Risks associated with enterococci as probiotics. (March 2020)

• Record Type: Journal Article
• Authors: Wang, Xingmin; Yang, Yonghong; Huycke, Mark M.
• Is Part Of: Food research international. Volume 129(2020)
• Publication Date: 2020-03
• Subjects: Enterococcus -- Probiotics -- Virulence -- Antibiotic resistance -- Infection -- Gene transfer -- Colorectal cancer; Food -- Analysis -- Periodicals; Food industry and trade -- Periodicals; Food industry and trade -- Canada -- Periodicals; Food Technology -- Periodicals; Food -- Periodicals; Food-Processing Industry -- Periodicals; Aliments -- Industrie et commerce -- Périodiques; Aliments -- Industrie et commerce -- Canada -- Périodiques; Aliments -- Recherche -- Périodiques; Food industry and trade; Canada; Periodicals; Electronic journals; 664.005
• DOI: 10.1016/j.foodres.2019.108788
• Languages: English
• ISSNs: 0963-9969

Abstract

Graphical abstract: Highlights: Enterococci express many virulence factors leading to severe infections. Enterococci can translocate intestinal mucosa and resist to innate immunity. Enterococci are susceptible to DNA acquisition due to lacking of CRISPR/Cas loci. E. faecalis may be associated with colorectal cancer. No large cohort study has proven the safety and efficacy of enterococcal probiotics. Abstract: Probiotics are naturally occurring microorganisms that confer health benefits by altering host commensal microbiota, modulating immunity, enhancing intestinal barrier function, or altering pain perception. Enterococci are human and animal intestinal commensals that are used as probiotics and in food production. These microorganisms, however, express many virulence traits including cytolysin, proteases, aggregation substance, capsular polysaccharide, enterococcal surface protein, biofilm formation, extracellular superoxide, intestinal translocation, and resistance to innate immunity that can lead to serious hospital-acquired infections. In addition, enterococci are facile in acquiring antibiotic resistance genes to many clinically important antibiotics encoded on a wide variety of conjugative plasmids, transposons, and bacteriophages. The pathogenicity and disease burden caused by enterococci render them poor choices as probiotics. No large, randomized, placebo-controlled clinical trials have demonstrated the safety and efficacy of any enterococcal probiotic. As a result, no enterococcal probiotic has been approved by the United States Food and Drug Administration for the treatment, cure, or amelioration of human disease. In 2007, the European Food Safety Authority concluded that enterococci do not meet the standard for "Qualified Presumption of Safety". Enterococcal strains used or proposed for use as probiotics should be carefully screened for efficacy and safety.