Infectious Diarrhea In Infants Research Articles

Purification of Antibodies From Human Milk and Infant Digestates for Viral Inhibition Assays.

Oral administration of enteric pathogen-specific immunoglobulins may be an ideal approach for preventing infectious diarrhea in infants and children. For oral administration to be effective, antibodies must survive functionally intact within the highly proteolytic digestive tract. As an initial step toward assessing the viability of this approach, we examined the survival of palivizumab, a recombinant monoclonal antibody (IgG1κ), across infant digestion and its ability to neutralize respiratory syncytial virus (RSV). Human milk and infant digestive samples contain substances known to interfere with the RSV neutralization assay (our selected functional test for antibody survival through digestion), therefore, antibody extraction from the matrix was required prior to performing the assay. The efficacy of various approaches for palivizumab purification from human milk, infant's gastric and intestinal digestates, including casein precipitation, salting out, molecular weight cut-off, and affinity chromatography (protein A and G) were compared. Affinity chromatography using protein G with high-salt elution followed by 30-kDa molecular weight cut-off centrifugal filtration was the most effective technique for purifying palivizumab from human milk and infant digestates with a high yield and reduced background interference for the viral neutralization assay. This work is broadly applicable to the optimal isolation of antibodies from human milk and infant digesta for viral neutralization assays, enables the examination of how digestion affects the viral neutralization capacity of antibodies within milk and digestive samples, and paves the way for assessment of the viability of oral administration of recombinant antibodies as a therapeutic approach to prevent enteric pathogen-induced infectious diarrhea in infants.

Clinical Characteristics of Rotavirus-Induced Gastroenteritis in Infants

Abstract Rotavirus is the most common cause of acute infectious diarrhea in infants and young children up to the age of five. The disease is characterized by profuse watery diarrhea, vomiting and fever. The major complications of rotavirus gastroenteritis (RVGE) are dehydration, middle ear inflammation and upper respiratory tract infection. The basis of treatment is compensation for fluid loss and administration of probiotics. The aim of this study was to analyze the clinical characteristics of rotavirus gastroenteritis in infants. The study was conducted by the type of retrospective-prospective clinical study on infants with rotavirus gastroenteritis diagnosed on the basis of a positive Rotalex test (Orion Diagnostica Finland) and exclusion of other etiological factors at the University Children's Clinic in Belgrade, from April 2005 to December 2010. In addition to the detailed medical history and clinical examination, relevant laboratory analyzes were performed in all patients. Descriptive and analytical statistical methods were applied in the study. Among the descriptive methods, we used grouping, tabulation, graphing, calculating measures of central tendency, calculating measures of variability and calculating relative numbers. Of the analytical statistical methods, distribution normality testing, χ2 test, Mann-Whitney U test and T test were used. Statistical significance will be taken to mean p < 0.05. The average infant mortality was 6.7 ± 3.7 months. All respondents were divided into two groups according to the age. The first group consisted of infants aged 0 to 5 months (46%), the second group consisted of infants aged 6 to 12 months (54%). The incidence of aqueous diarrhea (100%), vomiting (84%) and fever (74%) in infants suffering from rotavirus gastroenteritis was analyzed. The significance of the age on the symptomatology of rotavirus gastroenteritis as well as on the importance of using probiotics has been demonstrated.

Self-assembling Rotavirus VP6 Nanoparticle Vaccines Expressed in Escherichia coli Elicit Systemic and Mucosal Responses in Mice.

Rotavirus is the most common cause of infectious diarrhea in infants and young children around the world. The inner capsid protein VP6 has been discussed as alternative vaccine as it can induce cross-protective immune responses against different RV strai. The use of ferritin nanoparticle may enhance the immunogenicity of the subunit vaccine. In this article, our motivation is to design and obtain a self-assemble rotavirus nanoparticle vaccine which can induce efficiency immune response. The VP6 protein was fused with ferritin and expressed in the Escherichia coli expression system. The recombinant VP6-ferritin (rVP6-ferritin) protein was purified by His-tag affinity chromatography and fast protein liquid chromatography. Transmission electron micrographic analysis was used to detect the nanostructure of the self-assembled protein. Mice were gavage with the protein and ELISA was used to detect the titer of the VP6 specific antibody. The recombined VP6-ferritin was expressed in the Escherichia coli as an inclusion body form and the purified protein has similar antigenicity to rotavirus VP6. Transmission electron micrographic analysis of rVP6-ferritin exhibited spherical architecture with a uniform size distribution, which is similar to the ferritin nanocage. Immune response analysis showed that mice immunized by rVP6-ferritin protein induced 8000 (8000±1093) anti-VP6 IgG titers or 1152 (1152±248.8) anti-VP6 IgA titers. According to the above research, the rotavirus VP6-ferritin protein can be easily express and self-assemble to the nano-vaccine and induce efficiency humoral and mucosal immunity. Our research makes a foundation for the development of oral rotavirus vaccine.

CARBOHYDRATE MALABSORPTION SYNDROME IN CHILDREN WITH VIRAL GASTROENTERITIS

Background: Enteric viruses (mainly rotaviruses) are the most common cause of infectious diarrhea in infants. One of the pathophysiologic mechanisms in rotaviral gastroenteritis is the reduction of the surface activity of enterocyte disaccharidases and osmotic diarrhea. Aim: To determine the clinical significance of metabolic activity of intestinal microbiota in the formation of the osmotic component of viral diarrhea in children of various ages. Materials and methods: The study involved 139 children aged from 1 month to 14 years admitted to the hospital in the first 24 to 72 hours of moderate-degree viral gastroenteritis. Rotaviral infection was the most prevalent (90%). Viral etiology was confirmed by the reaction of indirect hemagglutination and multiplex real-time PCR (in feces). Total carbohydrate content in the feces was measured and fecal microflora was investigated by two methods: bacteriological and gas liquid chromatography with the determination of short-chain fatty acids. Results: The mean carbohydrate content in the feces of children below 1.5 years of age was higher than that in older children (p = 0.014). There was an inverse correlation between the concentration of rotaviral antigens and carbohydrate contents (r = -0,43, p < 0.05) and the production of acetic and propionic acids (R = -0,35, p < 0.01). The carbohydrate content in acute stage of the disease was linearly associated with time to normalization of the stool (r = +0,47, p < 0.01). Previous acute respiratory or intestinal infections within 2 months (odds ratio [OR], 14.10; 95% confidence interval [CI] 3.86–51.53), previous hospitalizations (OR = 14.17; 95% CI 2.74–74.32) and past history of intestinal dysfunction (OR 5.68; 95% CI 1.67–19.76) were predictive of severe carbohydrate malabsorption in children below 1.5 years of age. Conclusion: The lack of microbiota functional activity (assessed by production of short-chain fatty acids) determines the development of osmotic phenotype of diarrhea, that marks the total carbohydrate contents in the feces. Its predisposing factors should be taken into account when making a decision to hospitalize.

Etiology of infectious diarrhea in infants and young children

Objective To understand the etiologic and epidemiologic characteristics of infectious diarrhea in infants and young children aged 5 years in central and northern Zhejiang in recent three years and provide evidence for the development of prevention and control measures.Methods Case investigation and stool sample collection were conducted among children aged 5 years who sought medical care in Children's Hospital of School of Medicine, Zhejiang University from January 2012 to December 2014. Bacteria culture was done to detect 14 kinds of intestinal bacteria and real-time PCR was conducted to detect nucleic acid of 5 kinds of viruses and the virulence genes of 5 kinds of Escherichia coli.Results A total of 248 strains of diarrhea pathogens were detected in 426 stool samples(58.22%). The virus detection rate was 43.90%, the viruses detected mainly included rotavirus group A(19.25%) and norovirus GⅡ(18.30%), adenovirus(3.29%), sapovirus(2.82%) and astrovirus(0.23%). The bacterium detection rate was 14.32%, and 5 kinds of bacteria were detected, i.e. diarrhoeagenic Escherichia coli(8.92%), Salmonella(3.99%), Yersinia enterocolitica(0.71%), Aeromonas hydrophila(0.47%) and Campylobacter jejuni(0.23%).Conclusion Rotavirus group A, norovirus GⅡ and diarrhoeagenic Escherichia coli were the major pathogens causing infectious diarrhea in infants and young children in central and northern Zhejiang The prevention and control of viral diarrhea should be strengthened in autumn and winter, and the prevention and control of bacterial diarrhea should be strengthened in summer and autumn.

Rotavirus activity and meteorological variations in an Asian subtropical city, Hong Kong, 1995–2009

Rotavirus is a leading cause of severe infectious diarrhea in infants and young children aged <5 years. Rotavirus infections have minimal to strong seasonality depending on geographical locations. In this study, a comprehensive retrospective analysis was performed to evaluate the association between rotavirus admission and multiple key meteorological variables, including air temperature, relative humidity, atmospheric pressure, and solar radiation over a 15-year period from 1995 to 2009 in Hong Kong. Rotavirus infections were found to show a distinct cyclical pattern with an annual peak in cold season. The weekly number of cases showed the strongest correlation with average air temperature of the previous 7 days (rho=-0.69; P<0.0001), followed by atmospheric pressure (rho=+0.67; P<0.0001); whereas only weak correlation with relative humidity (rho=-0.252; P<0.0001) and solar radiation (rho=-0.312; P<0.0001) was observed. Curve fitting regression analysis suggested that the correlation was nonlinear in nature in which the effect was more profound towards lower air temperature and higher atmospheric pressure conditions. In binary logistic regression analysis, a final model that included air temperature (≤ 20°C) and atmospheric pressure (≥ 1,013 hPa) predicted correctly 85.3% and 82.6% of weeks with rotavirus activity above and below the baseline level, respectively. In multivariate Poisson model, air temperature and solar radiation were independent factors associated with the weekly number of rotavirus cases, adjusted for seasonal variation. In summary, the current study provides evidence suggesting that local seasonal activity of rotavirus correlated strongly with air temperature, followed by atmospheric pressure but only minimally with relative humidity in pre-vaccine era.

Probiotics, Enteric and Diarrheal Diseases, and Global Health

Enteric and diarrheal diseases are a major worldwide cause of death among children under the age of 5. In this age group, diarrhea occurs 2.5 billion times per year [1] and causes 15% of childhood deaths.[2] Diarrheal diseases claim 59 million disability-adjusted life years (DALYs), nearly all from children in low- and middle-income countries.[3] Despite this enormous burden, these numbers fail to capture the full impact of enteric and diarrheal diseases. Early and frequent exposure to intestinal pathogens begins a cycle (Figure 1A) that affects digestion, nutrient absorption, growth, and immunity.[4] Repeated infections, with either overt diarrhea or subclinical enteropathy, produce acute and chronic undernutrition,[5] which leads to more frequent and severe infections.[6] Undernutrition contributes to 53% of childhood deaths [7] and is the leading risk factor for poor health outcomes in childhood;[8] survivors are at risk for developmental deficits in growth, fitness, and cognition that persist into adulthood with devastating consequences.[4] These consequences have a multiplicative effect on calculations of DALYs from diarrheal disease.[9] Open in a separate window Figure 1 The vicious cycle of diarrhea and undernutrition in susceptible children (A) The devastating synergy between enteric infections and undernutrition is influenced by the environment, the human genome, host nutrition, and the human microbiome. Various interventions (red boxes) may inhibit progression to the next step in the cycle, minimizing both acute and chronic morbidities. (B) Employing a spectrum of disease outcome measures would lend greater insight into the pathology underlying enteric and diarrheal diseases, while providing a more complete understanding of interventions targeting basic steps of enteric and diarrheal disease pathogenesis. Adapted with permission from Wiley: Nutrition Reviews,4 copyright 2008. http://www.http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1753-4887.

Guidance for Substantiating the Evidence for Beneficial Effects of Probiotics: Prevention and Management of Infections by Probiotics1–3

The rationale for the use of probiotics in the management of infectious diseases is supported by their potential to influence and stabilize the composition of gut microbiota, enhance colonization resistance, and modulate immune function parameters. A literature review was conducted to determine the efficacy of using probiotics in selected infections: 1) infectious diarrhea in infants and children, 2) traveler's diarrhea, 3) necrotizing enterocolitis in infants, 4) Helicobacter pylori infection, 5) respiratory tract infections in adults and children, 6) ear, nose, and throat infections, and 7) infectious complications in surgical and critically ill patients. The different types of infections that have been subject to clinical studies with different probiotics obviously prevent any generic conclusions. Furthermore, the lack of consistency among studies focusing on 1 specific infection, in study design, applied probiotic strains, outcome parameters, and study population, along with the still limited number of studies, preclude clear and definite conclusions on the efficacy of probiotics and illustrate the need for better-aligned study designs and methodology. Exceptions were the management of infectious diarrhea in infants and traveler's diarrhea, antibiotic-associated diarrhea, and necrotizing enterocolitis. Sufficient consistent data exist for these applications to conclude that certain probiotics, under certain conditions, and in certain target populations, are beneficial in reducing the risk of infection. In addition, some evidence exists, although conclusions are premature, for the management of Helicobacter pylori infection and possible reduction of treatment side effects. Certain probiotics may also reduce the risk of various symptoms of respiratory tract infections in adults and children, including ear, nose, and throat infections, although data are currently far too limited to distill any clinical recommendations in this area. Positive but also negative results have been obtained in prevention of infectious complications in surgical and critically ill patients. For future studies it is recommended that researchers provide adequate power, identify pathogens, and report both clinical outcomes and immune biomarkers relating to putative underlying mechanisms.

Fermented Infant Formulae Without Live Bacteria

Infant and follow-on (or "follow-up") formulae fermented with lactic acid-producing bacteria during the production process contain no viable bacteria in the final product due to their inactivation by heat or other means. In this article the ESPGHAN Committee on Nutrition reviews published information on their clinical evaluation. In a systematic literature review, 2 randomized clinical trials including 933 infants were identified as meeting our predefined inclusion criteria. Our analysis reveals that only limited published data are available on the effects of fermented infant formulae. There are indications from 2 studies that some fermented infant formulae may reduce the occurrence or severity of infectious diarrhea in infants. It is recommended that the effects of fermented infant formulae on infectious diarrhea and other relevant outcomes should be assessed in further randomized controlled trials according to current scientific standards. The available data do not allow general conclusions to be drawn on the use and effects of fermented formulae for infants.

Molecular characterization of group A rotavirus isolates obtained from hospitalized children in Salvador, Bahia, Brazil

Rotavirus is a major cause of infectious diarrhea in infants and young children. The objective of this study was to characterize the genotypes of Human Rotavirus found in children hospitalized with acute diarrhea in the Pediatric Hospital Prof. Hosannah de Oliveira of the UFBA in Salvador, Bahia, Brazil, during the years of 1999, 2000 and 2002. Fecal samples were analyzed (n=358) by methods EIARA and SDS-PAGE for detection of Rotavirus. Positive samples of one or two of these methods (n=168) were submitted to RT-PCR and Multiplex-Nested PCR to determine genotypes G and P. A hundred sixty-eight (46.9%) samples were positive and 190 (53.1%) negative. Only 17 (4.7%) samples had divergent results. The distribution of genotypes G during the first year, showed that the genotype G9 was present in 96,8% of the analyzed samples, in the second year, it was responsible for 96% and in the third year, 88,1%. The characterization of genotypes P demonstrated that the genotype P1A[8] was the most outstanding in all years. In this study we discuss the benefit to control the genotypes of Rotavirus through the molecular characterization for the development of potential vaccines.

Probiotics in the treatment and prevention of acute infectious diarrhea in infants and children: a systematic review of published randomized, double-blind, placebo-controlled trials.

This review was designed to assess the evidence from randomized controlled trials on effects of probiotics in the treatment and prevention of acute infectious diarrhea in infants and children. A systematic review of published, randomized, double-blind, placebo-controlled trials on probiotics in the treatment or prevention of acute diarrhea defined as >3 loose or watery stools per 24 hours in infants and children. The use of probiotics as compared with placebo was associated with a significantly reduced risk of diarrhea lasting >3 days. The pooled estimate risk was 0.43 (95% CI, 0.34-0.53) with a fixed-effect model, and remained significant in a random-effect model (0.40; 95% CI, 0.28-0.57). Only Lactobacillus GG showed a consistent effect. Probiotics significantly reduced the duration of diarrhea when compared with placebo, particularly in rotaviral gastroenteritis-the pooled, weighted, mean difference (WMD) assuming the random-effect model was -20.1 hours (95% CI, -26.1 to -14.2) and -24.8 (95% CI, -31.8 to -17.9) respectively. A meta-analysis of the prevention studies was not feasible because of significant clinical and statistical heterogeneity. There is evidence of a clinically significant benefit of probiotics in the treatment of acute infectious diarrhea in infants and children, particularly in rotaviral gastroenteritis. Lactobacillus GG showed the most consistent effect, although other probiotic strains may also be effective. Further research is needed. Clinical and statistical heterogeneity of the prophylactic interventions preclude drawing firm conclusions about the efficacy of probiotics in preventing acute gastroenteritis.

Probiotics in the Treatment and Prevention of Acute Infectious Diarrhea in Infants and Children: A Systematic Review of Published Randomized, Double‐Blind, Placebo‐Controlled Trials

ABSTRACTBackgroundThis review was designed to assess the evidence from randomized controlled trials on effects of probiotics in the treatment and prevention of acute infectious diarrhea in infants and children.MethodsA systematic review of published, randomized, double‐blind, placebo‐controlled trials on probiotics in the treatment or prevention of acute diarrhea defined as &gt;3 loose or watery stools per 24 hours in infants and children.ResultsThe use of probiotics as compared with placebo was associated with a significantly reduced risk of diarrhea lasting &gt;3 days. The pooled estimate risk was 0.43 (95% CI, 0.34–0.53) with a fixed‐effect model, and remained significant in a random‐effect model (0.40; 95% CI, 0.28–0.57). Only Lactobacillus GG showed a consistent effect. Probiotics significantly reduced the duration of diarrhea when compared with placebo, particularly in rotaviral gastroenteritis—the pooled, weighted, mean difference (WMD) assuming the random‐effect model was −20.1 hours (95% CI, −26.1 to −14.2) and −24.8 (95% CI, −31.8 to −17.9) respectively. A meta‐analysis of the prevention studies was not feasible because of significant clinical and statistical heterogeneity.ConclusionsThere is evidence of a clinically significant benefit of probiotics in the treatment of acute infectious diarrhea in infants and children, particularly in rotaviral gastroenteritis. Lactobacillus GG showed the most consistent effect, although other probiotic strains may also be effective. Further research is needed. Clinical and statistical heterogeneity of the prophylactic interventions preclude drawing firm conclusions about the efficacy of probiotics in preventing acute gastroenteritis.

Survival of Rotavirus Antibody Activity Derived From Bovine Colostrum After Passage Through the Human Gastrointestinal Tract

ABSTRACTBackgroundRotavirus is a major cause of infectious diarrhea in infants and young children. Several studies have shown that hyperimmune bovine colostrum, derived from cows immunized with rotavirus, can prevent rotavirus diarrhea when given passively. The objective of this study was to determine whether colostral antibody activity survived transit through the gut by measuring the level of rotavirus antibody activity in the feces.MethodsHyperimmune colostrum containing different levels of rotavirus antibody was administered to 105 children attending nine Adelaide childcare centres. Subjects were asked to drink 100 ml of whole milk supplemented with colostrum 3 times a day, for a period of 6 days. Stool samples were collected from the subjects before, during , and after consumption of the study product. Rotavirus activity was determined using a novel virus reduction enzyme‐linked immunosorbent assay (ELISA) and a virus neutralization assay.ResultsRotavirus antibody activity was detected in 521 (86%) of 602 fecal specimens obtained during the study using the virus reduction ELISA. The antibody activity was detected as early as 8 hours after ingestion of hyperimmune colostrum and up to 72 hours after consumption had ceased. There was a strong relation (r = 0.81) between the titer of rotavirus antibody administered to subjects and the level of antibody activity detected in the feces.ConclusionsThe results show that antirotavirus activity survived passage through the gut. Therefore, passive immunotherapy may be used to prevent or treat infectious diseases that affect the entire length of the gastrointestinal tract.

Survival of rotavirus antibody activity derived from bovine colostrum after passage through the human gastrointestinal tract.

Rotavirus is a major cause of infectious diarrhea in infants and young children. Several studies have shown that hyperimmune bovine colostrum, derived from cows immunized with rotavirus, can prevent rotavirus diarrhea when given passively. The objective of this study was to determine whether colostral antibody activity survived transit through the gut by measuring the level of rotavirus antibody activity in the feces. Hyperimmune colostrum containing different levels of rotavirus antibody was administered to 105 children attending nine Adelaide childcare centres. Subjects were asked to drink 100 ml of whole milk supplemented with colostrum 3 times a day, for a period of 6 days. Stool samples were collected from the subjects before, during, and after consumption of the study product. Rotavirus activity was determined using a novel virus reduction enzyme-linked immunosorbent assay (ELISA) and a virus neutralization assay. Rotavirus antibody activity was detected in 521 (86%) of 602 fecal specimens obtained during the study using the virus reduction ELISA. The antibody activity was detected as early as 8 hours after ingestion of hyperimmune colostrum and up to 72 hours after consumption had ceased. There was a strong relation (r = 0.81) between the titer of rotavirus antibody administered to subjects and the level of antibody activity detected in the feces. The results show that antirotavirus activity survived passage through the gut. Therefore, passive immunotherapy may be used to prevent or treat infectious diseases that affect the entire length of the gastrointestinal tract.

A high-Mr glycoprotein fraction from cow's milk potent in inhibiting replication of human rotavirus in vitro.

Rotavirus is the major cause of infectious diarrhea in infants and young children all over the world. We have found that a high-M(r) glycoprotein fraction from cow's milk is potent in inhibiting replication of human rotaviruses in vitro. Since the activity seems to be unique and specific, this fraction may be useful as a novel agent for treatment or prevention of rotavirus diarrhea.

Balance Studies and Polymeric Glucose Solution to Optimize Therapy After Massive Intestinal Resection

The aim of this study was to determine whether fluid homeostasis could be maintained by using a hypo-osmolar (200 to 221 mosmol/kg), relatively low-sodium (50 to 52 mmol/liter) solution that contained a glucose polymer in a 54-year-old patient with high ileostomy output attributed to short-gut syndrome and resultant prerenal azotemia. Sequential balance studies were performed to assess stool and urinary output, stool fat, and urinary electrolytes initially during intravenous rehydration and subsequently during administration of the necessary fluids and nutrients exclusively by oral supplementation. The additional effects of high-fat and low-fat diet, loperamide hydrochloride, and octreotide acetate were evaluated. When the patient sipped a hypo-osmolar oral rehydration solution while she was awake during the day and received a high dose of loperamide and a 40-g fat, disaccharide-free diet, salt and water homeostasis was maintained. The addition of octreotide did not substantially enhance fluid balance; rather, it increased fecal fat and fluid losses from the small bowel. Thus, hypo-osmolar polymeric glucose solutions maintain fluid homeostasis in patients with the short-gut syndrome. In such patients, simple balance studies are useful for assessing the absorptive capacity of the residual intestine, for developing an optimal individualized treatment, and for eliminating the need for costly, long-term home parenteral nutrition.

Etiology and mechanisms of acute infectious diarrhea in infants in the United States

Infectious diarrhea, caused by a wide variety of viral, bacterial and parasitic pathogens, is a common reason for morbidity and hospitalization for children in the United States. Overall, rotavirus is the most common cause of acute diarrheal disease in infants. Salmonella, Shigella, and Campylobacter are the most frequently isolated bacterial pathogens, and Giardia and Cryptosporidium are the parasites that most commonly produce acute infectious diarrhea. The mechanisms by which these enteropathogens cause diarrhea are highly variable, and include crypt cell proliferation, cellular invasion, elaboration of enterotoxins or cytotoxins, and enteroadhesion. In infants the incidence of diarrheal disease is higher and the severity of the illness is greater than in older children and adults. An increased rate of exposure to enteropathogens, as a result of fecal-oral contamination, may explain some of the increased incidence of diarrhea in infants. However, age-specific differences in host defense mechanisms may also account for the increased susceptibility to and severity of certain enteric infections in infants.

Effect of loperamide on stool output and duration of acute infectious diarrhea in infants

This study was designed to assess the effect of loperamide, given to infants in higher than recommended doses, on the severity and duration of acute diarrhea. Thirty infants with acute diarrhea and dehydration were given loperamide (0.8 mg/kg/day), in addition to standard fluid therapy, for 48 hours after admission to the hospital. The stool output in grams per kilograms of body weight per day and the duration of diarrhea in these infants were compared with those in 30 matched control infants receiving only standard fluid therapy. Two infants given loperamide had to be withdrawn from the trial because ileus developed in one and the other had persistent severe vomiting. In four other infants receiving loperamide, drowsiness developed but resolved rapidly on discontinuation of the drug. Infants receiving loperamide had a shorter duration of diarrhea (median 2.5 vs 6.0 days) and lower daily stool output than the control subjects had. The study confirmed the efficacy of loperamide in reducing the duration and severity of diarrhea but raised doubts regarding its safety in the treatment of young infants.

Antibodies against enterotoxigenic Escherichia coli in the colostrum isolated from infants with diarrhea.

The role of certain types of Escherichia coli in infectious diarrhea in infants and young children is well known. Infants who are breast-fed are less prone to gastroenteritis during their first year of life. Antibodies against three types of fimbrial antigens (adhesions) of enterotoxigenic E. coli (ETEC) in the colostrum were studied. The hemagglutination inhibition test method was used to detect antibodies against ETEC adhesions, i.e. colonization factors, I and II and fimbria type I. The colostrum of mothers on the 1st and 3rd day post partum was standard for the presence of antibodies. The results show that most of the colostrum samples contained antibodies against adhesions of the types of ETEC that we worked with. This study will enhance the knowledge as to why mothers should breast-feed their babies.

B. Dysenteriæ As a Cause of Infectious Diarrhea in Infants

B. Dysenteriæ As a Cause of Infectious Diarrhea in Infants