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Volume 27, Number 8—August 2021

Fungemia and Other Fungal Infections Associated with Use of Saccharomyces boulardii Probiotic Supplements

Juha RannikkoComments to Author , Ville Holmberg, Matti Karppelin, Pertti Arvola, Reetta Huttunen, Eero Mattila, Niina Kerttula, Teija Puhto, Ülle Tamm, Irma Koivula, Risto Vuento, Jaana Syrjänen, and Ulla Hohenthal
Author affiliations: Tampere University, Tampere, Finland (J. Rannikko); Tampere University Hospital, Tampere (J. Rannikko, M. Karppelin, P. Arvola, R. Huttunen, J. Syrjänen); University of Helsinki, Helsinki, Finland (V. Holmberg); Helsinki University Hospital, Helsinki (V. Holmberg, E. Mattila); Oulu University Hospital, Oulu, Finland (N. Kerttula, T. Puhto); Kuopio University Hospital; Kuopio Finland (Ü. Tamm, I. Koivula); Fimlab Laboratories, Tampere (R. Vuento); Turku University Hospital, Turku, Finland (U. Hohenthal)

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Table 2

Characteristics of 46 case-patients who had Saccharomyces fungemia in 5 hospital districts, Finland, January 1, 2009‒December 31, 2018*

Characteristic Value
No. patients 46
Median age, y (range)
68 (30–93)
Sex 29 (63)
M 29 (63)
17 (37)
Use of S. cerevisiae var. boulardii probiotic in preceding 3 mo† 25/46 (54)
Use of S. cerevisiae var. boulardii probiotic in preceding 7 d† 20/46 (43)
Use of S. cerevisiae var. boulardii probiotic in preceding 7 d in control group‡ 4/76 (5)
Central venous catheter 8 (17)
Use of antimicrobial drugs in preceding 4 weeks 33 (72)
Change in antimicrobial drugs because of fungemia
23 (50)
Underlying diseases
Digestive tract 27 (59)
Neurologic 11 (24)
Cardiovascular 8 (17)
Solid tumor with metastasis 6 (13)
Diabetes mellitus (any type) 6 (13)
Pulmonary 5 (11)
Liver 4 (9)
Rheumatic 4 (9)
Chronic kidney§
3 (7)
McCabe score†
No or nonfatal underlying disease 22 (48)
Ultimately fatal underlying diseases (<5 y) 9 (20)
Rapidly fatal underlying diseases (<1 y)
5 (11)
Severity of disease
qSOFA score >2 at time of fungemia 16 (35)
Septic shock at time of fungemia 6 (13)
Death by day 7 after fungemia 10 (22)

*Values are no. (%) or no. positive/no. tested (%) unless otherwise indicated. †Medical records were not available for 10 case-patients. ‡Medical records were not available for 6 control case-patients. §History of creatinine level >120 μmol/L.

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Page created: May 10, 2021
Page updated: July 14, 2021
Page reviewed: July 14, 2021
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