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Background  Little is studied about complications related to probiotic ingestion. This study proposes to present a synthesis and critical evaluation of the reports and series of cases on the infectious complications related to the ingestion of probiotics, which can raise awareness for the prescribing and use of probiotics for certain groups of patients.    Methods  Systematic review of reports and series of cases researched in the PubMed, SciELO and Scopus databases published until August 2018. The references of the articles were investigated manually for the search of cross references. SPSS version 23.0 was used for descriptive statistics and univariate analysis.    Results  We found 60 case reports and 7 case series, making up a total of 93 patients. Fungemia was the most common infectious complications with 35 (37.6%) cases. The genus  Saccharomyces  was the most frequent with 47 (50.6%) cases, followed by  Lactobacillus ,  Bifidobacterium ,  Bacillus ,  Pedioccocus  and  Escherichia  with 26 (27.9%), 12 (12.8%), 5 (5.4%), 2 (2.2%) and 1 (1.1%) case, respectively. Adults over 60 years of age,  Clostridium difficile  colitis, antibiotic use and  Saccharomyces  infections were associated with overall mortality. HIV infections, immunosuppressive drugs, solid organ transplantation, deep intravenous lines, enteral or parenteral nutrition were not associated with death.    Conclusion  The use of probiotics cannot be considered risk-free and should be carefully evaluated for some patient groups.    Trial registration    CRD42016042289Electronic supplementary material  The online version of this article (10.1186/s12906-018-2394-3) contains supplementary material, which is available to authorized users.

Infectious complications following probiotic ingestion: a potentially underestimated problem? A systematic review of reports and case series