Bovine Colostrum in Increased Intestinal Permeability in Healthy Athletes and Patients: A Meta-Analysis of Randomized Clinical Trials

BACKGROUND

Increasing intestinal permeability causes chronic inflammation, which is one of the etiological factors of many diseases that presently constitute global challenges.

AIMS

Considering the importance of developing therapies to eliminate the increased intestinal permeability, in this systematic review and meta-analysis, we analyze the impact of bovine colostrum (BC) on the gut barrier and its permeability.

METHODS

Online databases, including PubMed, ISI Web of Science, and Scopus, were searched to find pertinent articles up to March 2022. Weighted mean difference (WMD) and 95% confidence intervals (CI) were considered as effect sizes. The random-effects model was used to pool the study results.

RESULTS

A total of ten articles were included in the meta-analysis. The pooled effect revealed a significant reduction in the 5-h urinary lactulose/rhamnose ratio after BC consumption [mean difference (MD): -0.24; 95% CI -0.43 to -0.04; I2 = 99%] and urinary lactulose/mannitol ratio (MD: -0.01; 95% CI -0.02 to -0.001; I2 = 29.8%). No differences were observed in the plasma intestinal fatty acid-binding protein (I-FABP) between BC and control groups (MD: 2.30; 95% CI -293.9 to 298.5; I2 = 92%).

CONCLUSIONS

BC supplementation significantly reduced intestinal permeability; however, to confirm the results, more randomized clinical trials considering different quality, dose, and duration are needed.

Therapeutics effects of bovine colostrum applications on gastrointestinal diseases: a systematic review

BACKGROUND

Evidence on the effects of bovine colostrum (BC) supplementation on gastrointestinal (GI) diseases is conflicting.

OBJECTIVES

This systematic review summarized the findings of clinical trials (CTs) on the effects of BC supplementation on GI diseases.

METHODS

A systematic search was conducted in online databases, including PubMed, ISI Web of Science, and Scopus, until March 2021 and updated until December 2023. CTs investigated BC's effect on any measurable symptomatic change in terms of GI health as the primary outcome variable or as one of the outcomes in any population eligible for this systematic review.

RESULTS

Out of 6881 records, 22 CTs (uncontrolled = 4, cross-over = 1, and parallel = 17) with 1427 patients were enrolled in the systematic review. Diarrhea, the most frequently evaluated symptom (20 interventional arms), was decreased in frequency with BC supplementation in 15 of these arms. However, most studies reported no change in its duration. BC supplementation consistently reduced stool frequency across all seven studies. Abdominal pain relief was noted in four interventional arms but showed no improvement in five others. Assessment of other GI symptoms was limited, yielding inconclusive results.

CONCLUSIONS

There is limited evidence on the effects of BC on GI diseases, with mixed findings. More well-designed controlled clinical trials are required to explore its effects.

Global evaluation of the antibacterial activity of Ceftolozane/Tazobactam against ESBLs-producing Escherichia coli and Klebsiella pneumoniae: a systematic review and meta-analysis

Background

Ceftolozane/Tazobactam is a β-lactam/β-lactamase inhibitor combination with a high range of efficacy and broad-spectrum action against multidrug-resistant bacterial strains.

Objectives

The present study aimed to analyze the in vitro activity of Ceftolozane/Tazobactam against extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli (ESBLs-EC) and Klebsiella pneumonia (ESBLs-KP) in the published literature to provide international data on the antimicrobial stewardship programs.

Design

Systematic review and meta-analysis.

Methods

A systematic literature search was conducted on the Web of Science, Embase, PubMed, Scopus, and Google Scholar electronic databases from the beginning of databases to December 2022 to cover all published articles relevant to our scope.

Results

At last, 31 publications that met our inclusion criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software. The pooled prevalence of Ceftolozane/Tazobactam susceptibility for ESBLs-EC and ESBLs-KP was estimated at 91.3% [95% confidence interval (CI): 90.1-92.5%] and 65.6% (95% CI: 60.8-70.2%), respectively. There was significant heterogeneity among the 31 studies for ESBLs-EC (χ2 = 91.621; p < 0.001; I2 = 67.256%) and ESBLs-KP (χ2 = 348.72; p < 0.001; I2 = 91.4%). Most clinical isolates of ESBLs-EC had MIC50 and MIC90 at a concentration of 0.5 and 2 µg/mL [minimum inhibitory concentration (MIC) at which 50% and 90% of isolates were inhibited], respectively. In contrast, most clinical isolates of ESBLs-KP had MIC50 and MIC90 at a concentration of 1 and 32 µg/mL, respectively.

Conclusion

Based on the meta-analysis results, Ceftolozane/Tazobactam has a more promising in vitro antibacterial activity against ESBLs-EC isolates from different clinical sources than ESBLs-KP isolates. Therefore, Ceftolozane/Tazobactam can be a useful therapeutic drug as an alternative to carbapenems. Randomized clinical trials are needed to provide clinical evidence to support these observations.

Macrolide-resistance, capsular genotyping and associated factors of group B Streptococci colonized pregnant women in Isfahan, Iran

Background and Objectives:

Group B streptococcus (GBS) can cause severe and invasive infections in pregnant women, infants, and adults. This study aimed to investigate the risk factors of GBS colonization in pregnant women and determine the macrolide resistance and capsular type of isolates.

Materials and Methods:

In a cross-sectional study, a total of 200 pregnant women were screened for GBS colonization by phenotypic methods. Antibiotic susceptibility pattern of colonizing isolates and ermB, ermTR, mefA/E genes were detected. Also, molecular capsular types of isolates were distinguished.

Results:

The overall prevalence of colonization of participates with GBS was 13.5%. Statistical analysis showed that there was no association between risk factors and colonization with GBS. The highest resistance was observed to erythromycin (44.4%) followed by clindamycin (29.6%), penicillin, ampicillin, and ceftriaxone (18.5%), levofloxacin (11.1%), and 29.6% isolates were multidrug-resistant. ermTR and mefA/E genes were detected in 37% and 11.1% isolates; respectively and the ermB gene was not detected. The most common capsular type was type Ib (44.4%) followed by type III (40.7%), type II (11.1), and type Ia (3.7%).

Conclusion:

In the present study, the prevalence of GBS was in the medium range. Resistance to key antibiotic agents was relatively high. Also, capsular serotype Ib was the predominant serotype, which emphasizes the importance of monitoring the molecular typing of the GBS isolates regularly.

High prevalence of SCC mec-associated Phenol-soluble modulin gene in clinical isolates of methicillin-resistant. Staphylococcus aureus

INTRODUCTION

We aimed to determine the distribution of Phenol-soluble modulin-mec (psm-mec) gene and its relationship with biofilm formation in clinical methicillin-resistant S. aureus (MRSA).

METHODS

In a descriptive study, a total of 94 cefoxitin-resistant S. aureus isolates were collected from patients and tested for antibiotic susceptibility testing, multiplex polymerase chain reaction (MPCR) for detection of mecA and pvl genes, PCR for detection of psm-mec gene and SCCmec typing of psm-mec and pvl-positive isolates. Furthermore, isolates were tested by microtiter plate method for biofilm formation assay.

RESULTS

Multiplex PCR for detection of mecA and pvl genes was performed for all cefoxitin-resistant isolates. The mecA gene was found in 92 (97.9%) isolates but none of the isolates carried the pvl gene. Sixty-five (69.1%) isolates harbored psm-mec genes and 95.4% of these isolates belong to SCCmec type III. Statistical analysis showed a significant difference between the presence or absence of psm-mec gene and biofilm production (P<0.001).

CONCLUSION

In this study, more than half of the MRSA strains harbored psm-mec gene and almost one-fifth of them produced strong biofilm. Since the strains with strong biofilm formation have more antibiotic resistance and cause the long-lasting infection, for the suitable treatment of hospitalized patients with this kind of MRSA strains, we should be paid more attention to these strains.