Impact of Exogenous <i>Lactiplantibacillus plantarum</i> on the Gut Microbiome of Hematopoietic Stem Cell Transplantation Patients Colonized by Multidrug-Resistant Bacteria: An Observational Study
Bruna D. G. C. Moraes,
Roberta C. R. Martins,
Joyce Vanessa da Silva Fonseca,
Lucas A. M. Franco,
Gaspar C. O. Pereira,
Thais F. Bartelli,
Marina F. Cortes,
Nazareno Scaccia,
Carolina F. Santos,
Priscila T. Musqueira,
Leonardo J. Otuyama,
Victor S. Pylro,
Livia Mariano,
Vanderson Rocha,
Steven S. Witkin,
Ester Sabino,
Thais Guimaraes,
Silvia Figueiredo Costa
Affiliations
Bruna D. G. C. Moraes
LIM-46 and LIM49, Department of Infectious Diseases, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas Carvalho de Aguiar, 470 Jardim America, São Paulo 05403-000, SP, Brazil
Roberta C. R. Martins
LIM-46 and LIM49, Department of Infectious Diseases, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas Carvalho de Aguiar, 470 Jardim America, São Paulo 05403-000, SP, Brazil
Joyce Vanessa da Silva Fonseca
LIM-46 and LIM49, Department of Infectious Diseases, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas Carvalho de Aguiar, 470 Jardim America, São Paulo 05403-000, SP, Brazil
Lucas A. M. Franco
LIM-46 and LIM49, Department of Infectious Diseases, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas Carvalho de Aguiar, 470 Jardim America, São Paulo 05403-000, SP, Brazil
Gaspar C. O. Pereira
LIM-46 and LIM49, Department of Infectious Diseases, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas Carvalho de Aguiar, 470 Jardim America, São Paulo 05403-000, SP, Brazil
Thais F. Bartelli
Centro Internacional de Pesquisa, CIPE, A.C.Camargo Cancer Center, Rua Taguá 440, São Paulo 01508-010, SP, Brazil
Marina F. Cortes
LIM-46 and LIM49, Department of Infectious Diseases, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas Carvalho de Aguiar, 470 Jardim America, São Paulo 05403-000, SP, Brazil
Nazareno Scaccia
LIM-46 and LIM49, Department of Infectious Diseases, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas Carvalho de Aguiar, 470 Jardim America, São Paulo 05403-000, SP, Brazil
Carolina F. Santos
Department of Hematology, Hemotherapy and Cell Therapy Service, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-000, SP, Brazil
Priscila T. Musqueira
Department of Hematology, Hemotherapy and Cell Therapy Service, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-000, SP, Brazil
Leonardo J. Otuyama
Department of Hematology, Hemotherapy and Cell Therapy Service, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-000, SP, Brazil
Victor S. Pylro
Department of Biology, Federal University of Lavras, Lavras 37200-000, MG, Brazil
Livia Mariano
Department of Hematology, Hemotherapy and Cell Therapy Service, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-000, SP, Brazil
Vanderson Rocha
Department of Hematology, Hemotherapy and Cell Therapy Service, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-000, SP, Brazil
Steven S. Witkin
Division of Immunology and Infectious Diseases, Weill Cornell Medicine of Cornell University, New York, NY 10065, USA
Ester Sabino
LIM-46 and LIM49, Department of Infectious Diseases, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas Carvalho de Aguiar, 470 Jardim America, São Paulo 05403-000, SP, Brazil
Thais Guimaraes
Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-000, SP, Brazil
Silvia Figueiredo Costa
LIM-46 and LIM49, Department of Infectious Diseases, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas Carvalho de Aguiar, 470 Jardim America, São Paulo 05403-000, SP, Brazil
Background: Lactiplantibacillus plantarum can inhibit the growth of multidrug-resistant organisms (MDROs) and modulate the gut microbiome. However, data on hematopoietic stem cell transplantation (HSCT) are scarce. Aim: In an observational study, we assessed the impact of L. plantarum on the modulation of the gut microbiome in HSCT patients colonized by MDROs. Methods: Participants were allocated to an intervention group (IG = 22) who received capsules of L. plantarum (5 × 109 CFU) twice per day until the onset of neutropenia or a control group (CG = 20). The V4 region of the 16S bacterial rRNA gene was sequenced in 87 stool samples from a subset of 33 patients (IG = 20 and CG = 13). The Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt2) program was used to predict metagenome functions. Results: L. plantarum demonstrated an average 86% (±11%) drug-target engagement at 43 (±29) days of consumption and was deemed safe, well-tolerated, and associated with an increase in the abundance of the Lactobacillales (p Lactococcus and a reduction in Turicibacter (p L. plantarum use. Although Enterococcus abundance had a greater rise in the CG (p = 0.07), there were no significant differences concerning the Gram-negative MDROs. No serious adverse effects were reported in the IG. We observed a greater, non-significant pyruvate fermentation to propanoate I (p = 0.193) relative abundance in the IG compared with the CG. L. plantarum use was safe and tolerable by HSCT patients. Conclusions: While L. plantarum is safe and may impact Enterococcus and Turicibacter abundance, it showed no impact on Gram-negative MDRO abundance in HSCT patients.
