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Lactobacillus plantarum 299v Does Not Reduce Enteric Bacteria or Bacterial Translocation in Patients Undergoing Colon Resection

Digestive Diseases and Sciences volume 57, pages 1915–1924 (2012)Cite this article

Abstract

Background

Probiotics may exert beneficial effects in the gastrointestinal tract. This randomized trial investigated the effect of the probiotic Lactobacillus plantarum 299v on the intestinal load of potentially pathogenic bacteria, bacterial translocation, and cell proliferation in elective colon surgery.

Methods

Seventy-five patients were randomized to pre- and postoperative oral intake of Lactobacillus plantarum 299v or placebo. Rectal swabs and mucosal biopsies were taken before the start of intake, after 1 week, at surgery, and after 6 days, weeks, and months. Viable counts were quantified for clostridia, Enterobacteriaceae, Gram-negative anaerobes, and lactobacilli. Bacterial translocation was determined by the analysis of bacterial DNA genes in mesenteric lymph nodes. Ki-67 was used as a marker of cell proliferation in normal mucosa and tumor.

Results

Lactobacillus plantarum 299v was given without adverse effects. Lactobacillus plantarum 299v as well as Enterobacteriaceae and Gram-negative anaerobes increased in the colon 1 week after the administration of Lactobacillus plantarum 299v. There were no significant differences between patients receiving Lactobacillus plantarum 299v and placebo in the incidence of bacterial translocation (27 vs. 13 %) and postoperative complications (16 vs. 31 %).

Conclusions

Lactobacillus plantarum 299v was established in the intestine, but no inhibitory effect on enteric bacteria, bacterial translocation, or postoperative complications was found. The mechanism behind the protective effects of probiotics found in animal and some human studies remain elusive and require further explorations. No adverse effects were recorded after the administration of high doses of Lactobacillus plantarum 299v.

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Acknowledgments

The authors wish to thank Alejandra Vásquez Moreno, Nadja Elginaid Osman, and Susanne Eiswohld for their excellent technical assistance in the laboratory. Very special thanks go to Ingrid Palmquist for the invaluable logistical management, patient handling, and sampling. Probi AB, Lund, Sweden, kindly provided the study preparations.

Conflict of interest

None.

Funding

This study was funded by the following organizations: the Swedish Cancer Foundation, the Swedish Research Council, Dir. A. Påhlsson’s Foundation, the Gunnar Nilsson Foundation, Malmö University Hospital, Apotekare Hedberg’s Foundation, the Bengt Ihre Foundation, the Ruth and Richard Juhlin Foundation, the Einar and Inga Nilsson Foundation, and the Agnes Nilsson Foundation.

Author information

Affiliations

  1. Department of Clinical Sciences, Lund University, 205 02, Malmö, Sweden

    Peter Mangell, Henrik Thorlacius, Ingvar Syk, Crister Olsson & Bengt Jeppsson

  2. Department of Surgery, Skane University Hospital, 205 02, Malmö, Sweden

    Peter Mangell, Henrik Thorlacius, Ingvar Syk & Bengt Jeppsson

  3. Department of Food Technology, Engineering and Nutrition, Lund University, 221 00, Lund, Sweden

    Siv Ahrné & Göran Molin

Authors
  1. Peter Mangell
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  2. Henrik Thorlacius
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  3. Ingvar Syk
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  4. Siv Ahrné
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  5. Göran Molin
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  6. Crister Olsson
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  7. Bengt Jeppsson
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Corresponding author

Correspondence to Peter Mangell.

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Mangell, P., Thorlacius, H., Syk, I. et al. Lactobacillus plantarum 299v Does Not Reduce Enteric Bacteria or Bacterial Translocation in Patients Undergoing Colon Resection. Dig Dis Sci 57, 1915–1924 (2012). https://doi.org/10.1007/s10620-012-2102-y

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  • DOI: https://doi.org/10.1007/s10620-012-2102-y

Keywords

  • Colon and rectal surgery
  • Probiotics
  • Lactobacillus plantarum
  • Bacterial translocation
  • Postoperative complications