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Background  Infection by  Staphylococcus aureus (S. aureus)  is a major cause of morbidity and mortality. Colonization by  S. aureus  increases the risk of infection. Little is known about decolonization strategies for  S. aureus  beyond antibiotics, however probiotics represent a promising alternative. A randomized controlled trial was conducted to determine the efficacy of  Lactobacillus rhamnosus  ( L. rhamnosus ) HN001 in reducing carriage of  S. aureus  at multiple body sites.    Methods  One hundred thirteen subjects, positive for  S. aureus  carriage, were recruited from the William S. Middleton Memorial Medical Center, Madison, WI, USA, and randomized by initial site of colonization, either gastrointestinal (GI) or extra-GI, to 4-weeks of oral  L. rhamnosus  HN001 probiotic, or placebo. Nasal, oropharyngeal, and axillary/groin swabs were obtained, and serial blood and fecal samples were collected. Differences in prevalence of  S. aureus  carriage at the end of the 4-weeks of treatment were assessed.    Results  The probiotic and placebo groups were similar in age, gender, and health history at baseline.  S. aureus  colonization within the stool samples of the extra-GI group was 15% lower in the probiotic than placebo group at the endpoint of the trial. Those in the probiotic group compared to the placebo group had 73% reduced odds (OR 0.27, 95% CI 0.07–0.98) of methicillin-susceptible  S. aureus  presence, and 83% reduced odds (OR 0.17, 95% CI 0.04–0.73) of any  S. aureus  presence in the stool sample at endpoint.    Conclusion  Use of daily oral  L. rhamnosus  HN001 reduced odds of carriage of  S. aureus  in the GI tract, however it did not eradicate  S. aureus  from other body sites.    Trial registration  ClinicalTrials.gov Identifier:  NCT01321606 . Registered March 21, 2011.    Electronic supplementary material  The online version of this article (10.1186/s12879-018-3028-6) contains supplementary material, which is available to authorized users.

bmc infectious diseases

Effect of Lactobacillus rhamnosus HN001 on carriage of Staphylococcus aureus: results of the impact of probiotics for reducing infections in veterans (IMPROVE) study