The DOI matches its Crossref record; 76 of the 77 references it cites were found in a registry or an index.
Assessing the Risk of Probiotic Dietary Supplements in the Context of Antibiotic Resistance
Open accessAbstract
Probiotic bacteria are known to harbor intrinsic and mobile genetic elements that confer resistance to a wide variety of antibiotics. Their high amounts in dietary supplements can establish a reservoir of antibiotic resistant genes in the human gut. These resistant genes can be transferred to pathogens that share the same intestinal habitat thus resulting in serious clinical ramifications. While antibiotic resistance of probiotic bacteria from food, human and animal sources have been well-documented, the resistant profiles of probiotics from dietary supplements have only been recently studied. These products are consumed with increasing regularity due to their health claims that include the improvement of intestinal health and immune response as well as prevention of acute and antibiotic-associated diarrhea and cancer; but, a comprehensive risk assessment on the spread of resistant genes to human health is lacking. Here, we highlight recent reports of antibiotic resistance of probiotic bacteria isolated from dietary supplements, and propose complementary strategies that can shed light on the risks of consuming such products in the context of a global widespread of antibiotic resistance. In concomitant with a broader screening of antibiotic resistance in probiotic supplements is the use of computational simulations, live imaging and functional genomics to harvest knowledge on the evolutionary behavior, adaptations and dynamics of probiotics studied in conditions that best represent the human gut including in the presence of antibiotics. The underlying goal is to enable the health benefits of probiotics to be exploited in a responsible manner and with minimal risk to human health.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Figures


Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Previous studies have shown that commercial probiotic products may contain ARGs or transferable resistance determinants, although the level of risk varies substantially among product types, bacterial taxa and analytical pipelines [15,16,17,18,19,20].”
From Integrated Phenotypic and Sequencing-Based Resistome Assessment of Antimicrobial Resistance Determinants in a Sample of Commercial Farm-Animal Probiotic Products (2026) · cites this paper as [15]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“previous studies have shown that probiotic products and probiotic-associated taxa may carry detectable ARGs, but that public-health relevance depends on taxon identity, gene function, genomic context and mobility potential rather than on ARG counts alone [15,16,17,18,22,23].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Fiji: an open-source platform for biological-image analysis
Schindelin, J., Arganda-Carreras, I., Frise, E., Kaynig, V., Longair, M., Pietzsch, T., Preibisch, S., Rueden, C., Saalfeld, S., Schmid, B., et al. (2012) · Nature Methods · doi:10.1038/nmeth.2019 · Cited by 66,890
A functional classification scheme for beta-lactamases and its correlation with molecular structure
Bush, K., Jacoby, G. A., & Medeiros, A. A. (1995) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.39.6.1211 · Cited by 2,485
Mechanisms of, and Barriers to, Horizontal Gene Transfer between Bacteria
Thomas, C. M., & Nielsen, K. M. (2005) · Nature Reviews Microbiology · doi:10.1038/nrmicro1234 · Cited by 2,194
Bacteriocins: safe, natural antimicrobials for food preservation.
Cleveland, J., Montville, T. J., Nes, I. F., & Chikindas, M. L. (2001) · International Journal of Food Microbiology · doi:10.1016/s0168-1605(01)00560-8 · Cited by 1,835
Sulakvelidze, A., Alavidze, Z., & Morris, J. G. (2001) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.45.3.649-659.2001 · Cited by 1,569
Microbiota-mediated colonization resistance against intestinal pathogens
Buffie, C. G., & Pamer, E. G. (2013) · Nature reviews. Immunology · doi:10.1038/nri3535 · Cited by 1,564
Probiotics and their fermented food products are beneficial for health
Parvez, S., Malik, K. A., Ah Kang, S., & Kim, H.-Y. (2006) · Journal of Applied Microbiology · doi:10.1111/j.1365-2672.2006.02963.x · Cited by 1,435
Health Benefits of Probiotics: A Review
Kechagia, M., Basoulis, D., Konstantopoulou, S. M., Dimitriadi, D., Gyftopoulou, K., Skarmoutsou, N., & Fakiri, E. (2013) · ISRN Nutrition · doi:10.5402/2013/481651 · Cited by 1,064
Probiotics: effects on immunity
Isolauri, E., Sütas, Y., Kankaanpää, P., Arvilommi, H. S., & Salminen, S. (2001) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/73.2.444s · Cited by 1,029
Intrinsic antibiotic resistance: Mechanisms, origins, challenges and solutions
Cox, G., & Wright, G. D. (2013) · International Journal of Medical Microbiology · doi:10.1016/j.ijmm.2013.02.009 · Cited by 788
Antibiotic resistance in food lactic acid bacteria—a review
Mathur, S., & Singh, R. (2005) · International Journal of Food Microbiology · doi:10.1016/j.ijfoodmicro.2005.03.008 · Cited by 754
Sharma, V. K., Johnson, N. M., Cizmas, L. H., McDonald, T. J., & Kim, H. (2016) · Chemosphere · doi:10.1016/j.chemosphere.2015.12.084 · Cited by 728
Antibiotic resistance in probiotic bacteria
Gueimonde, M., Sánchez, B., G. de los Reyes-Gavilán, C., & Margolles, A. (2013) · Frontiers in Microbiology · doi:10.3389/fmicb.2013.00202 · Cited by 691
Scholz-Ahrens, K. E., Ade, P., Marten, B., Weber, P., Timm, W., Asil, Y., Glüer, C.-C., & Schrezenmeir, J. (2007) · The Journal of Nutrition · doi:10.1093/jn/137.3.838s · Cited by 591
Spatiotemporal microbial evolution on antibiotic landscapes
Baym, M., Lieberman, T. D., Kelsic, E. D., Chait, R., Gross, R., Yelin, I., & Kishony, R. (2016) · Science · doi:10.1126/science.aag0822 · Cited by 548
Non-inherited antibiotic resistance
Levin, B. R., & Rozen, D. E. (2006) · Nature Reviews Microbiology · doi:10.1038/nrmicro1445 · Cited by 546
Antibiotic Susceptibility of Potentially Probiotic Lactobacillus Species
Charteris, W. P., Kelly, P. M., Morelli, L., & Collins, J. K. (1998) · Journal of Food Protection · doi:10.4315/0362-028x-61.12.1636 · Cited by 539
Huddleston, J. R. (2014) · Infection and Drug Resistance · doi:10.2147/idr.s48820 · Cited by 538
Probiotics, their health benefits and applications for developing healthier foods: a review
Nagpal, R., Kumar, A., Kumar, M., Behare, P. V., Jain, S., & Yadav, H. (2012) · FEMS Microbiology Letters · doi:10.1111/j.1574-6968.2012.02593.x · Cited by 517
Resurrecting the intestinal microbiota to combat antibiotic-resistant pathogens
Pamer, E. G. (2016) · Science · doi:10.1126/science.aad9382 · Cited by 443
Ejtahed, H., Mohtadinia, J., Rad, A. H., Niafar, M., Jafarabadi, M. A., Mofid, V., & Akbarian-Moghari, A. (2011) · Journal of Dairy Science · doi:10.3168/jds.2010-4128 · Cited by 427
Probiotics: potential pharmaceutical applications
Kaur, I. P., Chopra, K., & Saini, A. (2002) · European Journal of Pharmaceutical Sciences · doi:10.1016/s0928-0987(01)00209-3 · Cited by 392
Acquired antibiotic resistance in lactic acid bacteria from food
Teuber, M., Meile, L., & Schwarz, F. (1999) · Antonie van Leeuwenhoek · doi:10.1023/a:1002035622988 · Cited by 377
Klare, I., Konstabel, C., Werner, G., Huys, G. R. B., Vankerckhoven, V., Kahlmeter, G., Hildebrandt, B., Müller-Bertling, S., Witte, W., & Goossens, H. (2007) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkm035 · Cited by 365
A global view of antibiotic resistance
Martínez, J. L., Fajardo-Lubian, A., Garmendia, L., Hernandez, A., Linares, J. F., Martínez‐Solano, L., & Sánchez, M. B. (2008) · FEMS Microbiology Reviews · doi:10.1111/j.1574-6976.2008.00142.x · Cited by 362
Snydman, D. R. (2008) · Clinical Infectious Diseases · doi:10.1086/523331 · Cited by 336
Antibiotic resistance among commercially available probiotics
Sharma, P., Tomar, S. K., Goswami, P., Sangwan, V., & Singh, R. (2014) · Food Research International · doi:10.1016/j.foodres.2014.01.025 · Cited by 316
Recycling Metchnikoff: Probiotics, the Intestinal Microbiome and the Quest for Long Life
Mackowiak, P. A. (2013) · Frontiers in Public Health · doi:10.3389/fpubh.2013.00052 · Cited by 294
Imperial, I. C. V. J., & Ibana, J. A. (2016) · Frontiers in Microbiology · doi:10.3389/fmicb.2016.01983 · Cited by 284
Nawaz, M., Wang, J., Zhou, A., Ma, C., Wu, X., Moore, J. E., Cherie Millar, B., & Xu, J. (2011) · Current Microbiology · doi:10.1007/s00284-010-9856-2 · Cited by 281
Prediction of antibiotic resistance by gene expression profiles
Suzuki, S., Horinouchi, T., & Furusawa, C. (2014) · Nature Communications · doi:10.1038/ncomms6792 · Cited by 268
Bet-hedging during bacterial diauxic shift
Solopova, A., van Gestel, J., Weissing, F. J., Bachmann, H., Teusink, B., Kok, J., & Kuipers, O. P. (2014) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1320063111 · Cited by 245
The origins and molecular basis of antibiotic resistance
Hawkey, P. M. (1998) · BMJ · doi:10.1136/bmj.317.7159.657 · Cited by 222
Origins, Acquisition and Dissemination of Antibiotic Resistance Determinants
DAVIES, J. E. (2007) · Novartis Foundation symposium · doi:10.1002/9780470515358.ch2 · Cited by 215
Confinement-induced quorum sensing of individual Staphylococcus aureus bacteria
Carnes, E. C., Lopez, D. M., Donegan, N. P., Cheung, A. L., Gresham, H. D., Timmins, G. S., & Brinker, C. J. (2009) · Nature Chemical Biology · doi:10.1038/nchembio.264 · Cited by 212
Kästner, S., Perreten, V., Bleuler, H., Hugenschmidt, G., Lacroix, C., & Meile, L. (2005) · Systematic and Applied Microbiology · doi:10.1016/j.syapm.2005.07.009 · Cited by 205
Hamilton‐Miller, J., Shah, S. A., & Winkler, J. T. (1999) · Public Health Nutrition · doi:10.1017/s1368980099000282 · Cited by 201
Liu, W.-T., Yang, Y., Xu, Y., Lamsa, A., Haste, N. M., Yang, J. Y., Ng, J., Gonzalez, D. J., Ellermeier, C. D., Straight, P. D., et al. (2010) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1008368107 · Cited by 194
Liu, C., Zhang, Z. Y., Dong, K., Yuan, J., & Guo, X. (2009) · Biomedical and Environmental Sciences · doi:10.1016/s0895-3988(10)60018-9 · Cited by 171
Guo, H., Pan, L., Li, L., Lu, J., Kwok, L., Menghe, B., Zhang, H., & Zhang, W. (2017) · Journal of Food Science · doi:10.1111/1750-3841.13645 · Cited by 156
Mobile genetic elements of the human gastrointestinal tract
Broaders, E., Gahan, C. G. M., & Marchesi, J. R. (2013) · Gut Microbes · doi:10.4161/gmic.24627 · Cited by 151
Lakritz, J. R., Poutahidis, T., Levkovich, T., Varian, B. J., Ibrahim, Y. M., Chatzigiagkos, A., Mirabal, S., Alm, E. J., & Erdman, S. E. (2013) · International Journal of Cancer · doi:10.1002/ijc.28702 · Cited by 150
Tannock, G. W., Luchansky, J. B., Miller, L. A., Connell, H., Thode-Andersen, S., Mercer, A. A., & Klaenhammer, T. R. (1994) · Plasmid · doi:10.1006/plas.1994.1007 · Cited by 143
Detection of antibiotic resistance in probiotics of dietary supplements
Wong, A., Ngu, D. Y. S., Dan, L. A., Ooi, A., & Lim, R. L. H. (2015) · Nutrition Journal · doi:10.1186/s12937-015-0084-2 · Cited by 143
Self-citationTreatment of infectious disease: Beyond antibiotics
Nigam, A., Gupta, D., & Sharma, A. (2014) · Microbiological Research · doi:10.1016/j.micres.2014.02.009 · Cited by 137
Integrons and gene cassettes: hotspots of diversity in bacterial genomes
Hall, R. M. (2012) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2012.06588.x · Cited by 136
The Evidence to Support Health Claims for Probiotics
Farnworth, E. R. (2008) · Journal of Nutrition · doi:10.1093/jn/138.6.1250s · Cited by 135
Gradient Diffusion Antibiotic Susceptibility Testing of Potentially Probiotic Lactobacilli
Charteris, W. P., Kelly, P. M., Morelli, L., & Collins, J. K. (2001) · Journal of Food Protection · doi:10.4315/0362-028x-64.12.2007 · Cited by 133
Live from under the lens: exploring microbial motility with dynamic imaging and microfluidics
Son, K., Brumley, D. R., & Stocker, R. (2015) · Nature Reviews Microbiology · doi:10.1038/nrmicro3567 · Cited by 131
Insights into Bacteriophage Application in Controlling Vibrio Species
Letchumanan, V., Chan, K., Pusparajah, P., Saokaew, S., Duangjai, A., Goh, B. H., Mutalib, N. A., & Lee, L. (2016) · Frontiers in Microbiology · doi:10.3389/fmicb.2016.01114 · Cited by 131
Proteomics As a Tool for Studying Bacterial Virulence and Antimicrobial Resistance
Pérez-Llarena, F. J., & Bou, G. (2016) · Frontiers in Microbiology · doi:10.3389/fmicb.2016.00410 · Cited by 124
Exploiting genomics, genetics and chemistry to combat antibiotic resistance
Hughes, D. (2003) · Nature Reviews Genetics · doi:10.1038/nrg1084 · Cited by 119
Aquilanti, L., Garofalo, C., Osimani, A., Silvestri, G., Vignaroli, C., & Clementi, F. (2007) · Journal of Food Protection · doi:10.4315/0362-028x-70.3.557 · Cited by 112
Mutational Pathway Determines Whether Drug Gradients Accelerate Evolution of Drug-Resistant Cells
Greulich, P., Waclaw, B., & Allen, R. J. (2012) · Physical Review Letters · doi:10.1103/physrevlett.109.088101 · Cited by 109
A Probiotic Lactobacillus Strain Can Acquire Vancomycin Resistance during Digestive Transit in Mice
Mater, D. D. G., Langella, P., Corthier, G., & Flores, M. J. (2007) · Microbial Physiology · doi:10.1159/000106091 · Cited by 108
Savaiano, D. A., Ritter, A. J., Klaenhammer, T. R., James, G. M., Longcore, A. T., Chandler, J. R., Walker, W. A., & Foyt, H. L. (2013) · Nutrition Journal · doi:10.1186/1475-2891-12-160 · Cited by 99
Charteris, W. P., Kelly, K., Morelli, L., & Collins (1998) · Letters in Applied Microbiology · doi:10.1046/j.1472-765x.1998.00342.x · Cited by 95
Exploring the influence of the gut microbiota and probiotics on health: a symposium report
Thomas, L. V., Ockhuizen, T., & Suzuki, K. (2014) · British Journal Of Nutrition · doi:10.1017/s0007114514001275 · Cited by 93
Functional Foods and Health Claims Legislation: Applications to Dairy Foods
Berner, L. A., & O’Donnell, J. A. (1998) · International Dairy Journal · doi:10.1016/s0958-6946(98)00058-2 · Cited by 88
Bujňáková, D., Strakova, E., & Kmeť, V. (2013) · Anaerobe · doi:10.1016/j.anaerobe.2013.10.009 · Cited by 81
Amaral, L., & Kristiansen, J. E. (2000) · International Journal of Antimicrobial Agents · doi:10.1016/s0924-8579(99)00153-3 · Cited by 80
Using Probiotics in Gastrointestinal Disorders
Ringel, Y., Quigley, E. M., & Lin, H. C. (2012) · The American Journal of Gastroenterology Supplements · doi:10.1038/ajgsup.2012.7 · Cited by 77
Erythromycin- and tetracycline-resistant lactobacilli in Italian fermented dry sausages
Zonenschain, D., Rebecchi, A., & Morelli, L. (2009) · Journal of Applied Microbiology · doi:10.1111/j.1365-2672.2009.04338.x · Cited by 76
Zelaya, H., Tsukida, K., Chiba, E., Marranzino, G., Alvarez, S., Kitazawa, H., Agüero, G., & Villena, J. (2014) · International Immunopharmacology · doi:10.1016/j.intimp.2013.12.020 · Cited by 74
Disinfectant and antibiotic resistance of lactic acid bacteria isolated from the food industry
Sidhu, M. S., Langsrud, S., & Holck, A. (2001) · Microbial Drug Resistance · doi:10.1089/107662901750152846 · Cited by 66
Antibiotic Susceptibility of Potentially Probiotic Vaginal Lactobacilli
Ocaña, V. S., Silva, C., & Nader-Macı́as, M. E. (2006) · Infectious Diseases in Obstetrics and Gynecology · doi:10.1155/idog/2006/18182 · Cited by 61
Functional Dairy Probiotic Food Development: Trends, Concepts, and Products
Homayouni, A., Alizadeh, M., Alikhah, H., & Zijah, V. (2012) · InTech eBooks · doi:10.5772/48797 · Cited by 45
Cottell, J. L., Saw, H. T. H., Webber, M. A., & Piddock, L. J. V. (2014) · BMC Microbiology · doi:10.1186/1471-2180-14-168 · Cited by 39
Evolution of Drug Resistance in Bacteria
Waclaw, B. (2016) · Advances in experimental medicine and biology · doi:10.1007/978-3-319-32189-9_5 · Cited by 34
Muñoz, M. D. C. C., Benomar, N., Ennahar, S., Horvatovich, P. L., Lerma, L. L., Knapp, C. W., Gálvez, A., & Abriouel, H. (2016) · International Journal of Food Microbiology · doi:10.1016/j.ijfoodmicro.2016.01.012 · Cited by 31
Macrolide resistance and In Vitro selection of resistance to antibiotics in Lactobacillus isolates
Drago, L., Mattina, R., Nicola, L., Rodighiero, V., & Vecchi, E. D. (2011) · The Journal of Microbiology · doi:10.1007/s12275-011-0470-1 · Cited by 27
Consideration of possible legislation within existing regulatory frameworks
Przyrembel, H. (2001) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/73.2.471s · Cited by 24
Proteomics as the final step in the functional metagenomics study of antimicrobial resistance
Fouhy, F., Stanton, C., Cotter, P. D., Hill, C., & Walsh, F. (2015) · Frontiers in Microbiology · doi:10.3389/fmicb.2015.00172 · Cited by 24
Геннадьевна, Б. С., Poluektova, E. U., Glazova, A. A., Zakharevich, N. V., Koroban, N. V., Зинченко, В. В., Babykin, M. M., Zhilenkova, O. G., Amerkhanova, A. M., & Даниленко, В. Н. (2011) · Microbiology · doi:10.1134/s0026261711020032 · Cited by 21
Exploring the Arabidopsis Proteome: Influence of Protein Solubilization Buffers on Proteome Coverage
Marondedze, C., Wong, A., Groen, A. J., Serrano, N., Janković, B. R., Lilley, K. S., Gehring, C., & Thomas, L. A. (2014) · International Journal of Molecular Sciences · doi:10.3390/ijms16010857 · Cited by 10
Self-citationHarada, K., Kameda, M., Suzuki, M., Egawa, R., & Mitsuhashi, S. (1961) · PubMed · Cited by 9
Cited by
Sorted by citations
Probiotic supplements might not be universally-effective and safe: A review
Kothari, D., Patel, S., & Kim, S.-K. (2019) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2018.12.104 · Cited by 445
Jha, R., Das, R., Oak, S. J., & Mishra, P. (2020) · Animals · doi:10.3390/ani10101863 · Cited by 360
Probiotics and Preterm Infants
van den Akker, C. H. P., van Goudoever, J. B., Shamir, R., Domellöf, M., Embleton, N. D., Hojsak, I., Lapillonne, A., Mihatsch, W., Canani, R. B., Bronský, J., et al. (2020) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000002655 · Cited by 239
Potential Effects of Horizontal Gene Exchange in the Human Gut
Lerner, A., Matthias, T., & Aminov, R. I. (2017) · Frontiers in Immunology · doi:10.3389/fimmu.2017.01630 · Cited by 209
Li, M., Wang, Y., Cui, H., Li, Y., Sun, Y., & Qiu, H.-J. (2020) · Frontiers in Veterinary Science · doi:10.3389/fvets.2020.00049 · Cited by 179
Metadata
- Authors
- Zheng, M., Zhang, R., Tian, X., Zhou, X., Pan, X., & Wong, A.
- Affiliations
- Wenzhou-Kean University (CN)
- Corresponding author
- Wong, Aloysius
- Venue
- Frontiers in Microbiology
- Publisher
- Frontiers Media SA
- Published
- 2017-05-19
- Volume
- 8
- Pages
- 908-908
- ISSN
- 1664-302X (ISSN-L)
- PMC
- PMC5437161
- OpenAlex
- W2616265506
- Cited by
- 218
- References
- 77
- Citations by year
- 2026: 15 · 2025: 27 · 2024: 34 · 2023: 33 · 2022: 31 · 2021: 27 · 2020: 25 · 2019: 15 · 2018: 8 · 2017: 2
- FWCI
- 15.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Microbiology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
- Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
- Keywords
- probiotics, dietary supplements, antibiotic resistance, antibiotic resistance genes, mobile genetic elements, gut microbiota, horizontal gene transfer, risk assessment, human health risk
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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review