微生态制剂预防儿科ICU抗生素相关性腹泻的临床观察

目的 探讨在儿科ICU住院患儿中应用微生态制剂预防抗生素相关性腹泻的效果。方法 对符合研究的580例入住PICU的患儿,随机分为预防组和对照组,预防组在常规治疗基础上加用微生态制剂（金双歧）常规剂量口服或经鼻饲管给药直至出院,观察2组之间发生抗生素相关性腹泻的差异显著性。结果 580例分为预防组286例,对照组294例,腹泻预防组的发生率为5.24%,对照组的发生率为12.93%,预防组的发生率较对照组低（P＜0.05）。结论 儿科ICU住院患儿常规加用微生态制剂可以很好地预防抗生素相关性腹泻。其机制认为与微生态制剂具有保持肠道微生态平衡、提高局部和全身的免疫功能有关。     

戊糖乳杆菌制剂防治仔猪腹泻效果初探

目的进行戊糖乳杆菌活菌制剂防治仔猪腹泻的活体实验。方法以8头健康长白母猪所产的90头仔猪为实验材料,随机分组进行腹泻预防实验,设空白为对照。结果戊糖乳杆菌活菌制剂预防组的腹泻率为8．51％,对照组为78．57％,差异有非常显著性（P〈0．01）。对空白组出现腹泻的仔猪进行治疗比较实验,庆大霉素为对照。结果戊糖乳杆菌制剂治疗组的总有效率为100％,治愈率为76．47％,平均疗程5d;庆大霉素治疗组的有效率为93．75％,治愈率仅为31．25％,平均疗程6d,差异有显著性（P〈0．05）。此外,与对照比较,戊糖乳杆菌制剂预防组仔猪的精神状态好,毛色光亮,粪便成型;即使个别出现腹泻情况,连续灌服戊糖乳杆菌制剂2d（1次／d）,即可痊愈。结论戊糖乳杆菌制剂可有效预防和治疗仔猪腹泻。     

地衣芽胞杆菌活菌制剂联合庆大霉素预防伊立替康所致腹泻

目的观察地衣芽胞杆菌活菌制剂（整肠生胶囊）联合庆大霉素预防伊立替康（irinoteean,CPT-11）所致腹泻的疗效。方法31例接受含伊立替康方案化疗的晚期癌症患者,采用自身随机交叉对照的方法,分别于2个治疗周期接受化疗（对照组）、化疗＋整肠生胶囊＋庆大霉素（预防组）,比较腹泻及其他不良反应的差异。结果31例患者在2个治疗周期中,预防组较对照组腹泻发生率有显著降低（腹泻发生率分别为48．4％VS61．3％,P〈0．05;3／4级腹泻发生率分别为9．7％vs16．1％,P〈0．05）,且减少合并用药;同时骨髓抑制、食欲减退、恶心呕吐的发生率也有所降低（P〈0．05）,而2组便秘、肝肾功能异常差异无显著性。结论地衣芽胞杆菌活菌制剂联合庆大霉素能有效预防伊立替康所致腹泻。     

双歧杆菌DM-8504活菌制剂预防化疗引起的腹泻疗效观察

２２例肿瘤化疗患者采用随机对照交叉试验,对照组采用单纯化疗实验组采用化疗＋双歧杆菌活菌制剂。结果显示双歧杆菌活菌制剂可预防化疗引起的腹泻（对照组腹泻率４５．５％,实验组为２７．３％）,并可改善腹珠反应程度（重度腹泻率对照组为１８．２％,初级组为４．５％）,有统计学差异（Ｐ〈０．０１）,提示双歧杆菌活菌制剂预防化疗引起的腹泻疗效确切。     

双歧杆菌四联活菌在预防小儿抗生素相关性腹泻的临床应用

目的探讨双歧杆菌四联活菌预防小儿抗生素相关性腹泻（AAD）的临床效果。方法132例住院患儿随机分成2组;对照组常规抗感染治疗,预防组在此基础上加用口服双歧杆菌四联活菌片。结果对照组72例发生腹泻27例（37.5%）,预防组60例,发生腹泻10例（16.7%）（χ^2=7.58,P〈0.01）;发生腹泻次数：对照组为（6.42±2.66）次/d,预防组为（3.92±1.03）次/d（t=3.29,P〈0.01）;腹泻平均持续时间：对照组为（4.97±1.20）d,预防组为（3.90±1.02）d（t=5.60,P〈0.01）,2组比较差异均有显著性。结论口服双歧杆菌四联活菌制剂可以减少小儿抗生素相关性腹泻的发生率。     

微生态制剂预防老年抗生素相关性腹泻的临床研究

目的 评价预防性应用微生态制剂(金双歧)在老年人抗生素相关性腹泻中的作用.方法 2010年5月至2013年2月应用抗生素的住院老年患者55例纳入观察对象,随机分为2组,预防组28例,给予微生态制剂双歧杆菌乳杆菌三联活菌片(金双歧)4片,3次/d,连续服用7～l0d;对照组27例,腹泻患者给予给予思密达3.76 g,3次/d.观察两组发生抗生素相关性腹泻情况,并进行肠道菌群分析.结果 预防组腹泻发生率、腹泻次数、腹泻持续时间与对照组比较,差异有统计学意义(P＜0.05).两组腹泻病例的大便培养及常规检查无异常,大便涂片检查出现细菌计数减少或大便杆球菌比失调;预防组粪检结果杆球比例倒置、细菌计数减少、真菌感染例数等与对照组比较差异有统计学意义(P＜0.05).结论 双歧杆菌乳杆菌三联活菌片(金双歧)可预防和减少老年人抗生素相关性腹泻的发生,减轻腹泻症状.     

婴幼儿抗生素相关性腹泻的影响因素及其防治

目的分析婴幼儿抗生素相关性腹泻的影响因素,观察地衣芽孢杆菌活菌制剂在预防抗生素相关性腹泻中的疗效。方法选择大连医科大学附属二院2016年11月至2017年2月因支气管肺炎应用广谱抗生素治疗的265例婴幼儿患者,随机分成实验组(140例)和对照组(125例)。实验组患儿从应用抗生素治疗第1天开始预防性口服地衣芽孢杆菌(0.25g/次,3次/d)直至停用抗生素;对照组患儿出现腹泻后加用地衣芽孢杆菌治疗,用药至腹泻缓解,剂量和用法与实验组一致。观察两组患儿抗生素相关性腹泻出现的例数,腹泻出现时间,持续时间,大便次数及性状。分析年龄、抗生素应用时间、是否联合应用抗生素与抗生素相关性腹泻之间的关系。结果 (1)年龄小于1岁、应用抗生素时间大于7d和联合应用抗生素均是婴幼儿发生抗生素相关性腹泻的高危因素。(2)预防性使用地衣芽孢杆菌后,实验组患儿腹泻发生率明显低于对照组,腹泻出现时间晚于对照组,腹泻持续时间短于对照组,平均大便次数少于对照组,差异均有统计学意义(P0.05)。结论 (1)婴幼儿长时间应用抗生素和联合应用抗生素易导致抗生素相关性腹泻的发生。(2)预防性应用地衣芽孢杆菌活菌制剂可以有效减轻抗生素相关性腹泻的发生及其严重程度。     

凝结芽孢杆菌活菌片预防小儿肺炎继发性腹泻疗效观察

目的观察和评价凝结芽孢杆菌活菌片（商品名：爽舒宝）与抗菌药联用预防小儿肺炎继发性腹泻的临床疗效。方法将164例肺炎患儿随机分为预防组和对照组,预防组84例,对照组80例,两组均给予抗菌药及对症支持治疗。其中预防组在治疗的同时序贯（间隔2～3h）应用凝结芽孢杆菌活菌片,出现腹泻继续服用;对照组单用抗菌药,出现腹泻用凝结芽孢杆菌活菌片治疗。对两组继发性腹泻的发生率、腹泻持续天数、肺炎治疗的总疗程、腹痛和肠鸣音异常等症状和体征进行统计分析。结果预防组继发腹泻10例,发生率11．9％,对照组继发腹泻41例,发生率51．3％,两组相比差异具有统计学意义（P〈0．01）;预防组腹泻持续时间和治疗疗程显著短于对照组（P〈0．05）;预防组患儿腹痛、肠鸣音异常和脱水等症状和体征发生率均少于对照组（P〈0．05）。结论凝结芽孢杆菌活菌片与抗菌药序贯应用治疗肺炎,能显著降低继发性腹泻的发生率,缩短疗程,值得临床推广。     

酪酸梭菌活菌散与抗菌药间隔序贯应用预防抗生素相关性腹泻疗效观察

目的观察和评价酪酸梭菌活菌散（商品名：宝乐安）与抗菌药间隔序贯应用治疗小儿肺炎预防抗生素相关性腹泻的临床疗效。方法将203例肺炎患儿随机分为预防组和对照组,预防组103例,对照组100例,2组均给予抗菌药及对症支持治疗。其中预防组在治疗的同时间隔2～3 h序贯使用酪酸梭菌活菌散,0.5 g/次,3次/d,出现腹泻继续服用;对照组不用酪酸梭菌活菌散预防,出现腹泻用酪酸梭菌活菌散治疗,0.5 g/次,3次/d。对2组继发腹泻的发生率、腹泻持续天数、肺炎治疗的总疗程、腹痛和脱水等症状和体征进行统计分析。结果预防组继发腹泻12例,发生率为11.7%,对照组继发腹泻57例,发生率为57.0%,2组相比差异具有非常显著性（P〈0.01）;预防组腹泻持续时间和治疗疗程显著短于对照组（P〈0.01）;预防组患儿腹痛和脱水等症状和体征发生率均少于对照组（P〈0.01）。结论酪酸梭菌活菌散与抗菌药间隔序贯应用治疗肺炎,能显著降低小儿抗生素相关性腹泻的发生率,预防性应用具有积极的临床意义。     

复合乳酸菌预防小儿肺炎抗生素相关腹泻临床分析

目的探讨复合乳酸菌预防和减少小儿肺炎抗生素相关性腹泻临床效果.方法对我院 2000年 5月～2001年11月小儿肺炎住院患儿115例,应用复合乳酸菌胶囊(聚克)预防抗生素相关性腹泻,并进行临床分析.结果115例患儿,共出现抗生素相关性腹泻44例,其中对照组 27/51例(52.9%),组16/64例 (26.5%),经PEMS医学统计软件包处理(χ2=7.2813),差异有显著性 (P＞ 0. 01).结论复合乳酸菌胶囊可以预防和减少小儿肺炎抗生素相关腹泻,对于缓解肠道症状和调整肠道菌群均具有较好的疗效.     

Selective enumeration of Lactobacillus casei from yogurts and fermented milk drinks

A selective medium (LC agar) was developed for enumeration of Lactobacillus casei populations from commercial yogurts and fermented milk drinks that may contain strains of yogurt bacteria (Streptococcus thermophilus and Lactobacillus delbrueckii ssp. bulgaricus), probiotic bacteria (Lactobacillus acidophilus and bifidobacteria) and L. casei. Appropriate dilutions were pour-plated in specially formulated LC agar acidified to pH 5.1 and the plates incubated at 27°C for 72 to 96 h under anaerobic conditions. Growth of S. thermophilus was prevented by adjusting pH to 5.1. L. delbrueckii ssp. bulgaricus did not ferment ribose as the carbon source, as a result the organisms did not form colonies. L. acidophilus formed colonies on MRS-ribose agar; however, this organism did not grow in the specially formulated LC agar containing ribose. Similarly, Bifidobacterium spp. did not form colonies in LC agar. L. casei formed colonies on LC agar. © Rapid Science Ltd. 1998     

Pharmaceutical probiotics for the treatment of anaerobic and other infections

Pharmaceutical probiotics have been used as alternative treatments or preventative therapies for a variety of clinical diseases. The overuse of antibiotics and emergence of multiple-antibiotic resistant pathogens has refocused clinical attention on the field of probiotics. Anaerobic infections which seem to respond well to probiotics are infections which involve the disruption of normal microbial flora. Gastrointestinal infections (travelers' diarrhea, antibiotic-associated diarrhea,Clostridium difficile disease, rotavirus diarrhea) have been studied using the following pharmaceutical probiotics:Saccharomyces boulardii, Lactobacillus casei GG, Lactobacillus acidophilus, Lactobacillus bulgaricus, Bifidobacterium bifidum, Streptococcus thermophilus and Enterococcus faecium. Vaginitis has been experimentally studied using L. acidophilus and L. casei GG. The efficacy, safety and mechanisms of action of these various probiotics are reviewed. Requirements for drug approval are similar for biologic probiotics and new drug entities and these requirements involve preclinical tolerability studies, pharmacokinetic studies and large, well-controlled blinded clinical trials.     

Lactobacillus casei administration reduces lung injuries in a Streptococcus pneumoniae infection in mice

The effect of the oral administration of Lactobacillus casei on the prevention of a Streptococcus pneumoniae lung infection in a mouse experimental model was studied, analyzing the innate and specific immune response. Adult Swiss albino mice were treated with L. casei (10(9)CFU/day) for 2, 5 and 7 d. Mice were infected intranasally with S. pneumoniae (10(6)CFU/mouse) after each treatment and the microbiological, histopathological and host responses were determined for 15 d after infection. Feeding L. casei for 2 d induced a faster clearance of S. pneumoniae, with a lower number of pneumococci in lung and a shorter period of septicemia than in the control group. L. casei administration induced activation of phagocytes as evidenced by the strong myeloperoxidase activity and the nitro blue tetrazolium assay in lung. Mice given L. casei for 2 d showed higher levels of anti-pneumococcal serum IgG and bronchoalveolar lavage IgA than the control mice. The group fed L. casei for 2 d could beneficially regulate the balance between tumor necrosis factor alpha and interleukin 10, allowing a more effective immune response against infection and modulating the inflammatory response, with less damage to the lung.     

Antiproliferative effects of homogenates derived from five strains of candidate probiotic bacteria.

Unheated and heat-treated homogenates were separately prepared from candidate probiotic bacteria, including Lactobacillus rhamnosus GG, Bifidobacterium lactis, Lactobacillus acidophilus, Lactobacillus delbrueckii subsp. bulgaricus, and Streptococcus thermophilus. We compared the phytohemagglutinin-induced proliferation of mononuclear cells in the presence of homogenates and in the presence of a control containing no homogenate by assessing thymidine incorporation in cell cultures. All homogenates suppressed proliferation, whether the enzymatic activity was inactivated or not inactivated by heating. When the proliferation assays were repeated with cytoplasmic and cell wall extracts derived from the homogenate of L. rhamnosus GG, the cytoplasmic extract but not the cell wall extract was suppressive. These findings indicate that candidate probiotic bacteria possess a heat-stable antiproliferative component(s). These bacteria may be used to generate microbiologically nonviable yet immunologically active probiotic food products that are easier to store and have a longer shelf life.     

Selective enumeration of Lactobacillus casei in yoghurt-type fermented milks based on a 15°C incubation temperature

A procedure was developed to enumerate selectively Lactobacillus casei populations in yoghurt-type fermented milks that can also contain strains of Streptococcus thermophilus, Lactobacillus delbrueckii ssp. bulgaricus, Lactobacillus acidophilus and Bifidobacterium infantis. Commercial LBS agar was acidified to pH 5.4, and the plates were incubated at 15°C for 14 days under anaerobic conditions. Acidification prevented the development of streptococci, and incubation at 15°C limited the development of the lactobacilli and the bifidobacteria. L. casei formed colonies on HHD medium which were different from those obtained with L. bulgaricus. Counts of L. casei on HHD confirmed results obtained on LBS - pH 5.4 medium and incubated at 15°C. L. casei did not form colonies on M17, nor did L. acidophilus or L. bulgaricus.     

Culture media for differential isolation of Lactobacillus casei Shirota from oral samples

This study aimed to develop a solid culture medium for differential isolation of the probiotic strain Lactobacillus casei Shirota (LcS) and for selective cultivation of lactobacilli present in oral samples. Type strains of lactobacilli and isolates from commercial probiotic products were inoculated onto modified de Man Rogosa Sharpe agar (termed 'LcS Select'), containing bromophenol blue pH indicator, vancomycin and reducing agent L-cysteine hydrochloride for differential colony morphology development. L. casei Shirota cultured on the novel medium produced distinctive colony morphologies, different from other lactobacilli tested. LcS-characteristic colonies were recovered on LcS Select medium from samples of saliva and tongue plaque following a four-week probiotic intervention study. The viable count of presumptive LcS colonies correlated with those isolated on a non-commercial lactitol-LBS-vancomycin agar (LLV) developed for a selective isolation of LcS from faeces. The novel LcS Select medium proved suitable for differential isolation of the probiotic strain L. casei Shirota from oral samples containing mixed microbial populations. It can also be used for selective growth of vancomycin-resistant lactobacilli. There are few available culture media that are sufficiently selective to enable isolation of probiotic strains from mixed populations. LcS Select medium provides a cheaper, yet effective tool in this context.     

Utilization of UF-permeate for production of beta-galactosidase by lactic acid bacteria

Four lactobacilli strains (Lactobacillus bulgaricus, Lactobacillus acidophilus, Lactobacilus casei and Lactobacillus reuteri) were grown in MRS broth and three lactococci strains (Streptococcus thermophilus, Lactococcus lactis subsp. Lactis and Lactococcus lactis subsp. lactis biovar. diacetilactis) were grown in M17 broth. L. reuteri and S. thermophilus were chosen on the basis of the best mean beta-galactosidase activity of 10.44 and 10.01 U/ml respectively, for further studies on permeate-based medium. The maximum production of beta-galactosidase by L. reuteri was achieved at lactose concentration of 6%, initial pH 5.0-7.5, ammonium phosphate as nitrogen source at a concentration of 0.66 g N/L and incubation temperature at 30 degrees C/24 hrs to give 6.31 U/ml. While in case of S. thermophilus, maximum beta-galactosidase production was achieved at 10% lactose concentration of permeate medium, supplemented with phosphate buffer ratio of 0.5:0.5 (KH2PO4:K2HPO4, g/L), at initial pH 6.0-6.5, ammonium phosphate (0.66g N/L) as nitrogen source and incubation temperature 35 degrees C for 24 hrs to give 7.85 U/ml.     

Diffusion of lactose in kappa-carrageenan/locust bean gum gel beads with or without entrapped growing lactic acid bacteria

Effective diffusion coefficients (De) of lactose in kappa-carrageenan (2.75% wt/wt)/locust bean gum (0.25% wt/wt) (LBG) gel beads (1.5-2.0-mm diameter)with or without entrapped lactic acid bacteria (LAB) were determined at 40 degrees C. The effects of lactose concentration, bacteria strain (Streptococcus salivarius subsp. thermophilus and Lactobacillus casei subsp. casei) and cell content at various steps of the fermentation process (after immobilization, pre-incubation of the beads and successive fermentations) were measured on De as a first step for process modelling. Results were obtained from transiend concentration changes n well-stirred lactose solutions in which the beads were suspended. A mathematical model of unsteady-state diffusion in a sphere was used, and De was obtained from the best fit of the experimental data. Diffusivity of lactose in cell-tree beads was significantly lower than in pure water mainly because of the obstruction effect of the polymer chains and the hydration region. Furthermore, effective diffusivity and equilibrium partition factor were independent of lactose concentration in the range from 12.5 to 50 g/L. No significant difference was found for De (effective diffusivity) and Kp (partition) coefficients between beads entrapping S. thermophilus (approximately 5 x 10(9) CFU/mL) and cell-free beads. On the other hand higher cell counts obtained with L. casei (close to 1.8 x 10(11) CFU/mL) increased mass transfer resistance resulting in lower effective diffusivities and Kp. Finally, the effects of the type of bacteria and their distribution in the beads on the diffusivity were also discussed.     

The evaluation of mixtures of yeast and potato extracts in growth media for biomass production of lactic cultures

The effectiveness of yeast extracts (YE) and potato extracts (PE) to promote growth of seven lactic cultures was evaluated by automated spectrophotometry (AS). Two aspects of the growth curve were analysed: (1) maximum biomass obtained (using ODmax) and (2) highest specific growth rate mu(max)) Eleven lots from the same PE-manufacturing process were examined for lot-to-lot variability. The ODmax values of three of the seven strains were significantly affected by lot source, but mu(max) was not significantly affected. The growth of bacteria was systematically lower in base medium containing 100% PE than in base medium containing 100% YE for both ODmax or mu(max) data, which could be related to the lower content in nitrogen-based compounds in PE. In AS assays, highest OD values for Lactobacillus casei EQ28, Lactobacillus rhamnosus R-011, Lactobacillus plantarum EQ12, and Streptococcus thermophilus R-083 were obtained with a mixture of PE and YE. Fermentations (2 L) were also carried out to determine the accuracy of AS to predict biomass levels obtained under fermentation trials. In these fermentations, replacement of 50% YE with PE was shown to enable good growth of S. thermophilus. With L. rhamnosus R-011, a high correlation (R2 = 0.95) was found between ODmax data obtained in the AS assays and that of the 2-L bioreactor when the same growth medium was used for both series of fermentations. However, AS was not as efficient when industrial media were used for the bioreactor assays. The relationship was still good for ODmax between AS data and that of the bioreactor data with L. rhamnosus R-011 in industrial LBS medium (R2 = 0.87), but was very poor with the S. thermophilus R-083 on Rosell #43 industrial medium (R2 = 0.33). Since PE cost 40% less than YE, there are strong economic advantages in considering such a partial replacement of YE by PE.