Saccharomyces boulardii as an agent of systemic infection: an integrative review

Objective: To analyze possible cases of infection by Saccharomyces boulardii worldwide from 2018 to 2023. Methodology: An integrative review was conducted using the Virtual Health Library, PubMed, and ScienceDirect databases, with the descriptors “probiotics”, “Saccharomyces boulardii”, and “fungemia,” resulting in 11 articles. Results: A total of 69 cases of fungemia were identified in patients aged 3.5 to 93 years, with a mean age of 62 years and a male predominance. The main risk factors included antibiotic use, central venous catheterization, cancer, enteral nutrition, intensive care unit admission, and intubation. The most used antifungal was fluconazole. The fatality rate was 36.2%. Conclusion: Although probiotics containing Saccharomyces boulardii are generally used for their beneficial effects, it was found that, under certain circumstances, they may cause adverse events in some individuals. Therefore, the risk-benefit ratio should be carefully evaluated in each case.