Lactobacillus Rhamnosus Strain GG Research Articles

Lactobacillus rhamnosus GG-derived extracellular vesicles promote wound healing via miR-21-5p-mediated re-epithelization and angiogenesis

Extracellular vesicles (EVs), especially those derived from stem cells, have emerged as a novel treatment for promoting wound healing in regenerative medicine. However, the clinical application of mammalian cells-derived EVs is hindered by their high cost and low yields. Inspired by the ability of EVs to mediate interkingdom communication, we explored the therapeutic potential of EVs released by the probiotic strain Lactobacillus rhamnosus GG (LGG) in skin wound healing and elucidated the underlying mechanism involved. Using full-thickness skin wound-healing mouse models, we found that LGG-EVs accelerated wound healing procedures, including increased re-epithelialization and promoted angiogenesis. Using in vitro experiments, we further demonstrated that LGG-EVs boosted the proliferation and migration capacities of both epithelial and endothelial cells, as well as promoted endothelial tube formation. miRNA profiling analysis revealed that miR-21-5p was highly enriched in LGG-EVs and LGG-EV treatment significantly increased miR-21-5p level in recipient cells. Mechanically, LGG-EVs induced regulatory effects via miR-21-5p mediated metabolic signaling rewiring. Our results suggest that EVs derived from LGG could serve as a promising candidate for accelerating wound healing and possibly for treating chronic and impaired healing conditions.Graphical abstract

Oral rehydration in diarrhea: from history to current guidelines. A review

Acute gastroenteritis (AGE) is usually defined as a change in stool consistency (liquid or unformed) and/or an increase in the frequency of bowel movements, which can also be accompanied by vomiting and fever. Fever increases the metabolic rate by more than 1.5 times; for every 1°C increase in body temperature, fluid loss increases by 10%. AGE is a common cause of morbidity and mortality among infants and children. The prognosis is favorable if the condition is recognized promptly and appropriate treatment is started. The main goal of AGE therapy is to restore water balance and prevent dehydration, which can be achieved with an oral rehydration solution. The composition and proportion of the components of rehydration agents are described in the guidelines of the European Society for Paediatric Gastroenterology Hepatology and Nutrition, of which the Russian Society of Pediatric Gastroenterologists is a collective member, and such agents are fully consistent with the balanced formulations of RehydroStandard and Rehydron Bio rehydration agents. The latter includes the probiotic strain Lactobacillus rhamnosus GG, well studied and recommended by the European Society for Paediatric Gastroenterology Hepatology and Nutrition for acute intestinal infections since this strain reduces the duration and severity of diarrhea according to the results of studies. Rehydron Bio and RehydroStandard can be recommended for use in clinical pediatric practice.

A Microphysiological System with an Anaerobic Air-Liquid Interface and Functional Mucus Layer for Coculture of Intestinal Bacteria and Primary Human Colonic Epithelium.

Coculture of intestinal bacteria with primary human intestinal epithelium provides a valuable tool for investigating host-colon bacterial interactions and for testing and screening therapeutics. However, most current intestinal model systems lack key physiological features of the in vivo colon, such as both a proper oxygen microenvironment and a mucus layer. In this work, a new in vitro colonic microphysiological system is demonstrated with a cell-derived, functional mucus that closely resembles the in vivo colonic mucosa and apical microenvironment by employing an anaerobic air-liquid interface culture. The human primary colon epithelial cells in this new in vitro system exhibit high cell viability (>98%) with ≈100 μm thick functional mucus layer on average. Successful coculture of model anaerobic gut bacterial strains Lactobacillus rhamnosus GG and Anaerobutyricum hallii without loss in human cell viability demonstrates that this new model can be an invaluable tool for future studies of the impact of commensal and pathogenic bacteria on the colon.

How xylitol, gluten, and lactose change human gut microbiota Escherichia coli and Lactobacillus rhamnosus GG biofilm

The human gut microbiota is composed of many viruses, bacteria, and fungi. Escherichia coli representatives are facultative anaerobic bacteria in the colon that play a crucial role in the metabolism of lactose, vitamin synthesis, and immune system modulation. E. coli forms a biofilm on the epithelial cell surface of the intestine that can be modified by diet compounds, i.e., gluten, xylitol, lactose, and probiotics. In the present study, the impact of probiotic-derived Lactobacillus rhamnosus GG strain on non-pathogenic E. coli biofilm was examined. The mono- and multispecies biofilm was also treated with gluten, xylitol, and lactose. We used 96-well plates to obtain biofilm growth. Biofilm was stained using crystal violet. To evaluate the type of interaction in mono- and multispecies biofilm, a new formula was introduced: biofilm interaction ratio index (BIRI). To describe the impact of nutrients on biofilm formation, the biofilm formation impact ratio (BFIR) was calculated. The biofilms formed by both examined species are stronger than in monocultures. All the BIRI values were above 3.0. It was found that the monospecies biofilm of L. rhamnosus is strongly inhibited by gluten (84.5%) and the monospecies biofilm of E. coli by xylitol (85.5%). The mixed biofilm is inhibited by lactose (78.8%) and gluten (90.6%). The relations between bacteria in the mixed biofilm led to changes in biofilm formation by E. coli and L. rhamnosus GG. Probiotics might be helpful in rebuilding the gut microbiota after broad spectrum antibiotic therapy, but only if gluten and lactose are excluded from diet.

Randomized double-blind, placebo-controlled multicenter phase III study of prevention of irinotecan-induced diarrhea by a probiotic mixture containing Bifidobacterium BB-12®Lactobacillus rhamnosus LGG® in colorectal cancer patients.

The incidence of irinotecan-induced diarrhea varies between 60-90%, by which the incidence of severe diarrhea is 20-40%. The objective of this phase III trial was to determine the effectiveness of the probiotic mixture containing Bifidobacterium, BB-12® and Lactobacillus rhamnosus, LGG® in the prophylaxis of irinotecan-induced diarrhea in metastatic colorectal cancer patients due to a reduction in the activity of intestinal beta-D-glucuronidase. From March 2016 to May 2022, a total of 242 patients with colorectal cancer starting a new line of irinotecan-based therapy were registered to the study in 11 cancer centers in Slovakia. Patients were randomized in a ratio 1:1 to probiotic formula vs. placebo that was administered for 6 weeks. Each capsule of Probio-Tec® BG-Vcap-6.5 contained 2.7x109 colony-forming units (CFU) of 2 lyophilized probiotic strains Bifidobacterium, BB-12® (50%) and Lactobacillus rhamnosus GG, LGG® (50%). Administration of probiotics compared to placebo was not associated with a significant reduction of grade 3/4 diarrhea (placebo arm 11.8% vs. probiotic arm 7.9%, p=0.38). Neither the overall incidence of diarrhea (46.2% vs. 41.2%, p=0.51) nor the incidence of enterocolitis (3.4% vs. 0.9%, p=0.37) was different in the placebo vs. probiotic arm. Subgroup analysis revealed that patients with colostomy had higher incidence of any diarrhea and grade 3/4 diarrhea in the placebo arm compared to the probiotic arm (48.5% vs. 22.2%, p=0.06 and 15.2% vs. 0%, p=0.06, respectively). Moreover, patients on probiotic arm had significantly better diarrhea-free survival (HR = 0.41, 95%CI 0.18 - 0.95, p=0.05) and needed less loperamide (p=0.01) compared to patients on placebo arm. We did not observe any infection caused by probiotic strains used in this study. This study failed to achieve its primary endpoint, and results suggest a lack of benefit of administered probiotic formula for the prevention of irinotecan-induced diarrhea. However, subgroup analysis suggests a possible benefit in patients with colostomy.

Unlocking the Power of Probiotics: A Comprehensive Review on Safeguarding Hospitalised Patients from Clostridium Difficle Infection

Antibiotic-associated diarrhea (AAD) is a commoncomplication of antibiotic therapy, with Clostridiumdifficile infection (CDI) being a major cause of severeAAD. CDI is associated with high morbidity, mortality,and healthcare costs. The administration of probiotics isa promising strategy for the prevention of AAD and CDI,as they can create a favorable gut environment andalter the composition of the intestinal flora. Thissystematic review evaluated the use of probiotics inpreventing CDI in hospitalized adult patients. Thereview of 12 randomized controlled trials involving3,586 patients found that probiotics reduced theincidence of CDI in hospitalized adult patients by up to70%. Specifically, the probiotic strains Lactobacillusrhamnosus GG and Saccharomyces boulardii werefound to be effective in preventing CDI. However,further research is needed to establish optimal dosingregimens and to identify the most effective probioticstrains for CDI prevention. Nonetheless, the use ofprobiotics appears to be a promising strategy forreducing the incidence of CDI in hospitalized adultpatients receiving antibiotics.

Cost-effectiveness of therapeutic infant formulas for cow's milk protein allergy management.

Cow's milk protein allergy (CMPA) is children's most common food allergy. Therapeutic infant formulas for CMPA lead to symptom-free and potentially benefit early tolerance induction and reducing the allergic march in non-breastfed babies. This study assessed the cost-effectiveness of CMPA management with different therapeutic infant formulas in Thailand, which may reflect situations in developing countries throughout Asia. An analytic decision model was developed to simulate the occurrence of eczema, urticaria, asthma, rhinoconjunctivitis, or being symptom-free in infants with CMPA over 36 months. Extensively hydrolyzed casein formula with added probiotic Lacticaseibacillus rhamnosus (previously Lactobacillus rhamnosus) strain GG (EHCF+LGG), extensively hydrolyzed whey formula (EHWF), soy protein-based formula (SPF), and amino acid formula (AAF) were compared from the healthcare payer perspective. The results from a prospective cohort study were used for comparative effectiveness measures, while local experts were interviewed to estimate the healthcare resource used in the management of CMPA. The costs of healthcare resources were obtained from standard, publicly available sources. The direct medical cost of CMPA management was lowest for EHCF+LGG (USD 1,720), followed by SPF (USD 2,090), EHWF (USD 2,791), and AAF (USD 7,881). Compared with other formulas, EHCF+LGG was expected to save USD 370 (SPF), USD 1,071 (EHWF), and USD 6,161 (AAF) in the total cost of CMPA management over 36 months. In conclusion, EHCF+LGG was the most cost-effective strategy for managing non-breastfed infants with CMPA. This strategy was associated with more children developing immune tolerance to cow's milk and being symptom-free, contributing to overall cost-saving potential.

Randomized double-blind, placebo-controlled multicenter phase III study of prevention of irinotecan-induced diarrhea by a probiotic mixture containing Bifidobacterium, BB-12 and Lactobacillus rhamnosus, LGG in colorectal cancer patients: The Probio SK 006-Slovak cooperative oncology group trial.

e24109 Background: The incidence of irinotecan-induced diarrhea varies between 60-90%, by which the incidence of severe diarrhea is 20-40%. The objective of this phase III trial was to determine the effectiveness of the probiotic mixture containing Bifidobacterium, BB-12 and Lactobacillus rhamnosus, LGG in the prophylaxis of irinotecan-induced diarrhea in metastatic colorectal cancer patients due to a reduction in the activity of intestinal beta-D-glucuronidase. Methods: From March 2016 to May 2022, a total of 242 patients with colorectal cancer starting a new line of irinotecan-based therapy were registered to the study in 11 cancer centers in Slovakia. Patients were randomized in a ratio 1:1 to probiotic formula vs. placebo that was administered for 6 weeks. Each capsule of Probio-Tec BG-Vcap-6.5 contained 2.7x109colony-forming units (CFU) of 2 lyophilized probiotic strains Bifidobacterium, BB-12 (50%) and Lactobacillus rhamnosus GG, LGG (50%). Results: Administration of probiotics compared to placebo was not associated with a significant reduction of grade 3/4 diarrhea (placebo arm 11.8% vs. probiotic arm 7.9%, p = 0.38). Neither the overall incidence of diarrhea (46.2% vs. 41.2%, p = 0.51) nor the incidence of enterocolitis (3.4% vs. 0.9%, p = 0.37) was different in the placebo vs. probiotic arm. Subgroup analysis revealed that patients with colostomy had higher incidence of any diarrhea and grade 3/4 diarrhea in the placebo arm compared to the probiotic arm (48.5% vs. 22.2%, p = 0.06 and 15.2% vs. 0%, p = 0.06, respectively). Moreover,patients on probiotic arm had significantly better diarrhea-free survival (HR = 0.41, 95%CI 0.18 – 0.95, p = 0.05) and needed less loperamide (p = 0.01) compared to patients on placebo arm. We did not observe any infection caused by probiotic strains used in this study. Conclusions: This study failed to achieve its primary endpoint, and results suggest a lack of benefit of administered probiotic formula for the prevention of irinotecan-induced diarrhea. However, subgroup analysis suggests a possible benefit in patients with colostomy. Clinical trial information: NCT02819960 .

Advanced "Green" Prebiotic Composite of Bacterial Cellulose/Pullulan Based on Synthetic Biology-Powered Microbial Coculture Strategy.

Bacterial cellulose (BC) is a biopolymer produced by different microorganisms, but in biotechnological practice, Komagataeibacter xylinus is used. The micro- and nanofibrillar structure of BC, which forms many different-sized pores, creates prerequisites for the introduction of other polymers into it, including those synthesized by other microorganisms. The study aims to develop a cocultivation system of BC and prebiotic producers to obtain BC-based composite material with prebiotic activity. In this study, pullulan (PUL) was found to stimulate the growth of the probiotic strain Lactobacillus rhamnosus GG better than the other microbial polysaccharides gellan and xanthan. BC/PUL biocomposite with prebiotic properties was obtained by cocultivation of Komagataeibacter xylinus and Aureobasidium pullulans, BC and PUL producers respectively, on molasses medium. The inclusion of PUL in BC is proved gravimetrically by scanning electron microscopy and by Fourier transformed infrared spectroscopy. Cocultivation demonstrated a composite effect on the aggregation and binding of BC fibers, which led to a significant improvement in mechanical properties. The developed approach for “grafting” of prebiotic activity on BC allows preparation of environmentally friendly composites of better quality.

Gut Bifidobacteria enrichment following oral Lactobacillus-supplementation is associated with clinical improvements in children with cystic fibrosis

BackgroundRelationships between gut microbiomes and airway immunity have been established in murine and human studies of allergy and asthma. Early life Lactobacillus supplementation alters the composition and metabolic productivity of the gut microbiome. However, little is known of how Lactobacillus supplementation impacts the gut microbiota in children with cystic fibrosis (CF) and whether specific microbiota states that arise following gut microbiome manipulation relate to pulmonary outcomes.MethodsStool samples were collected from CF patients enrolled in a multi-center, double-blind, randomized placebo-controlled trial of daily Lactobacillus rhamnosus strain GG (LGG) probiotic supplementation over a 12-month period. Fecal 16S rRNA biomarker sequencing was used to profile fecal bacterial microbiota and analyses were performed in QiiME.ResultsBifidobacteria-dominated fecal microbiota were more likely to arise in LGG-treated children with CF (P = 0.04). Children with Bifidobacteria-dominated gut microbiota had a reduced rate of pulmonary exacerbations (IRR = 0.55; 95% CI 0.25 to 0.82; P = 0.01), improved pulmonary function (+ 20.00% of predicted value FEV1; 95% CI 8.05 to 31.92; P = 0.001), lower intestinal inflammation (Calprotectin; Coef = − 16.53 μg g−1 feces; 95% CI − 26.80 to − 6.26; P = 0.002) and required fewer antibiotics (IRR = 0.43; 95% CI 0.22 to 0.69; P = 0.04) compared to children with Bacteroides-dominated microbiota who were less likely to have received LGG.ConclusionsThe majority of pediatric CF patients in this study possessed a Bacteroides- or Bifidobacteria-dominated gut microbiota. Bifidobacteria-dominated gut microbiota were more likely to be associated with LGG-supplementation and with better clinical outcomes.

Optimization of cultural conditions for enhancement of anti-quorum sensing potential in the probiotic strain Lactobacillus rhamnosus GG against Pseudomonas aeruginosa.

The online version contains supplementary material available at 10.1007/s13205-022-03187-2.

In vitro evaluation of probiotic properties and antioxidant activities of Bifidobacterium strains from infant feces in the Uyghur population of northwestern China

PurposeBifidobacterium is an important probiotic used in food and medicine production. The probiotic properties of bifidobacteria are strain specific, so it is necessary to evaluate the probiotic properties of bifidobacteria isolated from specific populations, especially when developing products suitable for specific populations. The objective of this study was to evaluate the probiotic potential and safety of bifidobacteria isolated from healthy Uyghur infants from northwestern China.MethodsIn this study, antimicrobial activity, antibiotic sensitivity, hemolytic, acid and bile tolerance, hydrophobicity, co-aggregation, auto-aggregation, and antioxidant activity were evaluated.ResultsBased on antagonistic activity spectrum against seven intestinal pathogenic bacteria, 14 excellent strains were initially selected. Among 14 strains, four bifidobacteria strains (BF17-4, BF52-1, BF87-3, and BF88-5) were superior to strain Lactobacillus rhamnosus GG in cell surface hydrophobicity and auto-aggregation percentages and close to strain GG in co-aggregation with Escherichia coli EPEC O127: K63 (CICC 10411). The antioxidant activities of each of the 14 bifidobacteria strains varied with the cell components. Most of the strains were sensitive to all the antimicrobials tested, except kanamycin and amikacin.ConclusionBF17-4 and BF52-1 are good candidates for further in vivo studies and further used in functional foods.

Colonization of Lactobacillus rhamnosus GG in Cirrhinus molitorella (Mud Carp) Fingerling: Evidence for Improving Disease Resistance and Growth Performance

The use of probiotic bacteria can not only enhance the nutritional utilization of fish feeds to produce more biomass but can also provide a practically “safer” alternative to the fish farming industry to reduce the abuse of antibiotics and drugs. This study investigated the possibility of colonizing Lactobacillus rhamnosus strain GG (LGG) to the intestine of Cirrhinus molitorella (mud carp) fingerling. Colonization of LGG was observed in gut tissue after 14 days of administration with a diet supplemented with 1 × 108 CFU/mL LGG. Moreover, growth performance parameters of the LGG-supplemented diet group, including relative weight gain, feed conversion ratio and feed efficiency, were found about two-fold higher than the control group after 60 days. In addition, fish fed with an LGG-supplemented diet for 60 days showed substantial resistance against the infection of pathogenic bacterial Aeromonas hydrophila, with a relative survival rate of up to 57% compared to the control group. In summary, the results indicated that LGG as dietary supplement for mud carp fingerling can enhance nutrition utilization and better protect fish against the infection of Aeromonas hydrophila. The results provide an insight to the fish farming industry, encouraging a reduction in the use of antibiotics and drugs and the production of “safer” mud carp for the market at a manageable cost.

The role of yogurt enriched with LGG culture (Lactobacillus rhamnosus GG) in dental caries prevention

Introduction/Objective. Contemporary tendencies suggest that probiotics can significantly reduce the prevalence of caries in children, so it can be considered that they have a positive effect on general and oral health. Lactobacillus rhamnosus GG (LGG) is a probiotic culture of particular importance in preventive dentistry. The aim was to assess the effects of consumption of probiotic strain Lactobacillus rhamnosus GG on the dental plaque accumulation in children with mixed dentition. Methods. Research included 90 children with mixed dentition (5?12 years old). The first study group consumed 200 ml of Lactobacillus rhamnosus GG-enriched yogurt (B-Activ LGG, Dukat) daily for a period of 14 days, while the remaining 30 formed the second study group who consumed 200 ml of yogurt (Jogurt 1.5% milk fat, Imlek) with manually added powder from probiotic capsule (Wayaforte LGG capsule, Medis) daily for 14 days. The control group consisted of 30 children who had regular diet during examination period. Silness?Loe plaque index and saliva pH (pH-Fix-0-14, Macherey-Nagel) were determined at baseline and also upon intervention completion. Results. An increase in pH values was observed in both study groups. In general sample, there is a significant decrease of mean plaque index values (p < 0.001). Both study groups had significant decrease of mean plaque index values on the baseline and after 14 days consumption of yogurt. In the control group the number of subjects with decrease plaque index values did not correlate and no association was found. Conclusion. Consistent consumption of LGG culture-enriched yogurt inhibits dental film accumulation and promotes saliva pH increase in children with mixed dentition.

Development of Herbal Bio-yoghurt Powder using Freeze Drying Technology

A study was undertaken to produce freeze-dried herbal bio-yoghurt with Lactobacillus delbrueckii subsp. bulgaricus, Streptococcus thermophilus, and an additional probiotic strain Lactobacillus rhamnosus GG. Aqueous extract of licorice (Glycyrrhiza glabra) at different concentration levels (0.5, 1.0, 1.5, 2.0, 2.5%) was incorporated into the yoghurt, to study the effect of licorice as a prebiotic in promoting the growth of yoghurt starters and Lactobacillus rhamnosus GG. The incorporation of licorice extract at different levels positively affected the total viable count of the bio-yoghurt. Antioxidant properties of the herbal bio-yoghurt were analysed and it ranged between 39.26±0.02 and 68.13±0.04% when compared to control yoghurt (22.08±0.03%). The optimum level of incorporation of licorice extract was standardized based on the physico-chemical, functional, and viability of microbes. Among the five different levels of incorporation of herbal extract, 2% level was ideal based on the sensory and physicochemical parameters for the preparation of herbal bio-yoghurt. On freezedrying the herbal bio-yoghurt with trehalose and lactose as cryoprotectants, trehalose showed more promising results in protecting the viability of microbes during freeze-drying when compared to lactose, and there was no significant difference between two cryoprotectants and control concerning acidity, pH, moisture and ash of the freeze-dried herbal bio-yoghurt.

P.0634 A pilot randomized control trial with the probiotic strain Lactobacillus rhamnosus GG (LGG) in children and adolescents with ADHD

P.0634 A pilot randomized control trial with the probiotic strain Lactobacillus rhamnosus GG (LGG) in children and adolescents with ADHD

Isolation and identification of cholesterol-degrading intestinal bacteria by culturomics and evaluation of their functions

High cholesterol is one of the important factors inducing cardiovascular and cerebrovascular diseases. Drug therapy is the main method for reducing cholesterol, but has the disadvantages such as high cost and side effects. Studies have shown that intestinal bacteria play important roles in cholesterol metabolism. However, there are few reports on the screening and functional evaluation of cholesterol-lowering intestinal bacteria. In this study, 36 bile-tolerant bacteria were screened from healthy people stool through culturomics using bovine bile acid or artificial mixed bile acids as substrates. Taking Lactobacillus rhamnosus GG (LGG) as a positive control, three bile acid concentration groups (0 g/L, 0.3 g/L, 3 g/L) were set up to evaluate the cholesterol-lowering ability of bile-tolerant bacteria in vitro. Ten bacteria (including Proteus mirabilis, Providencia stuartii, Proteus vulgaris et al) were identified as the dominant cholesterol-lowering bacteria. Six of the above bacteria, Proteus mirabilis, Providencia stuartii, Proteus vulgaris, Proteus penneri, Wohlfahrtiimonas chitiniclastica, Providencia rettger, were evaluated for their ability to reduce triglycerides in vitro and tolerance to artificial gastric juice. Comparing with strain LGG, the six bacteria showed better triglyceride-lowering ability in vitro. With the decrease of pH value of artificial gastric juice and the increase of treatment time, the survival rate of six bacteria decreased. The above screening experiments and functional evaluation provide a basis for further development of potential cholesterol-lowering bacterial products.

Fermented Cranberry Fortified Buckwheat Product—Phenolic Composition, Antioxidant and Microbiological Properties

This study determined the effect of fermentation by Fresco DVS 1010 starter culture with added probiotic strain Lactobacillus rhamnosus GG and potentially probiotic isolate Lactobacillus plantarum HM1, at fermentation times (0, 8 h) and cold storage period (24 h, 4th day, 7th day, 14th day), on microbial parameters, pH changes, total phenolic content, phenolic compounds profile, and antioxidant activity of buckwheat water- and milk-based mashes, flavored with cranberries and unflavored. The tested starter Fresco culture effectively fermented the buckwheat products and the viable cell counts of potentially probiotic bacteria were sufficient to demonstrate the health-promoting properties of final products. Lactic acid bacteria had a positive impact on total phenolic compound content, total flavonoid content, and antioxidant activity of buckwheat mashes, whereby final values (14 days) were higher by about 16.9–130.8%, 13.4–37.7%, and 14.5–145.9%, respectively, in comparison to initial values (0 h). Seven phenolic acids (gallic, protocatechuic, vanillic, syringic, caffeic, p-coumaric, and ferulic) and two flavonoids (rutin and quercetin) in buckwheat mashes were measured during the experimental period. The content of quercetin, gallic, and protocatechuic acids increased and, conversely, p-coumaric acid decreased, in all products. Prepared buckwheat fermented products have the potential to meet the criteria for potentially functional foods.

Використання розчину для оральної регідратації (оральної регідратаційної солі) з додаванням пробіотичного штаму для лікування дітей із гострою інфекційною патологією

Актуальність. На тлі гострої інфекційної патології в дітей існує ймовірність розвитку дегідратації, для ліквідації якої можливо використовувати розчини для оральної регідратації (оральна регідратаційна сіль — ОРС). При призначенні антибактеріальної терапії в 11–40 % дітей спостерігається антибіотик-асоційована діарея (ААД). Для профілактики розвитку ААД рекомендують застосовувати пробіотичні препарати. Мета: вивчити ефективність та переносимість розчину для оральної регідратації (Регідрон Біо) для підтримання водно-електролітного балансу та запобігання дисбіотичним порушенням у дітей із гострими інфекційними захворюваннями. Матеріали та методи. Було проведено спостереження за 60 дітьми віком від 3 до 14 років, які перебували на стаціонарному лікуванні на клінічній базі кафедри дитячих інфекційних хвороб НМУ ім. О.О. Богомольця й отримували антибактеріальну терапію. Основну групу становили 30 дітей, яким у комплексній терапії призначався розчин ОРС Регідрон Біо. Групу порівняння становили 30 дітей, які отримували стандартну терапію й компенсація втрат рідини яким проводилась традиційними засобами (чай, питна вода тощо). Результати. Серед симптомів зневоднення найчастіше виявлялись спрага та сухість слизових оболонок, які були присутні в 40–63 % хворих при надходженні до стаціонару. Відновлення водно-електролітного балансу за рахунок введення води та основних мінеральних речовин забезпечує швидке зникнення симптомів дегідратації. Діарея на тлі застосування антибактеріальної терапії спостерігалась у 10,0 % хворих, додаткове введення пробіотичного штаму Lactobacillus rhamnosus GG запобігало розвитку цього ускладнення. Висновки. Застосування оральної регідратаційної терапії препаратом ОРС Регідрон Біо є ефективним засобом корекції водно-електролітних порушень при гострих інфекційних захворюваннях у дітей. Наявність у складі ОРС Регідрон Біо пробіотичного штаму Lactobacillus rhamnosus GG дозволяє застосовувати його для профілактики ААД у дітей, які отримують антибіотики при інфекційних діареях.

Пробиотическая терапия антибиотик-ассоциированной диареи у детей

Антибиотик-ассоциированная диарея (AAД) считается одним из самых распространенных осложнений антибиотикотерапии на амбулаторном и госпитальном этапах лечения у детей. Ведущими факторами риска развития AAД являются нарушение колонизационной резистентности кишечного микробиома или непосредственное раздражение антибиотиками (АБ) слизистой оболочки желудочно-кишечного тракта. Тяжелые формы AAД, известные как псевдомембранозный колит, ассоциированы с инфицированием Clostridium difficile, который является одним из лидеров в структуре нозокомиальных и внегоспитальных инфекций и характеризуется значительной резистентностью к медикаментозному лечению. Исследованы альтернативные стратегии лечения, а именно рассмотрены возможности адъювантной пробиотической терапии, которая может способствовать нормализации нарушенного вследствие воздействия АБ баланса индигенной микробиоты и быть целесообразной в профилактике развития и лечении AAД и Clostridium difficile-инфекции (CDI). Проведен обзор литературы по оценке клинической эффективности профилактики и лечения AAД и CDI пробиотическими препаратами и определенными пробиотическими штаммами. Поиск литературы осуществлялся с помощью электронных баз данных (Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health, CyberLeninka, РИНЦ). Представлена общая характеристика пробиотических препаратов, рассмотрены механизмы действия пробиотиков и проанализированы основные эффекты влияния пробиотических штаммов. Систематизированы и проанализированы данные рандомизированных контролируемых исследований, представлены доказательства эффективности профилактики и лечения AAД и CDI с помощью пробиотических препаратов. Проанализированы штамм-специфические эффекты пробиотиков в профилактике и лечении AAД и CDI у детей. Рассмотрены индивидуальные свойства пробиотического штамма Lactobacillus rhamnosus GG. Представлена сравнительная характеристика доказательной базы целесообразности применения пробиотиков в определенных клинических ситуациях. Даны рекомендации по оценке возможности применения пробиотических штаммов и выбора конкретного штамма пробиотика для профилактики и лечения AAД и CDI у детей, получающих антибиотики.