Emerging Issues in Probiotic Safety: 2023 Perspectives

Authors

Daniel Merenstein
Bruno Pot
Gregory Leyer
Arthur C Ouwehand
Geoffrey A Preidis
Christopher A Elkins
Colin Hill
Zachery T Lewis
Andi L Shane
Niv Zmora
Mariya I Petrova
Maria Carmen Collado
Lorenzo Morelli
Gina A Montoya
Hania Szajewska
Daniel J Tancredi
Mary Ellen Sanders

Publication Date

1-1-2023

Journal

Gut Microbes

DOI

10.1080/19490976.2023.2185034

PMID

36919522

PMCID

PMC10026873

PubMedCentral® Posted Date

3-15-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Anti-Bacterial Agents, Gastrointestinal Microbiome, Prebiotics, Probiotics, Probiotic, safety, next-generation probiotics, antibiotic resistance, microbiome, microbiota, genome sequencing, live biotherapeutic products, International Scientific Association for Probiotics and Prebiotics, ISAPP

Abstract

Probiotics are used for both generally healthy consumers and in clinical settings. However, theoretical and proven adverse events from probiotic consumption exist. New probiotic strains and products, as well as expanding use of probiotics into vulnerable populations, warrants concise, and actionable recommendations on how to work toward their safe and effective use. The International Scientific Association for Probiotics and Prebiotics convened a meeting to discuss and produce evidence-based recommendations on potential acute and long-term risks, risks to vulnerable populations, the importance for probiotic product quality to match the needs of vulnerable populations, and the need for adverse event reporting related to probiotic use. The importance of whole genome sequencing, which enables determination of virulence, toxin, and antibiotic resistance genes, as well as clear assignment of species and strain identity, is emphasized. We present recommendations to guide the scientific and medical community on judging probiotic safety.