A Four-Probiotic Regime to Reduce Surgical Site Infections in Multi-Trauma Patients.

Investigations that focused on the protective role of probiotics against Surgical Site Infections (SSI) in multiple-trauma (MT) patients are generally few, probably due to the complexity of the concept of trauma. We aimed to assess the efficacy of a four-probiotic regime to reduce the incidence of SSI in MT patients, with a brain injury included. MT patients, being intubated and expected to require mechanical ventilation for >10 days, were randomly allocated into placebo ( n = 50) or probiotic treatment ( n = 53) comprising Lactobacillus acidophilus LA-5 (1.75 × 10 9 cfu), Lactiplantibacillus plantarum UBLP-40 (0.5 × 10 9 cfu), Bifidobacterium animalis subsp. lactis BB-12 (1.75 × 10 9 cfu), and Saccharomyces boulardii Unique-28 (1.5 × 10 9 cfu) in sachets. All patients received two sachets of placebo or probiotics twice/day for 15 days and were followed-up for 30 days. The operations were classified as neurosurgical, thoracostomies, laparotomies, orthopedics, and others; then, the SSI and the isolated pathogen were registered. A total of 23 (46.0%) and 13 (24.5%) infectious insults in 89 (50 placebo patients) and 88 (53 probiotics-treated) operations ( p = 0.022) were recorded, the majority of them relating to osteosynthesis-17 and 8, respectively. The most commonly identified pathogens were Staphylococcus aureus and Acinetobacter baumannii . Our results support published evidence that the prophylactic administration of probiotics in MT patients exerts a positive effect on the incidence of SSI.