The effect of probiotics in the prevention of urinary tract infections in elderly patients hospitalized in intensive care units

Background: Urinary tract infections  (UITs) are the most common hospital-acquired infections and elderly people hospitalized in the intensive care unit (ICU) are highly susceptible to this infection. In this study, according to the hypothesis that probiotic organisms may represent a safe and effective intervention for control purposes infection, the role of a probiotic consists of four strains of Lactobacillus in the prevention of UITs in elderly patients hospitalized in the ICU were studied.

Methods:A randomized, double-blind, placebo-controlled study was conducted on 50 elderly patients admitted to ICUs. Patients in addition to conventional treatment, received randomly either probiotics contained 109× 5 CFU viable lyophilized bacteria consisting of 4 strains of Lactobacillus (Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus Gasser and Lactobacillus Plantarm) or placebo, twice a day for seven days. At baseline and on the fourteenth day of the study, two groups in terms of the level of CRP, urine culture testresults and leukocyturia were compared. Acute Physiology and Chronic Health Evaluation (APACHE II) score and survival status at follow-up one-month also were measured.

Results: Probiotics could significantly reduce the number of leukocyturia
(p=0.002) and a positive urine culture  (p=0.002) in the probiotic group compared to placebo. The use of probiotics had no significant effect on the levels of CRP. Despite the reduction in APACHE II score and lower mortality rates in the probiotic group compared to the placebo group, these differences were not statistically significant.

Conclusion: Probiotics can significantly prevent UITs in elderly patients hospitalized in the ICU. Administering probiotics led to changes in the urinary tract microflora and reduced the colonization of pathogens. Therefore, probiotics can be considered as an adjunctive therapy in critically ill elderly patients.

Keywords: Probiotics, Nosocomial infection, Urinary tract infection, Elderly patients