What is this article about?
Although probiotics are often considered safe, this outbreak highlights that they can cause serious infections in hospitalised and vulnerable patients, especially those with weakened immune systems or underlying conditions. Understanding such risks is critical for clinicians and the public to make informed decisions about probiotic use.

Why does this matter?
Although probiotics are often considered safe, this outbreak highlights that they can cause serious infections in hospitalised and vulnerable patients, especially those with weakened immune systems or underlying conditions. Understanding such risks is critical for clinicians and the public to make informed decisions about probiotic use.

What drew your interest in this area of research?
As a South African Field Epidemiology Training Programme (SAFETP) resident at the Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, I am directly involved in outbreak investigations. I was part of the response team when the unusual increase in A. clausii bacteraemia cases was reported. The novelty of a probiotic-associated outbreak and its clinical implications motivated me to pursue this work.

What was your role in the article?
I participated in the outbreak investigation, which included data analysis and reviewing clinical and laboratory records. I also contributed to drafting and finalising the manuscript to ensure that the lessons from this outbreak could be shared with both the scientific community and healthcare practitioners.

Why should people read this article?
This article provides valuable insights into the hidden risks of probiotic use in hospital settings, particularly for vulnerable patients. Readers will gain a better understanding of the balance between potential benefits and risks of probiotics.

What impact do you hope this article will have on public health policy and access to healthcare?
I hope the article will strengthen awareness among clinicians to prescribe probiotics cautiously, especially for high-risk patients. On a policy level, it should support stricter regulation of probiotic manufacturing and quality control, as well as clear clinical guidelines for their safe use. By highlighting these risks, the study can help prevent similar outbreaks, protect vulnerable patients, and improve infection prevention and control practices in healthcare facilities, while allowing safe access to probiotics where appropriate.

Dr Noluxabiso Mangwana is a SAFETP resident at the Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases.

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