In NOTE: There is an alternative E.Coli probiotic available, Symbioflor-2, less studied but in terms of demonstrated and reported traits desired for CFS, superior.

I thought it was time to revisit what is on PubMed for Mutaflor (the probiotic E.Coli Nissle 1917). There are 213 studies at the moment.

• “Probiotics as E. coli Nissle could be used as alternative to mesalazine for maintenance of remission in patients with ulcerative colitis. “[2014]
• “ The probiotic E. coli strain Nissle 1917 (EcN) is known to be effective in the treatment of several gastro-intestinal disorders. While both in vitro and in vivo studies have described strong inhibitory effects of EcN on enteropathogenic bacteria including pathogenic E. coli, the underlying molecular mechanisms remain largely unknown.” [2014]
• “Our results indicate that EcN can inhibit many of the pathological effects of C. perfringens in vitro conditions.”[2014]
• “Its beneficial effects in the treatment of UC have been demonstrated in several controlled clinical studies” [2014]
• “The data can be explained according to our “restaurant” hypothesis for commensal E. coli strains, i.e., that they colonize the intestine as sessile members of mixed biofilms, obtaining the sugars they need for growth locally, but compete for sugars with invading E. coli pathogens planktonically.“[2014]
• “Our results show that coseasonal treatment with EcN in grass pollen-allergic subjects was not superior to placebo” [2014] – i.e. does not cure allergies – no big deal
• “By administering Escherichia coli strain Nissle 1917, which assimilates iron by similar mechanisms, we show that this nonpathogenic bacterium can outcompete and reduce S. Typhimurium colonization“[2013]
• “Intestinal bacteria compete for the essential nutrient iron, leading to replacement of pathogenic Salmonella by the probiotic Escherichia coli Nissle, which is better equipped with iron acquisition systems, and resolution of infectious colitis.” [2013]
• “The combination of Lactobacillus, Bifidobacterium, Saccharomyces boulardi and the treatment with Escherichia coli Nissle were found beneficial in inducing and maintaining remission of disease activity of gut inflammation and moderately severe ulcerative colitis.” [2014]
• EcN “ consumed on average 65% glucoiberin and 78% glucoraphanin, transforming them into glucoiberverin and glucoerucin, respectively, and small amounts of iberverin nitrile and erucin nitrile. The lactic acid bacteria did not accumulate reduced glucosinolates, consuming all at 30-33% and transforming these into iberverin nitrile, erucin nitrile, sulforaphane nitrile, and further unidentified metabolites. ” [2013]
• “Probiotic EcN shows effects in irritable bowel syndrome, especially in patients with altered enteric microflora, e.g. after gastroenterocolitis or administration of antibiotics.”[2012]
• “In conclusion, EcN supplementation to minocycline treatment improves the recovery of the intestinal damage and prevents the reactivation of experimental colitis.” [2011]
• “In the mouse model E. coli Nissle can not be used alone to eradicate IBD associated E. coli; rather, 3 days of ciprofloxacin are apparently efficient in eradicating these strains, but surprisingly, after ciprofloxacin treatment (3 or 7 days), the introduction of E. coli Nissle may support re-colonization with IBD associated E. coli.” [2011] – interesting but some distinct study issue.
• “ oral administration of EcN might be an effective strategy in prevention and potentially therapy of allergic inflammatory skin diseases.” [2011]

Do NOT take with C. butyricum MIYAIRISAN Probiotics

“1.1 C. butyricum MIYAIRI antagonistic effects on toxinogenic Escherichia coli and 20 E. coli strains isolated from live stocks (cows, pigs and chickens) were evaluated by the plating method. C. butyricum MIYAIRI inhibited the growth of all E. coli strains tested” [Source]

Concerning Mutaflor, a reader wrote:

Here is one places to get Mutaflor in the US:

No longer available…Uriel Pharmacy in Wisconsin, if ordering as a prescription item. 100 mg. tablets are $2.95 ea. and 20 mg. tablets are $2.15 each (at March 2014). The 100 mg. tablets can be cut if one wants to start at a smaller dose. The pharmacy number is 866 642 2858.

http://urielpharmacy.com/index.php

Feel Good Natural Health Store in Canada
You MUST pay for the Express shipping if you live outside Canada, which is about $23. Even though the sales page says “Canada Only”, when you get to the shopping cart, you can select any state in the U.S. I ordered from here and received my order in a couple of days.

Home page:

In Italy it is also being manufactured.

20 Euros for 20 capsules.

http://cadigroup-shop.eu/shop2/colite-ulcerosa/ecn-p-27.html