Table 3.

Observed adverse events associated with dietary intake of probiotics [127,128,129].

Probiotic Strain	Case Studies	Side Effects
L. rhamnosus GG	Pre-term infant with short gut syndrome	Lactobacillus bacteremia
	11-month-old infant with short gut syndrome
	17-year-old boy with ulcerative colitis
	24-year-old female cardiosurgical patient	Probiotic sepsis
	Critically ill children with antibiotic related diarrhea	Sepsis
	Children (up to 4 years)	Allergic rhinitis and more serious asthma
	Pregnant (4–6 weeks before expected delivery) and breastfeeding mothers (up to 2 years)	Wheezing bronchitis; atopic sensitization
L. rhamnosus	11-month-old female with trisomy 21 with respiratory viral infection	Probiotic associated pneumonia
	>65-year-old patient with hemorrhagic telangiectasia (HHT)	Endocarditis
	11-month-old female with trisomy 21 with respiratory viral infection	Probiotic associated pneumonia
Lactobacillus spp.	58-year-old immunocompetent with mechanical ventilation	Lactobacillus bacteremia and sepsis
		Unregulated ‘bile salt hydrolase (BSH)’ activity
B. longum	74-year-old man with polymetastatic prostatic adenocarcinoma	Bifidobacterium bacteremia
	Pre-term infants, Low birth-weight infants
B. breve	2-year-old boy with Philadelphia chromosome-positive acute B-cell lymphoblastic leukemia	Bifidobacterium sepsis
E. coli NISSLE strain 1917	Pre-term infants	Severe sepsis
Saccharomyces cerevisiae var. boulardii	48-year-old diabetic with multiple co-morbidities	Multiple organ failure and septic shock in association with toxic megacolon and probiotic fungemia
	Immunocompromised 73-year-old patient on chemotherapy	Fungemia
	8-year-old boy with respiratory distress (Intensive care unit patient)
	Critically ill patients
	Premature neonate receiving nutrition enterally	Fungal septicemia
L. plantarum	30-year-old male with rheumatic valve disease	Endocarditis
L. jensenii	47-year-old immunocompetent patient
L. acidophilus	48-year-old male with heart disease and dental manipulations
L. casei	60-year-old with renal transplant patient	Intra-abdominal abscess
	53-year-old immunocompetent patient	Endocarditis
L. paracasei	65-year-old diabetic patient	Bacteremia and liver abscess
	77-year-old male patient with prostate cancer	Endocarditis
L. acidophilus LAVRI-A1	Infants (6 and 12 months)	Atopic sensitization
L. acidophilus, L. casei, L. salivarius, L. lactis, B. bifidum, and B. lactis	Critically ill patients (acute pancreatitis)	Increased local oxygen demand
L. lactis		Biogenic amine production
Pediococcus and Leuconostoc sp.		Vancomycin resistance → Staphylococcus aureus
Lactobacillus spp.		Broad spectrum antibiotic resistance (vancomycin, streptomycin, gentamicin, aztreonam, and ciprofloxacin) → Staphylococcus sp.