833Lactobacillus GG (LGG) Does Not Eliminate Colonization by Vancomycin Resistant Enterococcus (VRE) in Adults with Comorbidities

Background. VRE is an endemic hospital-acquired organism in the US. There are no proven methods or means of decreasing or eliminating carriage of VRE which is a risk factor for invasive disease. Two small clinical studies showed reduction or elimination of VRE colonization using the probiotic LGG but neither study cultured stool for the presence of LGG, raising questions about whether effects on VRE colonization were due to LGG or other factors. Methods. To determine whether LGG can eliminate colonization by VRE, we undertook a randomized, double blind, placebo controlled trial in which subjects with VRE received 2 weeks of LGG or placebo. Stool samples were collected and cultured for the presence of VRE and LGG at baseline and days 7, 14, 21, 28 and 56. Presence of LGG was also assessed by PCR on day 14 samples from a subset of 7 subjects. Subjects were monitored closely for adverse events. Results. Of 694 patients screened, 11 were randomized. Five subjects received LGG and 6 received placebo. VRE was not eliminated during or after treatment in any subject. No significant decreases in VRE colony counts occurred in the subjects receiving LGG (table). LGG was recovered from stool in 2/5 subjects who received LGG. These 2 subjects were among 3/5 who received LGG and were also treated with antibiotics. LGG was detected by PCR in 4/4 samples from subjects who received LGG and 0/3 subjects in the placebo group. Adverse events were similar in the 2 groups.