The Role of Probiotics, Prebiotics and Synbiotics in Combating Multidrug-Resistant Organisms

Abstract

The prevalence of multidrug-resistant organisms is increasing worldwide, posing a unique challenge to global health care systems. Novel approaches are needed to combat the spread of infection with these organisms. The enteric microbiome, and in particular the resistome, offers a unique target in both the prevention of infection with these organisms and the acquisition and spread within the community. We highlight a novel approach to combat multidrug-resistant organisms: the use of prebiotics, probiotics, and synbiotics to manipulate the microbiome and resistome. This review summarizes the published literature and clinical trials related to these products to date, with a focus on efficacious trials. It highlights the probable mechanism of action for each product, as well as its safety profile in selective populations. Ultimately, although further research is needed before a definitive statement can be made on the efficacy of any of these 3 interventions, the literature to date offers new hope and a new tool in the arsenal in the fight against bacterial drug resistance.

Keywords: microbiome; multidrug-resistant organisms; prebiotic; probiotic; resistome; synbiotic.

Figure.

Mechanism of action of prebiotics and probiotics on enteric multidrug-resistant organism (MDRO) colonization. The figure shows the process of developing dysbiosis and MDRO colonization, with subsequent figures on the far right detailing the action of probiotics (far right, top) and prebiotics (far right, middle). Without intervention, further stress and illness can allow translocation of MDRO pathogens into the bloodstream (far right, bottom). Th17 = T helper 17 cell.