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Saturio S, Rey A, Samarra A, Collado MC, Suárez M, Mantecón L, Solís G, Gueimonde M, Arboleya S. Old Folks, Bad Boon: Antimicrobial Resistance in the Infant Gut Microbiome. Microorganisms 2023; 11:1907. [PMID: 37630467 PMCID: PMC10458625 DOI: 10.3390/microorganisms11081907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
The development of the intestinal microbiome in the neonate starts, mainly, at birth, when the infant receives its founding microbial inoculum from the mother. This microbiome contains genes conferring resistance to antibiotics since these are found in some of the microorganisms present in the intestine. Similarly to microbiota composition, the possession of antibiotic resistance genes is affected by different perinatal factors. Moreover, antibiotics are the most used drugs in early life, and the use of antibiotics in pediatrics covers a wide variety of possibilities and treatment options. The disruption in the early microbiota caused by antibiotics may be of great relevance, not just because it may limit colonization by beneficial microorganisms and increase that of potential pathogens, but also because it may increase the levels of antibiotic resistance genes. The increase in antibiotic-resistant microorganisms is one of the major public health threats that humanity has to face and, therefore, understanding the factors that determine the development of the resistome in early life is of relevance. Recent advancements in sequencing technologies have enabled the study of the microbiota and the resistome at unprecedent levels. These aspects are discussed in this review as well as some potential interventions aimed at reducing the possession of resistance genes.
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Affiliation(s)
- Silvia Saturio
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain; (S.S.); (A.R.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.); (L.M.); (G.S.)
| | - Alejandra Rey
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain; (S.S.); (A.R.)
| | - Anna Samarra
- Institute of Agrochemistry and Food Technology (IATA-CSIC), 46980 Paterna, Spain; (A.S.); (M.C.C.)
| | - Maria Carmen Collado
- Institute of Agrochemistry and Food Technology (IATA-CSIC), 46980 Paterna, Spain; (A.S.); (M.C.C.)
| | - Marta Suárez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.); (L.M.); (G.S.)
- Pediatrics Service, Central University Hospital of Asturias (HUCA-SESPA), 33011 Oviedo, Spain
| | - Laura Mantecón
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.); (L.M.); (G.S.)
- Pediatrics Service, Central University Hospital of Asturias (HUCA-SESPA), 33011 Oviedo, Spain
| | - Gonzalo Solís
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.); (L.M.); (G.S.)
- Pediatrics Service, Central University Hospital of Asturias (HUCA-SESPA), 33011 Oviedo, Spain
| | - Miguel Gueimonde
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain; (S.S.); (A.R.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.); (L.M.); (G.S.)
| | - Silvia Arboleya
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain; (S.S.); (A.R.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (M.S.); (L.M.); (G.S.)
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Sun Q, Shi Y, Wang F, Han D, Lei H, Zhao Y, Sun Q. Study on the effects of microencapsulated Lactobacillus delbrueckii on the mouse intestinal flora. J Microencapsul 2015; 32:669-76. [PMID: 26471401 DOI: 10.3109/02652048.2015.1057249] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To evaluate the protective effects of microencapsulation on Lactobacillus delbrueckii by random, parallel experimental design. MATERIALS AND METHODS Lincomycin hydrochloride-induced intestinal malfunction mouse model was successfully established; then the L. delbrueckii microcapsule was given to the mouse. The clinical behaviour, number of intestinal flora, mucous IgA content in small intestine, IgG and IL-2 level in peripheral blood were monitored. The histological sections were also prepared. RESULTS The L. delbrueckii microcapsule could have more probiotic effects as indicated by higher bifidobacterium number in cecal contents. The sIgA content in microcapsule treated group was significantly higher than that in non-encapsulated L. delbrueckii treated group (p < 0.05). Intestine pathological damage of the L. delbrueckii microcapsule-treated group showed obvious restoration. CONCLUSION The L. delbrueckii microcapsules could relieve the intestinal tissue pathological damage and play an important role in curing antibiotic-induced intestinal flora dysfunction.
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Affiliation(s)
- Qingshen Sun
- a College of Life Science, University Key Laboratory of Microbiology, Heilongjiang University , Harbin , China and.,b Engineering Research Center of Agricultural Microbiology Technology, Ministry of Education , Harbin , China
| | - Yue Shi
- a College of Life Science, University Key Laboratory of Microbiology, Heilongjiang University , Harbin , China and
| | - Fuying Wang
- a College of Life Science, University Key Laboratory of Microbiology, Heilongjiang University , Harbin , China and
| | - Dequan Han
- a College of Life Science, University Key Laboratory of Microbiology, Heilongjiang University , Harbin , China and.,b Engineering Research Center of Agricultural Microbiology Technology, Ministry of Education , Harbin , China
| | - Hong Lei
- a College of Life Science, University Key Laboratory of Microbiology, Heilongjiang University , Harbin , China and
| | - Yao Zhao
- a College of Life Science, University Key Laboratory of Microbiology, Heilongjiang University , Harbin , China and.,b Engineering Research Center of Agricultural Microbiology Technology, Ministry of Education , Harbin , China
| | - Quan Sun
- a College of Life Science, University Key Laboratory of Microbiology, Heilongjiang University , Harbin , China and
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Van Saene JJM, Van Saene HKF, Stoutenbeek CP, Lerk CF. Influence of Faeces on the Activity of Antimicrobial Agents used for Decontamination of the Alimentary Canal. ACTA ACUST UNITED AC 2015. [DOI: 10.3109/inf.1985.17.issue-3.09] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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High-throughput sequencing reveals the incomplete, short-term recovery of infant gut microbiota following parenteral antibiotic treatment with ampicillin and gentamicin. Antimicrob Agents Chemother 2012; 56:5811-20. [PMID: 22948872 DOI: 10.1128/aac.00789-12] [Citation(s) in RCA: 334] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The infant gut microbiota undergoes dramatic changes during the first 2 years of life. The acquisition and development of this population can be influenced by numerous factors, and antibiotic treatment has been suggested as one of the most significant. Despite this, however, there have been relatively few studies which have investigated the short-term recovery of the infant gut microbiota following antibiotic treatment. The aim of this study was to use high-throughput sequencing (employing both 16S rRNA and rpoB-specific primers) and quantitative PCR to compare the gut microbiota of nine infants who underwent parenteral antibiotic treatment with ampicillin and gentamicin (within 48 h of birth), 4 and 8 weeks after the conclusion of treatment, relative to that of nine matched healthy controls. The investigation revealed that the gut microbiota of the antibiotic-treated infants had significantly higher proportions of Proteobacteria (P = 0.0049) and significantly lower proportions of Actinobacteria (P = 0.00001) (and the associated genus Bifidobacterium [P = 0.0132]) as well as the genus Lactobacillus (P = 0.0182) than the untreated controls 4 weeks after the cessation of treatment. By week 8, the Proteobacteria levels remained significantly higher in the treated infants (P = 0.0049), but the Actinobacteria, Bifidobacterium, and Lactobacillus levels had recovered and were similar to those in the control samples. Despite this recovery of total Bifidobacterium numbers, rpoB-targeted pyrosequencing revealed that the number of different Bifidobacterium species present in the antibiotic-treated infants was reduced. It is thus apparent that the combined use of ampicillin and gentamicin in early life can have significant effects on the evolution of the infant gut microbiota, the long-term health implications of which remain unknown.
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Abstract
This article will focus on the role of the colon in the pathogenesis of diarrhea in carbohydrate malabsorption or physiologically incomplete absorption of carbohydrates, and on the most common manifestation of carbohydrate malabsorption, lactose malabsorption. In addition, incomplete fructose absorption, the role of carbohydrate malabsorption in other malabsorptive diseases, and congenital defects that lead to malabsorption will be covered. The article concludes with a section on diagnostic tools to evaluate carbohydrate malabsorption.
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Affiliation(s)
- Heinz F Hammer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Austria.
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Lambert SE, Kinder JM, Then JE, Parliament KN, Bruns HA. Erythromycin treatment hinders the induction of oral tolerance to fed ovalbumin. Front Immunol 2012; 3:203. [PMID: 22826710 PMCID: PMC3399375 DOI: 10.3389/fimmu.2012.00203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 06/28/2012] [Indexed: 11/30/2022] Open
Abstract
The mucosal immune system is constantly exposed to antigen, whether it be food antigen, commensal bacteria, or harmful antigen. It is essential that the mucosal immune system can distinguish between harmful and non-harmful antigens, and initiate an active immune response to clear the harmful antigens, while initiating a suppressive immune response (tolerance) to non-harmful antigens. Oral tolerance is an immunologic hyporesponsiveness to an orally administered antigen and is important in preventing unnecessary gastrointestinal tract inflammation, which can result in a number of autoimmune and hypersensitivity diseases. Probiotics (beneficial intestinal bacteria), T regulatory cells, and dendritic cells (DCs) are all essential for generating tolerance. Antibiotics are commonly prescribed to fight infections and often necessary for maintaining health, but they can disrupt the normal intestinal probiotic populations. There is increasing epidemiologic evidence that suggests that antibiotic usage correlates with the development of atopic or irritable bowel disorders, which often result due to a breakdown in immune tolerance. This study investigated the effect of the antibiotic erythromycin on oral tolerance induction to ovalbumin. The results demonstrated that antibiotic treatment prior to exposure to fed antigen prevents tolerance to that antigen, which may be associated with a reduction in intestinal Lactobacillus populations. Furthermore, antibiotic treatment resulted in a significant decrease in the tolerogenic CD11c+/CD11b+/CD8α- mesenteric lymph node DCs independent of tolerizing treatment. These results provide evidence that antibiotic treatment, potentially through its effects on tolerogenic DCs and intestinal microflora, may contribute to autoimmune and atopic disorders via a breakdown in tolerance and support prior epidemiologic studies correlating increased antibiotic usage with the development of these disorders.
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Fouhy F, Ross RP, Fitzgerald GF, Stanton C, Cotter PD. Composition of the early intestinal microbiota: knowledge, knowledge gaps and the use of high-throughput sequencing to address these gaps. Gut Microbes 2012; 3:203-20. [PMID: 22572829 PMCID: PMC3427213 DOI: 10.4161/gmic.20169] [Citation(s) in RCA: 148] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The colonization, development and maturation of the newborn gastrointestinal tract that begins immediately at birth and continues for two years, is modulated by numerous factors including mode of delivery, feeding regime, maternal diet/weight, probiotic and prebiotic use and antibiotic exposure pre-, peri- and post-natally. While in the past, culture-based approaches were used to assess the impact of these factors on the gut microbiota, these have now largely been replaced by culture-independent DNA-based approaches and most recently, high-throughput sequencing-based forms thereof. The aim of this review is to summarize recent research into the modulatory factors that impact on the acquisition and development of the infant gut microbiota, to outline the knowledge recently gained through the use of culture-independent techniques and, in particular, highlight advances in high-throughput sequencing and how these technologies have, and will continue to, fill gaps in our knowledge with respect to the human intestinal microbiota.
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Affiliation(s)
- Fiona Fouhy
- Teagasc Food Research Centre; Moorepark; Fermoy, Cork Ireland,Microbiology Department; University College Cork; Cork, Ireland
| | - R. Paul Ross
- Teagasc Food Research Centre; Moorepark; Fermoy, Cork Ireland,Alimentary Pharmabiotic Centre; Cork, Ireland
| | - Gerald F. Fitzgerald
- Microbiology Department; University College Cork; Cork, Ireland,Alimentary Pharmabiotic Centre; Cork, Ireland
| | - Catherine Stanton
- Teagasc Food Research Centre; Moorepark; Fermoy, Cork Ireland,Alimentary Pharmabiotic Centre; Cork, Ireland,Correspondence to: Catherine Stanton, and Paul D. Cotter,
| | - Paul D. Cotter
- Teagasc Food Research Centre; Moorepark; Fermoy, Cork Ireland,Alimentary Pharmabiotic Centre; Cork, Ireland,Correspondence to: Catherine Stanton, and Paul D. Cotter,
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Swann JR, Tuohy KM, Lindfors P, Brown DT, Gibson GR, Wilson ID, Sidaway J, Nicholson JK, Holmes E. Variation in antibiotic-induced microbial recolonization impacts on the host metabolic phenotypes of rats. J Proteome Res 2011; 10:3590-603. [PMID: 21591676 DOI: 10.1021/pr200243t] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The interaction between the gut microbiota and their mammalian host is known to have far-reaching consequences with respect to metabolism and health. We investigated the effects of eight days of oral antibiotic exposure (penicillin and streptomycin sulfate) on gut microbial composition and host metabolic phenotype in male Han-Wistar rats (n = 6) compared to matched controls. Early recolonization was assessed in a third group exposed to antibiotics for four days followed by four days recovery (n = 6). Fluorescence in situ hybridization analysis of the intestinal contents collected at eight days showed a significant reduction in all bacterial groups measured (control, 10(10.7) cells/g feces; antibiotic-treated, 10(8.4)). Bacterial suppression reduced the excretion of mammalian-microbial urinary cometabolites including hippurate, phenylpropionic acid, phenylacetylglycine and indoxyl-sulfate whereas taurine, glycine, citrate, 2-oxoglutarate, and fumarate excretion was elevated. While total bacterial counts remained notably lower in the recolonized animals (10(9.1) cells/g faeces) compared to the controls, two cage-dependent subgroups emerged with Lactobacillus/Enterococcus probe counts dominant in one subgroup. This dichotomous profile manifested in the metabolic phenotypes with subgroup differences in tricarboxylic acid cycle metabolites and indoxyl-sulfate excretion. Fecal short chain fatty acids were diminished in all treated animals. Antibiotic treatment induced a profound effect on the microbiome structure, which was reflected in the metabotype. Moreover, the recolonization process was sensitive to the microenvironment, which may impact on understanding downstream consequences of antibiotic consumption in human populations.
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Affiliation(s)
- Jonathan R Swann
- Biomolecular Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, South Kensington, London SW7 2AZ, United Kingdom.
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Health benefits of probiotics: are mixtures more effective than single strains? Eur J Nutr 2011; 50:1-17. [PMID: 21229254 DOI: 10.1007/s00394-010-0166-z] [Citation(s) in RCA: 280] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Accepted: 12/28/2010] [Indexed: 12/15/2022]
Abstract
PURPOSE Most studies on probiotics utilise single strains, sometimes incorporated into yoghurts. There are fewer studies on efficacy of mixtures of probiotic strains. This review examines the evidence that (a) probiotic mixtures are beneficial for a range of health-related outcomes and (b) mixtures are more or less effective than their component strains administered separately. RESULTS Mixtures of probiotics had beneficial effects on the end points including irritable bowel syndrome and gut function, diarrhoea, atopic disease, immune function and respiratory tract infections, gut microbiota modulation, inflammatory bowel disease and treatment of Helicobacter pylori infection. However, only 16 studies compared the effect of a mixture with that of its component strains separately, although in 12 cases (75%), the mixture was more effective. CONCLUSION Probiotic mixtures appear to be effective against a wide range of end points. Based on a limited number of studies, multi-strain probiotics appear to show greater efficacy than single strains, including strains that are components of the mixtures themselves. However, whether this is due to synergistic interactions between strains or a consequence of the higher probiotic dose used in some studies is at present unclear.
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Khoder M, Tsapis N, Fattal E. Mechanisms of antibiotic resistance and delivery strategies to prevent its emergence. J Drug Deliv Sci Technol 2010. [DOI: 10.1016/s1773-2247(10)50072-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Plummer SF, Garaiova I, Sarvotham T, Cottrell SL, Le Scouiller S, Weaver MA, Tang J, Dee P, Hunter J. Effects of probiotics on the composition of the intestinal microbiota following antibiotic therapy. Int J Antimicrob Agents 2005; 26:69-74. [PMID: 15967639 DOI: 10.1016/j.ijantimicag.2005.04.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2005] [Accepted: 04/06/2005] [Indexed: 01/10/2023]
Abstract
The effects of probiotic supplementation on the intestinal re-growth microbiota following antibiotic therapy were studied in a double-blind placebo-controlled study. In the placebo group, numbers of facultative anaerobes and enterobacteria increased significantly, and at day 35 the numbers were significantly higher in the placebo group than in the active group; in the active group, the numbers of bacteroides increased significantly. Although the numbers of enterococci in both groups did not change, in the placebo group the number of patients harbouring antibiotic-resistant enterococci post therapy increased significantly. There was no change in the incidence rate of antibiotic resistance among the patients in the probiotic group.
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Affiliation(s)
- Susan F Plummer
- Cultech Biospeciality Products, Research Department, York Chambers, York Street, Swansea SA1 3NJ, UK.
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Madden JAJ, Plummer SF, Tang J, Garaiova I, Plummer NT, Herbison M, Hunter JO, Shimada T, Cheng L, Shirakawa T. Effect of probiotics on preventing disruption of the intestinal microflora following antibiotic therapy: A double-blind, placebo-controlled pilot study. Int Immunopharmacol 2005; 5:1091-7. [PMID: 15829425 DOI: 10.1016/j.intimp.2005.02.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2004] [Revised: 11/29/2004] [Accepted: 02/09/2005] [Indexed: 12/23/2022]
Abstract
In this pilot-scale, double-blind, placebo-controlled trial, 30 patients with Helicobacter pylori infection were randomised into three groups prior to their 7 days eradication therapy, to study the effects of probiotic supplement comprising Lactobacillus acidophilus and Bifidobacterium bifidum on the intestinal microflora in response to antibiotic therapy. Group I received the placebo product from day 1 to day 15, Group II received placebo from day 1 to day 7 and probiotics from day 8 to day 15 and Group III received probiotics from day 1 to day 15. Patients provided stool samples for analysis on days 1, 7, 12, 17 and 27. For patients in Groups I and II, significant increases in the facultative anaerobe component of the microflora occurred between days 1 and 7. In Group I, the numbers remained elevated to day 27 but in Group II, the numbers decreased significantly between days 7 and 27 back to the starting levels. In Group III, the facultative anaerobe population remained stable throughout. The total anaerobe numbers increased significantly at day 27 than at day 1 for Group I, were unchanged throughout for Group II and decreased significantly for the patients in Group III between days 1 and 7 before reverting to the starting levels by day 27. From these results, it can be seen that probiotic supplementation modulates the response of the intestinal microflora to the effects of antibiotic therapy.
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Affiliation(s)
- Jennifer A J Madden
- Research and Development Division, Cultech Limited, York Chambers, York Street, Swansea, SA1 3NJ, UK
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JUNTUNEN M, KIRJAVAINEN PV, OUWEHAND AC, SALMINEN SJ, ISOLAURI E. Gut Microflora Changes and Probiotics in Children in Day-Care Centers. Biosci Microflora 2003. [DOI: 10.12938/bifidus1996.22.99] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Cremonini F, Di Caro S, Santarelli L, Gabrielli M, Candelli M, Nista EC, Lupascu A, Gasbarrini G, Gasbarrini A. Probiotics in antibiotic-associated diarrhoea. Dig Liver Dis 2002; 34 Suppl 2:S78-80. [PMID: 12408447 DOI: 10.1016/s1590-8658(02)80171-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Antibiotic-associated diarrhoea is a common event. In some cases, it could represent a life-threatening event. Clostridium difficile colitis is a further distinct complication of antibiotic administration. Treatment options for antibiotic-associated diarrhoea and Clostridium difficile colitis include supplementation with several types of probiotics, as overviewed in this paper. Three randomised, double-blind, controlled clinical trials show a therapeutic effect of Saccharomyces boulardii in antibiotic-associated diarrhoea. The efficacy of Lactobacillus acidophilus and bulgaricus has also been ascertained in two double-blind controlled studies. Other studies focusing on Lactobacillus as a new preventive agent for antibiotic-associated diarrhoea are not double-blind. Among these, a positive effect of Lactobacillus rhamnosus GG, Bifidobacterium longum and Enterococcus faecium SF68 has been reported. Effectiveness of probiotics in antibiotic-associated diarrhoea has, therefore, a consistent scientific rationale, however few studies have performed an assessment of bacterial recovery in stools, and this approach may be helpful in deciding a more rigorous dose standardisation.
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Affiliation(s)
- F Cremonini
- Internal Medicine, Catholic University Sacro Cuore, Rome, Italy
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Cremonini F, Di Caro S, Nista EC, Bartolozzi F, Capelli G, Gasbarrini G, Gasbarrini A. Meta-analysis: the effect of probiotic administration on antibiotic-associated diarrhoea. Aliment Pharmacol Ther 2002; 16:1461-7. [PMID: 12182746 DOI: 10.1046/j.1365-2036.2002.01318.x] [Citation(s) in RCA: 190] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Antibiotic-associated diarrhoea can be attributed in part to imbalances in intestinal microflora. Therefore, probiotic preparations are used to prevent this diarrhoea. However, although several trials have been conducted, no conclusive evidence has been found of the efficacy of different preparations, e.g. Lactobacillus spp. and Saccharomyces spp. AIM To conduct a meta-analysis of the data in the literature on the efficacy of probiotics in the prevention of antibiotic-associated diarrhoea. METHODS A literature search was performed of electronic databases, Abstract Books and single paper references. Data were also obtained from the authors. Only placebo-controlled studies were included in the search. The Mantel-Haenszel test was used to estimate the relative risk for single studies and an overall combined relative risk, each study being submitted to the Mantel-Haenszel test for homogeneity. RESULTS Twenty-two studies matched the inclusion criteria. Only seven studies (881 patients) were homogeneous. The combined relative risk was 0.3966 (95% confidence interval, 0.27-0.57). CONCLUSIONS The results suggest a strong benefit of probiotic administration on antibiotic-associated diarrhoea, but further data are needed. The evidence for beneficial effects is still not definitive. Published studies are flawed by the lack of a placebo design and by peculiar population features.
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Affiliation(s)
- F Cremonini
- Internal Medicine Department, Germelli Hospital, Rome, Italy
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Mavromanolakis E, Maraki S, Samonis G, Tselentis Y, Cranidis A. Effect of norfloxacin, trimethoprim-sulfamethoxazole and nitrofurantoin on fecal flora of women with recurrent urinary tract infections. J Chemother 1997; 9:203-7. [PMID: 9210003 DOI: 10.1179/joc.1997.9.3.203] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The effects of antibiotics used for prophylaxis in women with recurrent urinary tract infections (UTIs) on the aerobic intestinal flora were investigated. Twenty-one patients with recurrent UTIs were randomly divided into three groups. The patients of each group received monotherapy with oral norfloxacin, trimethoprim-sulfamethoxazole or nitrofurantoin for one month. Urine and stool quantitative aerobic cultures were performed before prophylaxis, 2 and 4 weeks after the initiation of therapy, and 2 weeks after antibiotics were discontinued. The gram-negative aerobic flora was strongly suppressed during the administration of norfloxacin and trimethoprim-sulfamethoxazole, while Enterococcus spp. were not affected. Resistant strains of Escherichia coli were detected in two patients, one in the norfloxacin and one in the trimethoprim-sulfamethoxazole group. The aerobic intestinal flora was not affected by nitrofurantoin. These findings help in the selection of the most appropriate antimicrobial agent for prophylaxis in recurrent UTIs, so as to reduce the possibility of emergence of resistant bacterial strains.
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Affiliation(s)
- E Mavromanolakis
- Department of Urology, University Hospital of Heraklion, Crete, Greece
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Benoni G, Cuzzolin L, Leone R, Fracasso ME. Hepatic and intestinal effects of flurithromycin and erythromycin in the rat. J Chemother 1992; 4:271-5. [PMID: 1479415 DOI: 10.1080/1120009x.1992.11739176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The effects of flurithromycin (30-100 mg/kg p.o.), a fluorinated macrolide, on rat hepatic enzymes and intestinal microflora have been compared with those of equal doses of erythromycin. This latter drug significantly decreases cytochrome b5, cytochrome P-450 and aminopyrine N-demethylase and moderately influences intestinal microbial flora. Flurithromycin showed almost opposite characteristics, with no hepatic interaction and marked effects on some bacterial species (e.g. Bacteroides) known to facilitate the colonization of pathogenetic bacteria.
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Affiliation(s)
- G Benoni
- Institute of Pharmacology, University of Verona, Italy
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Helovuo H, Forssell K, Hakkarainen K. Oral mucosal soft tissue necrosis caused by superinfection. Report of three cases. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1991; 71:543-8. [PMID: 2047093 DOI: 10.1016/0030-4220(91)90358-j] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Three patients in whom flap necrosis developed after oral surgeries and antibiotic therapies were studied microbiologically by routine aerobic and anaerobic methods. In all cases the bacteria Enterobacter cloacae, Klebsiella oxytoca, Escherichia coli, and coagulase-negative penicillinase-producing staphylococci were resistant to the antibiotics used. These bacteria are frequent microorganisms of superinfection and were not found after the necrotic tissues had repaired.
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Affiliation(s)
- H Helovuo
- Institute of Dentistry, University of Turku, Finland
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Osawa R, Carrick FN. Use of a dietary supplement in koalas during systemic antibiotic treatment of chlamydial infection. Aust Vet J 1990; 67:305-7. [PMID: 2222379 DOI: 10.1111/j.1751-0813.1990.tb07805.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- R Osawa
- Department of Zoology, University of Queensland, St Lucia
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20
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Ilett KF, Tee LB, Reeves PT, Minchin RF. Metabolism of drugs and other xenobiotics in the gut lumen and wall. Pharmacol Ther 1990; 46:67-93. [PMID: 2181492 DOI: 10.1016/0163-7258(90)90036-2] [Citation(s) in RCA: 125] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Metabolism in the gut lumen and wall can decrease the bioavailability and the pharmacological effects of a wide variety of drugs. Bacterial flora in the gut, the environmental pH and oxidative or conjugative enzymes present in the intestinal epithelial cells can all contribute to the process. Bacterial biotransformation is greatest in the colon, while gut wall metabolism is generally highest in the jejunum and decreases distally. Gut wall metabolism may be induced or inhibited by dietary or environmental xenobiotics or by co-administered drugs. Recent evidence suggests that some drugs, food-derived mutagens and other xenobiotics can be metabolized by gut flora and/or gut wall enzymes to reactive species which may cause tumors.
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Affiliation(s)
- K F Ilett
- Department of Pharmacology, University of Western Australia, Nedlands
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21
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Senerwa D, Olsvik O, Mutanda LN, Gathuma JM, Wachsmuth K. Colonization of neonates in a nursery ward with enteropathogenic Escherichia coli and correlation to the clinical histories of the children. J Clin Microbiol 1989; 27:2539-43. [PMID: 2681255 PMCID: PMC267073 DOI: 10.1128/jcm.27.11.2539-2543.1989] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Stool samples were examined from 30 preterm neonates admitted to a nursery ward; 16 neonates had diarrhea, 12 constituted an age-matched control group without diarrhea, and 2 had an unknown history regarding diarrhea. Variable numbers of enteropathogenic Escherichia coli serotype O111:HNT strains possessing the gene coding for the enteroadherence factor (EAF) were found in stool samples from 13 of the neonates. No other microbiological enteropathogen was found. A total of 294 strains (9 or 10 from each neonate, comprising 229 E. coli and 65 Klebsiella pneumoniae strains) were characterized with respect to plasmid content and grouped into 37 plasmid profile groups. Diarrhea was found not to be correlated with any specific plasmid profile or with the presence of the EAF-positive strains but rather with the number of strains with one specific plasmid profile or with the number of EAF-positive strains (of the 9 or 10 strains) isolated from each stool sample. All the neonates who died had diarrhea (5 died of 16 with diarrhea); all five of the neonates who died possessed strains with one specific plasmid profile group, and EAF-positive strains were isolated from four of them. Of the seven neonates from whom seven or more EAF-positive isolates were isolated, three died, compared with only one of five of those from whom only a few (1 to 3 of 10) EAF-positive strains were isolated. Both plasmid profiling and genetic probing with the EAF probe were found to be good alternatives when serotyping is not available for identification of O111:HNT enteropathogenic E. coli strains.
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Affiliation(s)
- D Senerwa
- Department of Microbiology and Immunology, Norwegian College of Veterinary Medicine, Oslo
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22
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Affiliation(s)
- K A Caprile
- Department of Veterinary Physiology, Pharmacology and Toxicology, School of Veterinary Medicine, Louisiana State University, Baton Rouge
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23
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Gott DM, Griffiths LA. Effects of antibiotic pretreatments on the metabolism and excretion of [U14C](+)-catechin [( U14C](+)-cyanidanol-3) and its metabolite, 3'-0-methyl-(+)-catechin. Xenobiotica 1987; 17:423-34. [PMID: 3604252 DOI: 10.3109/00498258709043949] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Antibiotic pretreatment significantly altered metabolism of (+)-catechin (cyanidanol-3) in the rat, with decreases in both the urinary elimination of flavanol conjugates and of ring scission of the O-heterocyclic aglycone. The majority of the beta-glucuronidase(s) active in the degradation of flavanol conjugates is associated with the anaerobic microflora of the rat intestine. Ring scission is a minor reaction in vivo and appears to be due to anaerobic bacteria, although in vitro it is the major reaction and is promoted by both anaerobes and aerobes. The intestinal microflora are capable of demethylating the metabolite 3'-O-methyl-(+)-catechin in vivo; the major activity being associated with the aerobic microflora. Faecal elimination of unchanged (+)-catechin is of minor importance.
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Welkon CJ, Long SS, Gilligan PH. Effect of imipenem-cilastatin therapy on fecal flora. Antimicrob Agents Chemother 1986; 29:741-3. [PMID: 3460522 PMCID: PMC284145 DOI: 10.1128/aac.29.5.741] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Alteration of fecal flora was prospectively studied in 21 children receiving imipenem-cilastatin therapy under protocol for therapy of infections. Although no profound reduction in facultative or anaerobic flora was observed, qualitative and quantitative increases in organisms which were resistant or less susceptible to imipenem occurred. Of 21 patients, 13 (62%) had increases in counts of Enterococcus spp. of at least 10(3) organisms per g (wet weight) of stool, and 7 (33%) had acquisition of or similar increases in counts of Candida species. No change in susceptibility of isolates to imipenem was demonstrable during therapy. However, the MICs for 50 and 90% of the strains of Enterococcus spp. (2 and 8 micrograms/ml, respectively) were higher than those previously reported.
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25
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Sakata H, Fujita K, Yoshioka H. The effect of antimicrobial agents on fecal flora of children. Antimicrob Agents Chemother 1986; 29:225-9. [PMID: 3087275 PMCID: PMC176381 DOI: 10.1128/aac.29.2.225] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Influences of antibiotics on the fecal flora in children were studied for oral ampicillin, penicillin V, erythromycin, cefaclor, and gentamicin and for intravenous ampicillin, methicillin, cefpiramide, and ceftazidime. All antibiotics affected the normal flora, although the quality and quantity of the changes were variable. No substantial differences were noted between the oral and intravenous use of ampicillin with regard to its effect on the flora. Three penicillins, ampicillin, penicillin V, and methicillin, caused remarkable changes. The characteristic pattern observed was the considerable suppression of Bifidobacterium, Streptococcus, and Lactobacillus species. Although enterobacteria did not significantly change in number, Klebsiella spp. frequently replaced Escherichia coli. In patients given erythromycin and cefaclor, the reduction in the number of Bifidobacterium spp. was 1 log10 and that of members of the family Enterobacteriaceae was 3 log10. Gentamicin administered orally caused a drastic change, including a remarkable decline of E. coli to less than 2 log10/g of feces. Cefpiramide, a parenteral expanded-spectrum cephalosporin, suppressed normal flora so markedly that almost all species of organisms were eradicated, and the active growth of yeasts was promoted (2.6 log10 increase). Ceftazidime caused similar changes as cefpiramide, but the changes were less extensive. Yeasts increased after treatment with most antibiotic groups. This increase was particularly prominent in patients given oral penicillins and expanded-spectrum cephalosporins.
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26
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Enzensberger R, Shah PM, Knothe H. Impact of oral ciprofloxacin on the faecal flora of healthy volunteers. Infection 1985; 13:273-5. [PMID: 2934338 DOI: 10.1007/bf01645437] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The intestinal flora was studied in 12 volunteers after the administration of 400 mg ciprofloxacin b.i.d. over seven days. Stool samples were taken prior to and several times after the initiation of therapy, and qualitative and quantitative analyses of microorganisms were performed. Escherichia coli was eliminated in all volunteers after two days of treatment. A selection of resistant enterobacteria could not be observed. A higher incidence of Streptococcus faecium was seen, mainly after the end of drug application. The number of cfu of Bacteroides and Bifidus species remained unchanged during the trial. There was no selection of Clostridium difficile. Based on this pattern of activity on the stool flora we suggest that ciprofloxacin could represent an appropriate drug for the therapy of bacterial intestinal infections as well as for selective decontamination in immunosuppressed patients.
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27
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Guggenbichler JP, Kofler J, Allerberger F. The influence of third-generation cephalosporins on the aerobic intestinal flora. Infection 1985; 13 Suppl 1:S137-9. [PMID: 4055044 DOI: 10.1007/bf01644235] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The influence of three third-generation cephalosporins with varying degrees of biliary excretion on the aerobic flora was investigated. The faecal flora prior to therapy with one of these substances consisted mainly of anaerobic bacilli. Escherichia coli was present in concentrations of 10(9) organisms/g stool. Candida albicans and enterococci were observed in concentrations of 10(5) - 10(6) organisms/g stool. Within 24 hours after the administration of ceftriaxone and cefoperazone, the gram-negative aerobic flora was completely eradicated. C. albicans and enterococci increased to 10(9) organisms/g stool. Between the third and tenth days (mean 6.7 days) of therapy Pseudomonas aeruginosa, Enterobacter and Citrobacter in this order of frequency reappeared in the faecal flora with complete resistance to all betalactam antibiotics. C. albicans and enterococci decreased to 10(7) organisms/g stool. The anaerobic flora was largely unaltered. In contrast, cefotaxime had only a moderate influence on the aerobic faecal flora. Concentrations of gram-negative organisms decreased to 5 X 10(7) organisms/g stool during the first five days of therapy; the concomitant increase in C. albicans and enterococci was approximately 1 log 10. No alterations in the susceptibility pattern were observed. We would like to emphasize that substantial alterations of the faecal flora and the susceptibility pattern of antibiotics may accompany the use of antimicrobial agents, particularly those with a high degree of biliary elimination.
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Mulligan ME, Citron D, Gabay E, Kirby BD, George WL, Finegold SM. Alterations in human fecal flora, including ingrowth of Clostridium difficile, related to cefoxitin therapy. Antimicrob Agents Chemother 1984; 26:343-6. [PMID: 6508264 PMCID: PMC176166 DOI: 10.1128/aac.26.3.343] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
To evaluate the effects of parenteral cefoxitin therapy on human fecal flora, we cultured fecal specimens obtained from six patients before, during, and after therapy and used standard methods to identify and quantify all microorganisms. The major changes (observed in at least three patients) included the acquisition or proliferation of group D Streptococcus species, coagulase-negative Staphylococcus species, cefoxitin-resistant members of the family Enterobacteriaceae, Pseudomonas species, and various species of the Bacteroides fragilis group. The most striking finding was ingrowth of Clostridium difficile, noted in five of the six patients. There was concomitant eradication or decrease of cefoxitin-susceptible Enterobacteriaceae family members, Bacteroides species other than the B. fragilis group, Clostridium species other than C. difficile, and Lactobacillus species. These marked alterations of fecal flora may have important clinical consequences.
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29
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Colburn WA. Pharmacokinetic analysis of concentration-time data obtained following administration of drugs that are recycled in the bile. J Pharm Sci 1984; 73:313-7. [PMID: 6585546 DOI: 10.1002/jps.2600730308] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A pharmacokinetic model for calculating the pharmacokinetic parameters for a compound that is recycled in the bile is presented and tested using theoretical as well as experimental data. The results indicate that this method is stable and only slightly susceptible to sampling and recycling times. It is apparent from the present study that pharmacokinetic terms that have been used in classical situations are not directly applicable to drugs that enter the enterohepatic circulation. Effective half-life and effective clearance are used to describe the intrinsic ability of the eliminating organs to remove drug from the blood, whereas net half-life and net clearance are used to describe the irreversible elimination of the drug from the body.
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Mulligan ME, Citron DM, McNamara BT, Finegold SM. Impact of cefoperazone therapy on fecal flora. Antimicrob Agents Chemother 1982; 22:226-30. [PMID: 6927284 PMCID: PMC183716 DOI: 10.1128/aac.22.2.226] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
To evaluate the effects of parenteral cefoperazone therapy upon human fecal flora, fecal specimens obtained from four patients before and during therapy (as well as after therapy for one patient) were cultured quantitatively for facultative, aerobic, and anaerobic bacteria and for fungi. Cefoperazone therapy was associated with major changes in fecal flora. There was suppression to undetectable levels or an appreciable reduction in all anaerobic bacteria as well as suppression of all initially detected Enterobacteriaceae. During therapy, there was acquisition or an increase in counts of Candida spp., so that these became the most numerous fecal microorganisms in all patients. In addition, Pseudomonas spp. and coagulase-negative Staphylococcus sp. were acquired by three patients. These marked alterations in flora have potentially important consequences.
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31
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Abstract
Gastrointestinal complications, including diarrhea, may occur with virtually all antimicrobial agents. Such diarrhea may represent either a common, nonspecific adverse effect, or it may be one of the manifestations of antimicrobial-associated colitis (AAC), a potentially fatal complication. Clostridium difficile and a cytotoxin neutralized by Clostridium sordellii antitoxin has been isolated from the stools of nearly all patients with antibiotic-associated pseudomembranous colitis, many patients with AAC, and approximately 20% of those with antimicrobial-induced diarrhea. Demonstration that C. difficile is responsible for cytotoxin production has allowed for specific therapy for these disorders. General treatment measures include discontinuation of the causative antimicrobial agent(s), bowel rest, and supportive care with fluids, electrolytes and colloids, if necessary. Antiperistaltic agents and corticosteroids are not recommended. Various antimicrobials demonstrate potential efficacy in treating AAC in humans. Oral vancomycin is the most widely tested and is currently the treatment of choice. It achieves high concentrations in the feces and is very active against C. difficile in doses of 125-500 mg by mouth every six hours. Other potentially useful but inadequately tested antimicrobials include metronidazole (500 mg by mouth every eight hours) and bacitracin (25,000 units by mouth every six hours). Tetracycline has been employed with some success in nonspecific antibiotic-associated diarrhea, although it is as yet untested in humans with AAC and may induce diarrhea itself. Both miconazole and rifampin are highly effective against C. difficile in vitro but have not been evaluated in AAC. Anion-exchange resins bind the cytotoxin found in stools of patients with AAC. Cholestyramine has been used with variable response in oral doses of 4 g every six to eight hours. Since these resins may also bind vancomycin, resulting in lowered vancomycin concentrations in the stool, combination therapy should be used cautiously. With specific therapy directed against the toxin and aggressive supportive therapy, surgical intervention is rarely necessary. More recently, investigations have been directed at using bacterial preparations to suppress C. difficile by restoring the normal flora. The development of immunological agents (i.e., vaccines, toxoids, antitoxins) for the prevention or treatment of AAC would be a significant advance in therapy.
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32
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Etude écologique de la flore fécale à bacilles Gram négatif aéro-anaérobies facultatifs du nouveau-né. Med Mal Infect 1980. [DOI: 10.1016/s0399-077x(80)80070-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Marks CG, Hawley PR, Peach SL, Drasar BS, Hill MJ. The effects of phthalylsulphathiazole on the bacteria of the colonic mucosa and intestinal contents as revealed by the examination of surgical samples. Scand J Gastroenterol 1979; 14:891-6. [PMID: 395632 DOI: 10.3109/00365527909181421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The isolation of a bacterial flora specifically associated with the colonic mucosa of patients undergoing large-bowel surgery is described. This flora differed from that of faeces in both the numbers and the types of bacteria isolated. The most striking difference was the reduction in the number of anaerobic bacteria isolated from the colonic mucosa. The ratio of anaerobic to aerobic was approximately 1:1 for mucosa compared with 100:1 for faeces.
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34
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Borgström A, Genell S, Ohlsson K. Elevated fecal levels of endogenous pancreatic endopeptidases after antibiotic treatment. Scand J Gastroenterol 1977; 12:525-9. [PMID: 918546 DOI: 10.3109/00365527709181329] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Feces from normal and antibiotic-treated persons were analyzed for the content of immunoreactive trypsin and elastase. In the control group the mean concentration of immunoreactive trypsin was 13 microgram per g feces as compared to 147 in the antibiotic-treated group. Elastase was demonstrable in only 3 of 30 samples in the control group but in 20 of 26 in the antibiotic-treated group. The decreased inactivation of pancreatic proteases must depend on an altered intestinal microflora. The results suggest that reestablishment of a normal enteric flora may take months after the short time oral administration of antibiotics.
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35
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Baldwin BB, Bromel MC, Aird DW, Johnson RL, Sell JL. Effect of dietary oxytetracycline on microorganisms in turkey feces. Poult Sci 1976; 55:2147-54. [PMID: 798178 DOI: 10.3382/ps.0552147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Thirty-six two-day old male turkey poults were divided into three groups and fed three levels of oxytetracycline; 0, 110 or 440 mg. per kg. of ration, respectively, for nine weeks. The poults were given an oral spectinomycin plus vitamin treatment at the hatchery but were not fed before the start of the experiment. Defecated feces from each group were sampled at weekly intervals and analyzed for bacteriological content, especially for members of the Enterobacteriaceae. Total aerobic counts of 3 x 10(8) and total anaerobic counts of 2 x 10(9) were obtained. The majority of the Enterobacteriaceae were Escherichia coli but some Klebsiella sp., the Bethesda-Ballerup group of paracolon bacteria and Arizona sp. were also isolated. Antibiograms of the enteric isolates indicated that an increase in multiple antibiotic resistance occurred when increased amounts of antibiotic were fed.
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Guggenbichler JP, Stickler GB. [Past and present aspects of diarrheal disease in childhood. Clinical study and treatment (author's transl)]. Infection 1975; 3:189-201. [PMID: 1346 DOI: 10.1007/bf01642765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The etiologic and pathophysiologic findings described in the first part of this paper have important consequences: The recognition of the specific etiology of diarrhea requires new laboratory methods: most of these, however, are technically easy to perform and do not require a large laboratory. A long-ranging consequence of this changed concept is a well-founded modification of therapy. The most important discovery was, that in a well balanced glucose electrolyte solution sodium and glucose enhance their absorption mutually and increase the absorption of water by solvent drag. Since in most acute diarrheas the mechanisms of absorption of glucose and electrolytes are retained this mechanism can be utilized for fast oral rehydration and reinstitution of normal intestinal homeostasis. Prompt institution of a diet consisting of the previously mentioned glucose-electrolyte solution usually prevents severe dehydration and the need for stationary treatment. The elimination of lactose and long chain fatty acids from the diet prevents continuation of the pathologic osmotic and chemical conditions in the intestine. Antibiotics are not indicated in acute diarrhea with the exception of diarrhea caused by enteroinvasive E. Coli or Shigella, in the case of Salmonella-gastroenteritis even contraindicated. Further research concentrates on the development of drugs for neutralisation of E. Coli enterotoxin and the prevention of diarrheas by development of effective vaccines.
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Alestig K, Lidin-Janson G. The effect of doxycycline and tetracycline hydrochloride on the aerobic fecal flora, with special reference to Escherichia coli. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1975; 7:265-71. [PMID: 1108176 DOI: 10.3109/inf.1975.7.issue-4.08] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The effect on the aerobic faecal flora of a 10-day course of doxycycline or tetracycline hydrochloride was compared in 36 patients with acute infections mainly of respiratory origin. The patients were treated in hospital with a well-developed barrier nursing technique. The proportions of isolates of Escherichia coli resistant to tetracyclines were significantly lower after 10 days' treatment with doxycycline (80%) as well as one month later (24%), compared to the figures for tetracycline HCI (100% and 46%, respectively). The resistant strains selected during therapy probably represented the community flora. Only a small increase in multiresistant strains occurred and no identical strains were found in different patients. Thus, it seems possible to limit the biological side-effects of tetracyclines by a good barrier nursing technique. An increase in the number of E. coli resistant to tetracyclines cannot be avoided, but is more limited when doxycycline is used.
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Boxenbaum HG, Jodhka GS, Ferguson AC, Riegelman S, MacGregor TR. The influence of bacterial gut hydrolysis on the fate of orally administered isonicotinuric acid in man. JOURNAL OF PHARMACOKINETICS AND BIOPHARMACEUTICS 1974; 2:211-37. [PMID: 4452938 DOI: 10.1007/bf01059763] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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