Résumé
La reconnaissance ces dernières années de la place cruciale du tube digestif et de sa flore en physiologie et en physiopathologie a suscité un regain d’intérêt pour les probiotiques (définis comme étant des « micro-organismes viables qui, lorsqu’ils sont ingérés en quantité suffisante, ont un effet bénéfique sur la santé ») en tant qu’alternative thérapeutique originale de diverses pathologies intestinales telles que maladies inflammatoires chroniques intestinales, entérocolite ulcéronécrosante, diarrhées postantibiotiques, allergie au lactose, mais également dans des pathologies extradigestives, comme la dermatite atopique, les allergies ou l’asthme. Les données cliniques robustes concernant l’utilisation de ces produits dans le domaine de la réanimation, et en particulier dans la prévention des infections et des pneumonies acquises sous ventilation mécanique (PAVM), restent cependant éparses et contradictoires. Après des rappels concernant la physiologie et la physiopathologie du tube digestif du patient critique, cette revue exposera l’utilisation des probiotiques en réanimation pour la prévention des infections nosocomiales et en particulier des PAVM.
Abstract
An acknowledgment of the crucial role of intestinal tract and digestive flora has aroused growing interest in the use of probiotics (defined as “live microorganisms that, when administered in adequate amount, confer a beneficial health effect”) during various intestinal disorders such as chronic inflammatory bowel disease, antibiotic-associated diarrhea, and extra-digestive diseases, namely atopic dermatitis, allergy, and asthma. However, clinical data related to their use in the intensive care unit, especially with the aim to prevent ventilator-associated pneumonia, are scarce and conflicting. We hereby review and discuss the usefulness of probiotics in critically ill patients.
Article PDF
Avoid common mistakes on your manuscript.
Références
Isakow W, Morrow LE, Kollef MH (2007) Probiotics for preventing and treating nosocomial infections: review of current evidence and recommendations. Chest 132:286–94
McNabb B, Isakow W (2008) Probiotics for the prevention of nosocomial pneumonia: current evidence and opinions. Curr Opin Pulm Med 14:168–75
Lilly DM, Stillwell RH (1965) Probiotics: growth-promoting factors produced by microorganisms. Science 147:747–8
Guidelines for the evaluation of probiotics in food: report of a joint FAO/WHO working group on drafting guidelines for the evaluation of probiotics in food. http://www.who.int/foodsafety/fs_management/en/probiotic_guidelines.pdf
Morrow LE, Kollef MH (2008) Probiotics in the intensive care unit: why controversies and confusion abound. Crit Care 12:160
Gareau MG, Sherman PM, Walker WA (2010) Probiotics and the gut microbiota in intestinal health and disease. Nat Rev Gastroenterol Hepatol 7:503–14
Butel MJ (2014) Probiotics, gut microbiota and health. Med Mal Infect 44:1–8
Sertaridou E, Papaioannou V, Kolios G, Pneumatikos I (2015) Gut failure in critical care: old school versus new school. Ann Gastroenterol 28:309–22
Macpherson AJ, Harris NL (2004) Interactions between commensal intestinal bacteria and the immune system. Nat Rev Immunol 4:478–85
Mittal R, Coopersmith CM (2014) Redefining the gut as the motor of critical illness. Trends Mol Med 20:214–23
Sekirov I, Russell SL, Antunes LCM, Finlay BB (2010) Gut microbiota in health and disease. Physiol Rev 90:859–904
Brestoff JR, Artis D (2013) Commensal bacteria at the interface of host metabolism and the immune system. Nat Immunol 14:676–84
Brown EM, Sadarangani M, Finlay BB (2013) The role of the immune system in governing host-microbe interactions in the intestine. Nat Immunol 14:660–7
Donaldson GP, Lee SM, Mazmanian SK (2016) Gut biogeography of the bacterial microbiota. Nat Rev Microbiol 14:20–32
Huang YJ, Charlson ES, Collman RG, et al (2013) The role of the lung microbiome in health and disease. A National Heart, Lung, and Blood Institute workshop report. Am J Respir Crit Care Med 187:1382–7
Zeissig S, Blumberg RS (2014) Life at the beginning: perturbation of the microbiota by antibiotics in early life and its role in health and disease. Nat Immunol 15:307–10
Maslowski KM, Mackay CR (2011) Diet, gut microbiota and immune responses. Nat Immunol 12:5–9
Pamer EG (2007) Immune responses to commensal and environmental microbes. Nat Immunol 8:1173–8
Bäckhed F, Ley RE, Sonnenburg JL, et al (2005) Host-bacterial mutualism in the human intestine. Science 307:1915–20
Hooper LV, Littman DR, Macpherson AJ (2012) Interactions between the microbiota and the immune system. Science 336: 1268–73
Kamada N, Chen GY, Inohara N, Núñez G (2013) Control of pathogens and pathobionts by the gut microbiota. Nat Immunol 14:685–90
Round JL, Mazmanian SK (2009) The gut microbiota shapes intestinal immune responses during health and disease. Nat Rev Immunol 9:313–23
Chu H, Mazmanian SK (2013) Innate immune recognition of the microbiota promotes host-microbial symbiosis. Nat Immunol 14:668–75
West CE, Renz H, Jenmalm MC, et al (2015) The gut microbiota and inflammatory noncommunicable diseases: associations and potentials for gut microbiota therapies. J Allergy Clin Immunol 135:3–13
Hayakawa M, Asahara T, Henzan N, et al (2011) Dramatic changes of the gut flora immediately after severe and sudden insults. Dig Dis Sci 56:2361–5
Shimizu K, Ogura H, Hamasaki T, et al (2011) Altered gut flora are associated with septic complications and death in critically ill patients with systemic inflammatory response syndrome. Dig Dis Sci 56:1171–7
Kanazawa H, Nagino M, Kamiya S, et al (2005) Synbiotics reduce postoperative infectious complications: a randomized controlled trial in biliary cancer patients undergoing hepatectomy. Langenbecks Arch Surg 390:104–13
Gatt M, Reddy BS, MacFie J (2007) Review article: bacterial translocation in the critically ill — evidence and methods of prevention. Aliment Pharmacol Ther 25:741–57
Alexandre Y, Le Blay G, Boisramé-Gastrin S, et al (2014) Probiotics: a new way to fight bacterial pulmonary infections? Med Mal Infect 44:9–17
Hill C, Guarner F, Reid G, et al (2014) Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol 11:506–14
Klarin B, Johansson ML, Molin G, et al (2005) Adhesion of the probiotic bacterium Lactobacillus plantarum 299v onto the gut mucosa in critically ill patients: a randomised open trial. Crit Care 9:R285–R93
Tan M, Zhu JC, Du J, et al (2011) Effects of probiotics on serum levels of Th1/Th2 cytokine and clinical outcomes in severe traumatic brain-injured patients: a prospective randomized pilot study. Crit Care 15:R290
McNaught CE, Woodcock NP, Anderson ADG, MacFie J (2005) A prospective randomised trial of probiotics in critically ill patients. Clin Nutr Edinb Scotl 24:211–9
Alberda C, Gramlich L, Meddings J, et al (2007) Effects of probiotic therapy in critically ill patients: a randomized, doubleblind, placebo-controlled trial. Am J Clin Nutr 85:816–23
Barraud D, Blard C, Hein F, et al (2010) Probiotics in the critically ill patient: a double blind, randomized, placebo-controlled trial. Intensive Care Med 36:1540–7
Jain PK, McNaught CE, Anderson ADG, et al (2004) Influence of synbiotic containing Lactobacillus acidophilus La5, Bifidobacterium lactis Bb 12, Streptococcus thermophilus, Lactobacillus bulgaricus and oligofructose on gut barrier function and sepsis in critically ill patients: a randomised controlled trial. Clin Nutr Edinb Scotl 23:467–75
Morrow LE, Kollef MH, Casale TB (2010) Probiotic prophylaxis of ventilator-associated pneumonia: a blinded, randomized, controlled trial. Am J Respir Crit Care Med 182:1058–64
Oudhuis GJ, Bergmans DC, Dormans T, et al (2011) Probiotics versus antibiotic decontamination of the digestive tract: infection and mortality. Intensive Care Med 37:110–7
Kotzampassi K, Giamarellos-Bourboulis EJ, Voudouris A, et al (2006) Benefits of a synbiotic formula (Synbiotic 2000Forte®) in critically Ill trauma patients: early results of a randomized controlled trial. World J Surg 30:1848–55
Spindler-Vesel A, Bengmark S, Vovk I, et al (2007) Synbiotics, prebiotics, glutamine, or peptide in early enteral nutrition: a randomized study in trauma patients. JPEN J Parenter Enteral Nutr 31:119–26
Knight DJW, Gardiner D, Banks A, et al (2009) Effect of synbiotic therapy on the incidence of ventilator associated pneumonia in critically ill patients: a randomised, double-blind, placebocontrolled trial. Intensive Care Med 35:854–61
Rayes N, Seehofer D, Hansen S, et al (2002) Early enteral supply of lactobacillus and fiber versus selective bowel decontamination: a controlled trial in liver transplant recipients. Transplantation 74:123–7
Rayes N, Seehofer D, Theruvath T, et al (2005) Supply of preand probiotics reduces bacterial infection rates after liver transplantation — a randomized, double-blind trial. Am J Transplant 5:125–30
Forestier C, Guelon D, Cluytens V, et al (2008) Oral probiotic and prevention of Pseudomonas aeruginosa infections: a randomized, double-blind, placebo-controlled pilot study in intensive care unit patients. Crit Care 12:R69
Sanaie S, Ebrahimi-Mameghani M, Hamishehkar H, et al (2014) Effect of a multispecies probiotic on inflammatory markers in critically ill patients: a randomized, double-blind, placebocontrolled trial. J Res Med Sci 19:827–33
Besselink MGH, van Santvoort HC, Buskens E, et al (2008) Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet 371:651–9
Siempos II, Ntaidou TK, Falagas ME (2010) Impact of the administration of probiotics on the incidence of ventilator-associated pneumonia: a meta-analysis of randomized controlled trials. Crit Care Med 38:954–62
Liu K, Zhu Y, Zhang J, et al (2012) Probiotics’ effects on the incidence of nosocomial pneumonia in critically ill patients: a systematic review and meta-analysis. Crit Care 16:R109
Gu WJ, Wei CY, Yin RX (2012) Lack of efficacy of probiotics in preventing ventilator-associated pneumonia probiotics for ventilator-associated pneumonia: a systematic review and metaanalysis of randomized controlled trials. Chest 142:859–68
Barraud D, Bollaert PE, Gibot S (2013) Impact of the administration of probiotics on mortality in critically ill adult patients: a meta-analysis of randomized controlled trials. Chest 143:646–55
Doron S, Snydman DR (2015) Risk and safety of probiotics. Clin Infect Dis 60:S129–S34
Bo L, Li J, Tao T, et al (2014) Probiotics for preventing ventilator-associated pneumonia. Cochrane Database Syst Rev 10:CD009066
Forsythe P (2014) Probiotics and lung immune responses. Ann Am Thorac Soc 11:S33–S7
Li J, Jia H, Cai X, et al (2014) An integrated catalog of reference genes in the human gut microbiome. Nat Biotechnol 32:834–41
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Barraud, D., Gibot, S. Probiotiques en réanimation. Réanimation 25, 328–339 (2016). https://doi.org/10.1007/s13546-016-1196-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13546-016-1196-1