In 2024 the National Institute of Communicable Diseases investigated an outbreak of bacteraemia due to a spore-forming non-pathogenic bacillus with known probiotic properties – Alkalihalobacillus clausii. The outbreak involved 11 patients across 8 hospitals in Gauteng and North West province over a 10-month period.

A. clausii is commonly included in probiotic formulations and is generally regarded as safe. Whole genome sequencing from patient clinical isolates and probiotic sachets were almost identical, confirming the likely source of the outbreak.  This incident highlights the necessity for quality control of probiotics which are currently regarded as dietary supplements as well as exercising due caution in the use of these products in hospitalized, vulnerable patients until clear clinical guidelines are available.

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