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Volume 27, Number 8—August 2021
CME ACTIVITY - Research

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)

Main Article

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)
F
 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.

Main Article

Page created: May 10, 2021
Page updated: July 14, 2021
Page reviewed: July 14, 2021
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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