In 2014, I did my My favorite probiotic: E.Coli Nissle 1917 (Mutaflor) and today, I discovered there have been a lot more studies done on since this post. Is it still my favorite?
Please note: I said FAVORITE (for me) and I am not claiming BEST.
Let us see what the new research says:
- The probiotic strain Escherichia coli Nissle 1917 prevents papain-induced respiratory barrier injury and severe allergic inflammation in mice.2018
- Escherichia coli Nissle 1917 restores epithelial permeability alterations induced by irritable bowel syndrome mediators. 
- The Probiotic Escherichia coli Strain Nissle 1917 Combats Lambdoid Bacteriophages stx and λ. 
- The Administration of Escherichia coli Nissle 1917 Ameliorates Development of DSS-Induced Colitis in Mice. 
- Prophylaxis of acute respiratory infections via improving the immune system in late preterm newborns with E. coli strain Nissle 1917: a controlled pilot trial. 
- “The present pilot trial provides first evidence that EcN is able to reduce the incidence of ARIs in the neonatal period of late preterm newborns. Additionally, EcN is characterized by an excellent individual biocompatibility in the absence of adverse drug reactions. “
- Probiotic Escherichia coli inhibits biofilm formation of pathogenic E. coli via extracellular activity of DegP. 
- dentification of an analgesic lipopeptide produced by the probiotic Escherichia coli strain Nissle1917. 
- “Administration of the probiotic Escherichia coli strain Nissle 1917 (EcN) decreases visceral pain associated with irritable bowel syndrome. “
- Oral Administration of the Probiotic Strain Escherichia coli Nissle 1917 Reduces Susceptibility to Neuroinflammation and Repairs Experimental Autoimmune Encephalomyelitis-Induced Intestinal Barrier Dysfunction. 
- In Vitro Evaluation of the Impact of the Probiotic E. coli Nissle 1917 on Campylobacter jejuni‘s Invasion and Intracellular Survival in Human Colonic Cells. 
- “We conclude that EcN might be a viable alternative for controlling C. jejuni infections.”
- Intestinal Anti-inflammatory Effects of Outer Membrane Vesicles from Escherichia coli Nissle 1917in DSS-Experimental Colitis in Mice. 
- Effects of Supernatants from Escherichia coli Nissle 1917 and Faecalibacterium prausnitzii on Intestinal Epithelial Cells and a Rat Model of 5-Fluorouracil-Induced Mucositis. 
- “Factors derived from Fp SN and EcN SN could have a role in reducing the severity of intestinal mucositis.”
- Escherichia coli Nissle 1917 protects gnotobiotic pigs against human rotavirus by modulating pDC and NK-cell responses.
- Synergic Interaction of Rifaximin and Mutaflor (Escherichia coli Nissle 1917) in the Treatment of Acetic Acid-Induced Colitis in Rats. 
- Use of Escherichia coli Nissle 1917 producing recombinant colicins for treatment of IBD patients. 
- Role and mechanisms of action of Escherichia coli Nissle 1917 in the maintenance of remission in ulcerative colitis patients: An update. 
- Intestinal-borne dermatoses significantly improved by oral application of Escherichia coli Nissle1917. 
- Amelioration of cadmium- and mercury-induced liver and kidney damage in rats by genetically engineered probiotic Escherichia coli Nissle 1917 producing pyrroloquinoline quinone with oral supplementation of citric acid. 
- Escherichia coli strain Nissle 1917 ameliorates experimental colitis by modulating intestinal permeability, the inflammatory response and clinical signs in a faecal transplantation model. 
- Escherichia coli Nissle 1917 in Ulcerative Colitis Treatment: Systematic Review and Meta-analysis.  “EcN is equivalent to mesalazine in preventing disease relapse, “
- Escherichia coli Nissle 1917 enhances bioavailability of serotonin in gut tissues through modulation of synthesis and clearance. 
- Efficacy of Probiotic Escherichia coli Nissle 1917 in Patients with Irritable Bowel Syndrome: a Double Blind Placebo-controlled Randomized Trial. 
- “probiotic therapy with E.coli Nissle 1917 was not able to induce significant improvement in the symptoms of patients with non-categorized IBS. Nevertheless, when IBS patients were recategorized to subgroups according to their main symptoms, evaluation of the efficacy of the probiotic on some individual items in the symptom list reached the significance level. “
- Pyrroloquinoline quinone (PQQ) producing Escherichia coli Nissle 1917 (EcN) alleviates age associated oxidative stress and hyperlipidemia, and improves mitochondrial function in ageing rats. 
- Probiotic Escherichia coli Nissle 1917 reduces growth, Shiga toxin expression, release and thus cytotoxicity of enterohemorrhagic Escherichia coli. 
- Preventive effects of Escherichia coli strain Nissle 1917 with different courses and different doses on intestinal inflammation in murine model of colitis. 
Answer is YES — please try finding any other specific strain of any probiotic (except Lactobacillus rhamnosus GG which has been studied more) that has been as well studied with so many significant impacts!
Others appear to agree:
For an excellent history of Mutaflor /E. Coli Nissle 1917, see Insights from 100 Years of Research with Probiotic E. Coli.  and Escherichia coli strain Nissle 1917-from bench to bedside and back: history of a special Escherichia coli strain with probiotic properties.
- I’m in the US, so I am forced to use the Canadian Supplier, (thanks to the FDA — because it is effective, they treat it as an experimental drug and thus highly restricted)
- It is available across Europe and also in Australia
Action Item for US Residents
The reason that it is not available in the US is the FDA and NOT the company. It was sold in the US for a while(2010-12) until the FDA forced it’s removal.
“Section 301(11) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 331(11)) prohibits the introduction or delivery for introduction into interstate commerce of any food (including a dietary supplement) that contains a drug approved under 21 U.S.C. 355, a biological product licensed under 42 U.S.C. 262, or a drug or a biological product for which substantial clinical investigations have been instituted and their existence made public, ”
Write your congressman and senator, asking them to demand the FDA to grant a waiver for Mutaflor to be sold in the US — just like it is in Australia, Canada and most of Europe. It has been in use for over 100 years. You may wish to copy and paste the PubMed articles above and in the prior post into your email or letter.