Effect of probiotic supplementation on Clostridioides difficile stool concentration in hospitalized patients in coma: A preliminary study

Introduction Clostridioides difficile (CD) is a major healthcare-associated pathogen responsible for antibiotic-associated diarrhea and severe colitis. Probiotics have been proposed as a preventive strategy. However, data in critically ill patients remain limited. Aim To evaluate the effect of probiotic supplementation on CD stool concentration in patients hospitalized in coma. Material and methods This prospective, randomized preliminary study was conducted from May to August 2023 at the Department of Medical Rehabilitation “Budzik dla Dorosłych”. Fourteen patients in coma were randomized to receive either a new probiotic mixture (Labifid®, containing Bifidobacterium animalis AMT30 and Bifidobacterium breve AMT32) or standard hospital probiotics (Lactobacillus rhamnosus, Saccharomyces boulardii). Stool samples were collected at baseline, 1, 2, and 4 months afterwards. Results and Discussion Baseline CD levels were comparable between groups (2.1 × 10⁵ vs. 2.2 × 10⁶ CFU/g; p = 0.607). At 1, 2, and 4 months, patients receiving the new probiotics demonstrated significantly lower CD concentrations than controls (p = 0.032, p = 0.017, and p = 0.029, respectively). After 4 months, CD levels in the new-probiotic group fell below the detection limit. No serious adverse events were observed. Conclusions Supplementation with Bifidobacterium animalis and Bifidobacterium breve was associated with a significant reduction in CD stool concentration in comatose patients. However, due to the small sample size, it should be interpreted with caution.