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Salazar-Parra MA, Cruz-Neri RU, Trujillo-Trujillo XA, Dominguez-Mora JJ, Cruz-Neri HI, Guzmán-Díaz JM, Guzmán-Ruvalcaba MJ, Vega-Gastelum JO, Ascencio-Díaz KV, Zarate-Casas MF, González-Ponce FY, Barbosa-Camacho FJ, Fuentes-Orozco C, Cervantes-Guevara G, Cervantes-Pérez E, Cervantes-Cardona GA, Cortés-Flores AO, González-Ojeda A. Effectiveness of Saccharomyces Boulardii CNCM I-745 probiotic in acute inflammatory viral diarrhoea in adults: results from a single-centre randomized trial. BMC Gastroenterol 2023; 23:229. [PMID: 37400812 DOI: 10.1186/s12876-023-02863-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 06/27/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Probiotics are effective for treating acute infectious diarrhoea caused by bacteria, but there are inconsistent results for the effectiveness of probiotics for diarrhoea caused by viruses. In this article we want to determine whether Sb supplementation has an effect on acute inflammatory viral diarrhoea diagnosed with the multiplex panel PCR test. The aim of this study was to evaluate the efficacy of Saccharomyces boulardii (Sb) as a treatment in patients diagnosed with viral acute diarrhoea. METHODS From February 2021 to December 2021, 46 patients with a confirmed diagnosis of viral acute diarrhoea diagnosed with the polymerase chain reaction multiplex assay were enrolled in a double-blind, randomized placebo-controlled trial. Patients received paracetamol 500 mg as a standard analgesic and 200 mg of Trimebutine as an antispasmodic treatment plus 600 mg of Sb (n = 23, 1 × 109/100 mL Colony forming unit) or a placebo (n = 23) orally once daily for eight days. The improvement in and severity of symptoms were measured using a symptom diary, the Patient Global Impression and the Patient Global Impression of Change scales (days 4 and 8), both answered and recorded by the patient. RESULTS Of the 46 patients who completed treatment, 24 (52%) were men and 22 (48%) were women. The average age was 35.6 ± 12.28 years (range 18 to 61 years). The average duration of the evolution of illness at the time of diagnosis was 0.85 ± 0.73 days (maximum 2 days). On day 4 after the diagnosis, 20% reported pain and 2% reported fever, but on day 8, no patient reported pain or fever. On day 4, 70% of patients in the Sb group and 26% in the placebo group reported improvement (P = 0.03), based on the Patients' Global Impression of Change scale, which assesses patient's rating of overall improvement. These findings suggest that 3 to 4 days of treatment with Sb helped to improve symptoms of diarrhoea caused by a virus. CONCLUSION Treatment with Sb on acute inflammatory diarrhoea of viral aetiology shows no changes regarding the severity of the symptoms; nevertheless, it seems to impact improvement positively. TRIAL REGISTRATION 22CEI00320171130 dated on 16/12/2020, NCT05226052 dated on 07/02/2022.
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Affiliation(s)
- Marcela Ag Salazar-Parra
- Biomedical Research Unit 02, Western National Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez #1000, Colonia Independencia, Guadalajara, Jalisco, 44340, Mexico
- Department of Medical Science, University of Colima, Avenida Universidad #333, Colonia las Víboras, Colima, Colima, 28040, México
| | - Roberto U Cruz-Neri
- Surgeon and Coloproctologist, Puerta de Hierro Sur Medical Center, Tlajomulco de Zúñiga, Avenida Adolfo López Mateos Sur #1401, Colonia La Tijera, Jalisco, 45640, Mexico
| | - Xóchitl Ar Trujillo-Trujillo
- University of Colima, Universitary Center of Biomedical Research, Colonia Villas de San Sebastián, Avenida 25 de Julio #965, Colima, Colima, 28045, Mexico
| | - Juan J Dominguez-Mora
- Puerta de Hierro Medical Center, Tlajomulco de Zúñiga, Avenida Adolfo López Mateos Sur #1401, Colonia La Tijera, Jalisco, 45640, Mexico
| | - Héctor I Cruz-Neri
- High Specialty Geriatric Care Unit, Hospital Civil Fray Antonio Alcalde, Calle Hospital #278, Colonia El Retiro, Guadalajara, Jalisco, 44280, México
| | - Jazmín M Guzmán-Díaz
- Biomedical Research Unit 02, Western National Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez #1000, Colonia Independencia, Guadalajara, Jalisco, 44340, Mexico
| | - Mario J Guzmán-Ruvalcaba
- Biomedical Research Unit 02, Western National Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez #1000, Colonia Independencia, Guadalajara, Jalisco, 44340, Mexico
| | - Jesús O Vega-Gastelum
- Biomedical Research Unit 02, Western National Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez #1000, Colonia Independencia, Guadalajara, Jalisco, 44340, Mexico
| | - Kriscia V Ascencio-Díaz
- Biomedical Research Unit 02, Western National Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez #1000, Colonia Independencia, Guadalajara, Jalisco, 44340, Mexico
| | - Maria F Zarate-Casas
- Biomedical Research Unit 02, Western National Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez #1000, Colonia Independencia, Guadalajara, Jalisco, 44340, Mexico
| | - Fanny Y González-Ponce
- Biomedical Research Unit 02, Western National Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez #1000, Colonia Independencia, Guadalajara, Jalisco, 44340, Mexico
| | - Francisco J Barbosa-Camacho
- Biomedical Research Unit 02, Western National Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez #1000, Colonia Independencia, Guadalajara, Jalisco, 44340, Mexico
| | - Clotilde Fuentes-Orozco
- Biomedical Research Unit 02, Western National Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez #1000, Colonia Independencia, Guadalajara, Jalisco, 44340, Mexico
| | - Gabino Cervantes-Guevara
- Departamento de Bienestar y Desarrollo Sustentable, Centro Universitario del Norte, Universidad de Guadalajara, Carretera Federal No. 23, Km. 191, Colotlán, Jalisco, C.P. 46200, México
| | - Enrique Cervantes-Pérez
- Departamento de Medicina Interna, Centro Universitario de Ciencias de la Salud, Hospital Civil de Guadalajara Fray Antonio Alcalde, Universidad de Guadalajara, Calle Hospital 278, Col. El Retiro, Guadalajara, Jalisco, 95100, México
| | - Guillermo Alonso Cervantes-Cardona
- Departamento de Disciplinas Filosófico, Metodológicas e Instrumentales, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950 Edificio "N" planta alta, Col. Independencia, Guadalajara, Jalisco, 44340, México
| | - Ana Olivia Cortés-Flores
- Surgical Oncology, Anker Global Oncology, Av. Juan Palomar y Arias 530, Guadalajara, Monraz, Guadalajara, Jal. Mexico, 44670, Mexico
| | - Alejandro González-Ojeda
- Biomedical Research Unit 02, Western National Medical Center, Mexican Institute of Social Security, Avenida Belisario Domínguez #1000, Colonia Independencia, Guadalajara, Jalisco, 44340, Mexico.
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Toro Monjaraz EM, Ignorosa Arellano KR, Loredo Mayer A, Palacios-González B, Cervantes Bustamante R, Ramírez Mayans JA. Gut Microbiota in Mexican Children With Acute Diarrhea: An Observational Study. Pediatr Infect Dis J 2021; 40:704-709. [PMID: 34250970 DOI: 10.1097/inf.0000000000003128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Acute diarrhea is the second leading cause of preventable mortality and morbidity in children worldwide. This study aimed to identify the main pathogens associated with acute diarrhea and to describe changes in gut microbiota in Mexican children. METHODS This single-center observational study included 30 children (6 months to 5 years old) with acute diarrhea who were referred to the Instituto Nacional de Pediatría of Mexico City and 15 healthy volunteers (control group). Stool samples at day 0 (D0) and day 15 (D15) were collected for identification of microorganisms (reverse transcriptase-polymerase chain reaction analyses with xTAG gastrointestinal pathogen panel multiplex assay) and microbiota analysis (16S gene amplification sequencing). Prescription decisions were made by the treating clinician. RESULTS The main pathogens identified were norovirus and Campylobacter jejuni (20% each). The majority of patients (n = 24) were prescribed Saccharomyces boulardii CNCM I-745 for treatment of acute diarrhea. Diarrheic episodes resolved within 1 week of treatment. Compared with D15 and control samples, D0 samples showed significantly lower alpha diversity and a clear shift in overall composition (beta diversity). Alpha diversity was significantly increased in S. boulardii-treated group between D0 and D15 to a level similar to that of control group. CONCLUSIONS In these children, acute diarrhea was accompanied by significant alterations in gut microbiota. S. boulardii CNCM I-745 treatment may facilitate gut microbiota restoration in children with acute diarrhea, mostly through improvements in alpha diversity.
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Affiliation(s)
| | | | - Alejandro Loredo Mayer
- From the Pediatric Gastroenterology and Nutrition Department, Instituto Nacional de Pediatría
| | - Berenice Palacios-González
- Scientific Bonding Unit, Medicine Faculty UNAM, Instituto Nacional De Medicina Genómica, Mexico City, Mexico
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