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Emerging issues in probiotic safety: 2023 perspectives. 2023
Daniel Merenstein, and
Bruno Pot, and
Gregory Leyer, and
Arthur C Ouwehand, and
Geoffrey A Preidis, and
Christopher A Elkins, and
Colin Hill, and
Zachery T Lewis, and
Andi L Shane, and
Niv Zmora, and
Mariya I Petrova, and
Maria Carmen Collado, and
Lorenzo Morelli, and
Gina A Montoya, and
Hania Szajewska, and
Daniel J Tancredi, and
Mary Ellen Sanders
Department of Family Medicine, Georgetown University Medical Center, Washington, DC USA.
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.
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