by consensus and, whenever necessary, by a third reviewer (Cristiane Lamas or Andrea De Lorenzo).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Data extraction divergences were resolved by consensus and, when necessary, by a third reviewer.

    “At this stage, the divergences were resolved by consensus and, when necessary, by the third reviewer.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study was registered at PROSPERO (CRD42016042289).

    “The study was registered at PROSPERO (CRD42016042289).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Due to the limitation for publication of case reports, several other serious cases may not have reached public knowledge.

    “on the other, due to the mentioned limitation for the publication of case reports, several other serious cases may not have reached public knowledge.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Case reports are increasingly difficult to publish.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    The proportion of cases of infectious complications is small when the total number of people who use probiotics is considered.

    “The proportion of cases of infectious complications is small when the total number of people who use probiotics is considered.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The total number of people who use probiotics is large enough that the proportion of infectious complications is small.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    There is a possibility of publication bias, with more serious cases having been published.

    “So, although on one hand there is the possibility of publication bias, with more serious cases having been published”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    Probiotics were often used in the context of excessive antibiotic use.

    “Probiotics were often used in the context of excessive antibiotic use, and a more judicious use of antibiotics is critical”
    Quote in the paperNot a substantial claim
37 of 37

  • The paper relies on this without support.

    Compatibility between a microorganism isolated from a patient and the probiotic product taken indicates that the probiotic caused the infection.

    “In 27 cases, the probiotic microorganisms in the medications were compatible with the isolates found in the blood samples of the patient.”
    “In 15 cases, additional methods showed that the microorganisms isolated from biological samples were compatible with the probiotics taken by the patients.”

  • The paper relies on this without support.

    Case reports are increasingly difficult to publish.

    “We believe that these cases represent only a small proportion of existing cases, since case reports are increasingly difficult to publish.”

  • The paper relies on this without support.

    The total number of people who use probiotics is large enough that the proportion of infectious complications is small.

    “The proportion of cases of infectious complications is small when the total number of people who use probiotics is considered.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • One report described 93 cases of serious infections with a 15% mortality rate, including fungemia (37.6%), sepsis (31.2%), bacteremia (20.4%), endocarditis, and abscesses.

    “For example, one report on observational results described 93 cases of serious infections (with a 15% mortality rate), with fungemia (37.6% of cases), sepsis (31.2%), bacteremia (20.4%), endocarditis, and abscesses [74,75].”

    From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [74]

    The Results (Occurrence of infectious complications) report 93 cases and the stated percentages for fungemia, sepsis, and bacteremia, as well as endocarditis and abscesses. But the Results (Gender and age distribution, and associated conditions) give overall all-cause mortality as 19.6% (18 cases). The 15% figure appears in the Saccharomyces subgroup, not for all 93 cases. (LLM, conf=0.92)

    Experimental — accuracy not yet measured

  • Age over 60 years, infections such as Clostridioides difficile, antibiotic exposure, immunosuppression, and use of Saccharomyces or Lactobacillus (especially L. rhamnosus) appear to increase the risk of probiotic-related adverse effects.

    “Age over 60 years, infections such as Clostridioides difficile, antibiotic exposure, immunosuppression, and the use of Saccharomyces or Lactobacillus (especially L. rhamnosus) all appear to increase the risk [74].”

    From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [74]

    The Conclusion and Results (pages not specified) associate age over 60, C. difficile colitis, antibiotic use, and Saccharomyces infection with mortality among patients who already had probiotic-related infectious complications—not with an increased risk of developing adverse effects. The Discussion describes immunosuppression as a risk factor for lactobacillemia, and the Results identify L. rhamnosus in 14 cases, but neither establishes increased adverse-effect risk from using Lactobacillus, especially L. rhamnosus. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Some findings on probiotic safety are isolated and based on single clinical cases, such as sepsis development in patients with established intravenous catheters.

    “Some findings are isolated, based on single clinical cases, such as sepsis development in patients with established intravenous catheters [74].”

    From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [74]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Saccharomyces mortality percentage does not match its case count

    Major

    This section identifies 47 Saccharomyces cases. Fourteen deaths among those cases represent 29.8%, not the reported 15%.

    Reported 15 · recomputed 29.787234

  • Solid-organ transplant patient counts conflict

    Minor

    The narrative says two patients had received transplants, whereas Table 3 assigns two to the no-death group and one to the death group.

  • Immunosuppressive-drug patient counts conflict

    Minor

    The narrative gives 14 patients, but Table 3 lists 15 without death and five with death, totaling 20.

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. FAO/WHO. Evaluation of health and nutritional properties of powder milk and live lactic acid bacteria. Food and Agriculture Organization of the United Nations and World Health Organization Expert Consultation Report, 2001.

Cited by

Sorted by citations

Related

Authors
Costa, R. L., Moreira, J., Lorenzo, A., & Lamas, C. C.
Affiliations
Instituto Nacional de Cardiologia (BR)
Corresponding author
Costa, Rafael Lessa
ORCID
Venue
BMC Complementary and Alternative Medicine
Publisher
Springer Science and Business Media LLC
Published
2018-12
Volume
18
Issue
1
Pages
329-329
ISSN
1472-6882 (ISSN-L)
DOI
10.1186/s12906-018-2394-3
PMC
PMC6292120
OpenAlex
W2905075966
Semantic Scholar
a43371345fa412734a8f54d6d0ca41882d8de45d
Cited by
105
References
31
Citations by year
2026: 20 · 2025: 15 · 2024: 12 · 2023: 6 · 2022: 10 · 2021: 20 · 2020: 15 · 2019: 7
FWCI
1.06
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Complementary and Alternative Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Arca - Repositório Institucional da Fiocruz (publishedVersion, other-oa)
  • Americanae (AECID Library) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
Funders
  • Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico
  • Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (202.782/2015)
  • National Institutes of Health
Topics
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
Keywords
probiotics, infectious complications, fungemia, Saccharomyces, Lactobacillus, Bifidobacterium, Bacillus, Clostridium difficile colitis, mortality, antibiotic use, immunosuppression, elderly patients, probiotic safety
MeSH terms
Administration, Oral, Adolescent, Adult, Aged, Aged, 80 and over, Bifidobacterium, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Lactobacillus, Male, Middle Aged, Mycoses, Saccharomyces, Gram-Positive Bacterial Infections, Probiotics, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

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