• Scott Mayer, Colin Bonhag, Patrick Jenkins, Brendon Cornett, Paula Watts, and Dmitriy Scherbak.
• HCA HealthONE, Denver, CO.
• Crit. Care Med. 2023 Nov 1; 51 (11): 146914781469-1478.

ObjectivesTo determine the occurrence rate and impact on patient outcomes of probiotic-associated central venous catheter bloodstream infections in the ICU.DesignRetrospective observational cohort study.SettingThe cohort was gathered using HCA Healthcare's data warehouse.PatientsAdult patients with central venous catheters in the ICU.InterventionsNone.Measurements And Main ResultsBlood culture data were used to determine whether an infection had occurred with an organism contained in an administered probiotic. Eighty-six probiotic-associated central venous catheter bloodstream infections were identified among the 23,015 patient cohort who received probiotics (0.37%). The number needed to harm was 270. Zero infections were found in the cohort that did not receive probiotics. Patients who contracted a probiotic infection had increased mortality (odds ratio, 2.23; 1.30-3.71; p < 0.01). Powder formulations had an increased rate of infection compared with nonpowder formulations (0.76% vs 0.33%; odds ratio, 2.03; 1.05-3.95; p = 0.04).ConclusionsProbiotic administration is associated with a substantial rate of probiotic-associated bloodstream infection in ICU patients with central venous catheters in place. Probiotic-associated bloodstream infections result in significantly increased mortality. Powder formulations cause bloodstream infections more frequently than nonpowder formulations. In ICU patients with central venous catheters, the risks of probiotic-associated central venous catheter bloodstream infection and death outweigh any potential benefits of probiotic administration.Copyright © 2023 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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