Probiotics [LGG-BB12 or RC14-GR1] versus placebo as prophylaxis for urinary tract infection in persons with spinal cord injury [ProSCIUTTU]: a randomised controlled trial

Spinal Cord, 2019 · DOI: 10.1038/s41393-019-0251-y · Published: February 27, 2019

Spinal Cord Injury Immunology Nutrition & Dietetics

Simple Explanation

This study investigated whether probiotics could prevent urinary tract infections (UTIs) in people with spinal cord injuries (SCI). UTIs are a common complication for individuals with SCI. Participants were given either Lactobacillus reuteri RC-14+Lactobacillus GR-1 (RC14-GR1) and/or Lactobacillus rhamnosus GG+Biﬁdobacterium BB-12 (LGG-BB12) or a placebo for 6 months to see if it would reduce the occurrence of UTIs. The study found that neither RC14-GR1 nor LGG-BB12 significantly reduced the risk of UTIs in people with SCI. However, post-hoc analysis suggested RC14-GR1 alone might have a protective effect, which needs further confirmation.

Study Duration

6 months

Participants

207 participants with SCI and stable neurogenic bladder management

Evidence Level

Level 1: Randomised double-blind factorial-design placebo-controlled trial

Key Findings

1
RC14-GR1 did not significantly reduce the risk of UTI compared to placebo (HR 0.67; 95% CI: 0.39–1.18; P = 0.17).
2
LGG-BB12 also did not significantly reduce the risk of UTI compared to placebo (HR 1.29; 95% CI: 0.74–2.25; P = 0.37).
3
Post hoc analysis suggested a potential protective effect of RC14-GR1 alone (HR 0.46; 95% CI: 0.21–0.99; P = 0.03), but this requires confirmation.

Research Summary

This study aimed to determine whether probiotic therapy with Lactobacillus reuteri RC-14+Lactobacillus GR-1 (RC14-GR1) and/or Lactobacillus rhamnosus GG+Biﬁdobacterium BB-12 (LGG-BB12) are effective in preventing UTI in people with SCI. The results of this RCT showed no significant effect of either RC14-GR1 or LGG-BB12 in preventing UTI in people with SCI when administered using a factorial design. Post hoc analysis suggested that RC14-GR1 alone may have a protective effect against UTI, but this requires further confirmation and was not the primary aim of the study.

Practical Implications

Clinical Practice

Current findings do not support routine use of RC14-GR1 or LGG-BB12 for UTI prophylaxis in SCI patients.

Future Research

Further research should investigate the potential protective effect of RC14-GR1 alone in preventing UTI in SCI patients.

Probiotic Specificity

Future studies should focus on task selectivity and appropriate dosages of probiotics for UTI prevention.

Study Limitations

1
Failure to recruit the targeted sample size due to funding constraints and competition from other trials.
2
Endpoint urine analysis was not performed in a central laboratory for all participants due to logistical reasons.
3
Lack of follow-up data after trial completion to assess long-term effects on UTI incidence.

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