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Nandha MC, Shukla RM. Exploration of probiotic attributes in lactic acid bacteria isolated from fermented Theobroma cacao L. fruit using in vitro techniques. Front Microbiol 2023; 14:1274636. [PMID: 37808281 PMCID: PMC10552159 DOI: 10.3389/fmicb.2023.1274636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
Probiotics are known for their health-promoting properties and are recognized as beneficial microorganisms. The current investigation delves into the isolation and comprehensive in vitro characterization of lactic acid bacteria (LAB) obtained from the Indian-origin Theobroma cacao L. Forastero variety to assess their potential as probiotic candidates. Eleven LAB isolates were obtained, and among them, five exhibited classical LAB traits. These five isolates underwent rigorous in vitro characterization to evaluate their suitability as probiotics. The assessments included resilience against acid and bile salts, which are crucial for probiotic viability. Additionally, the isolates were subjected to simulated gastric and pancreatic fluids and lysozyme exposure to assess their survival rates. Auto- aggregation, co-aggregation, hydrophobicity, and exopolysaccharide production were also examined. The inhibitory potential of α-glucosidase, an enzyme related to glucose metabolism, was measured, and antioxidant activity was evaluated using DPPH and ABTS assays. A safety assessment was conducted to confirm the non-pathogenic nature of the isolates. Among the five isolates, CR2 emerged as a standout candidate with maximal bile salt hydrolase activity, phenol resistance, and lysozyme resistance. CR2 and CYF3 exhibited notable survival rates under simulated conditions. The isolates displayed variable degrees of auto-aggregation, co-aggregation, and hydrophobicity. CR2 exhibited the highest exopolysaccharide production (0.66 mg/mL), suggesting diverse applications in the food industry. CR2 also demonstrated the highest inhibition rate against α-glucosidase (56.55%) and substantial antioxidant activity (79.62% DPPH, 83.45% ABTS). Safety assessment confirmed the non- pathogenic nature of the isolates. Molecular characterization identified CR2 as Lactococcus lactis subsp. lactis and CYF3 as Limnosilactobacillus fermentum. Both strains exhibited commendable probiotic and technological attributes, positioning them as promising candidates for functional foods and beyond. This study provides valuable insights into the in vitro characterization of LAB isolated from Indian Theobroma cacao L., highlighting their potential as probiotic candidates with advantageous traits, including survival in hostile conditions, beneficial enzymatic activities, bioactivity, and other essential attributes.
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Affiliation(s)
- Mausamy C. Nandha
- Department of Microbiology and Biotechnology, School of Science, Gujarat University, Ahmedabad, India
| | - Rachana M. Shukla
- Department of Microbiology, Gandhinagar Institute of Technology, Gandhinagar, India
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The Effect of Essential Oils on the Survival of Bifidobacterium in In Vitro Conditions and in Fermented Cream. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Essential oils derived from plant materials are a mixture of compounds that exhibit antibacterial properties. Due to their distinct aroma, they also serve as a desirable natural additive for various food products, including dairy products. In this study, the essential oils of lemon peels, clove buds, and juniper berries were obtained by steam distillation and characterized using gas chromatography–mass spectrometry to determine their chemical compositions and effects on the viability of seven Bifidobacterium strains. Furthermore, the effect of essential oils on the viability of Bifidobacterium animalis subsp. lactis Bb-12 was investigated in cream samples during fermentation and after storage for 21 days at 6 °C. The fatty acid composition of fat extracted from essential oils containing sour cream samples and the volatile aroma compound profile of the sour cream samples were also determined chromatographically. Among the 120 compounds identified, monoterpene hydrocarbons were dominant in the essential oils of lemon peels (limonene and γ-terpinene) and juniper berries (sabinene and β-myrcene), while eugenol and eugenol acetate were abundant in the essential oil of clove buds. In addition to these compounds, butanoic and acetic acids were found in the tested sour cream samples. In turn, fat extracted from these samples was rich in saturated fatty acids, mainly palmitic acid. Among the tested strains of the genus Bifidobacterium, B. animalis subsp. lactis Bb-12 was the most sensitive to the essential oils of clove and juniper, as indicated by the larger growth inhibition zones. However, both the concentration and type of essential oils used had no effect on the number of cells of this strain present in the cream samples immediately after fermentation and after its 21-day storage, which suggests that the tested essential oils could be a natural additive to dairy products.
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Somashekaraiah R, Mottawea W, Gunduraj A, Joshi U, Hammami R, Sreenivasa MY. Probiotic and Antifungal Attributes of Levilactobacillus brevis MYSN105, Isolated From an Indian Traditional Fermented Food Pozha. Front Microbiol 2021; 12:696267. [PMID: 34290687 PMCID: PMC8287902 DOI: 10.3389/fmicb.2021.696267] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
The use of probiotics and antifungal capabilities of the lactic acid bacteria (LAB) isolated from different niches is a strategy to prepare functional cultures and biopreservatives for food/feed industries. In the present study, LAB strains isolated from an Indian traditional fermented food, Pozha, were evaluated for their probiotic properties and biocontrol potential. A total of 20 LAB isolates were selected from Pozha samples collected aseptically and screened for their antagonistic activity against Fusarium verticillioides. Among the bioactive isolates, Lacticaseibacillus brevis MYSN105 showed the highest antifungal activity in vitro, causing some morphological alterations such as damaged mycelia and deformed conidia. Cell-free supernatant (CFS) from L. brevis MYSN105 at 16% concentration effectively reduced the mycelial biomass to 0.369 g compared to 1.938 g in control. Likewise, the conidial germination was inhibited to 20.12%, and the seed treatment using CFS induced a reduction of spore count to 4.1 × 106 spores/ml compared to 1.1 × 109 spores/ml for untreated seeds. The internal transcribed spacer (ITS) copy number of F. verticillioides decreased to 5.73 × 107 and 9.026 × 107 by L. brevis MYSN105 and CFS treatment, respectively, compared to 8.94 × 1010 in control. The L. brevis MYSN105 showed high tolerance to in vitro gastrointestinal conditions and exhibited high adhesive abilities to intestinal epithelial cell lines. The comparative genome analysis demonstrated specific secondary metabolite region coding for bacteriocin and T3PKS (type III polyketide synthase) possibly related to survival and antimicrobial activity in the gut environment. Our results suggest that L. brevis MYSN105 has promising probiotic features and could be potentially used for developing biological control formulations to minimize F. verticillioides contamination and improve food safety measures.
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Affiliation(s)
| | - Walid Mottawea
- Department of Microbiology and Immunology, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt.,School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Adithi Gunduraj
- Departmen of Studies in Microbiology, University of Mysore, Mysuru, India
| | - Udit Joshi
- Departmen of Studies in Microbiology, University of Mysore, Mysuru, India
| | - Riadh Hammami
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - M Y Sreenivasa
- Departmen of Studies in Microbiology, University of Mysore, Mysuru, India
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Abstract
In recent years, the intestinal microbiota has been found to greatly influence a number of biological processes important for human health and longevity. Microbial composition changes easily in response to external factors, such as an unbalanced diet, lack of physical activity, and smoking. Probiotics are a key factor in maintaining the optimal composition of the intestinal microbiota. However, a number of important questions related to probiotics, such as indication for prescription, comparative efficacy of monostrain and multistrain probiotics, methods of delivery, and shelf life, remain unresolved. The aim of this review is to highlight existing issues regarding probiotic production and their prescription. The review presents the most recent findings regarding advantages and efficacy of monostrain and multistrain probiotics, preservation of probiotic strains in capsules and microcapsules, production of probiotics in the form of biofilms for improved efficacy and survival, and results of clinical studies evaluating the benefits of probiotics against different pathologies. We believe that this work will be of interest to physicians and researchers alike and will promote the development of new probiotics and ensuing regimens aimed at the treatment of various diseases.
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Research on the Effect of Pediococcus pentosaceus on Salmonella enteritidis-Infected Chicken. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6416451. [PMID: 33102586 PMCID: PMC7576369 DOI: 10.1155/2020/6416451] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/28/2020] [Indexed: 12/19/2022]
Abstract
Salmonella enteritidis can cause significant morbidity and mortality in humans and economic loss in the animal industry. Improving the innate immunity is an effective method to prevent S. enteritidis infection. Pediococcus pentosaceus is a Gram-positive coccus which had probiotics properties. Numerous previously published studies reported that probiotics were beneficial to gut microbiota by changing the intestinal flora structure and inhibiting the harmful microbial growth to enhance the innate immunity. We investigated the immunological effects of P. pentosaceus on Salmonella-infected chickens by the following experiment. A total of 120 broilers from AA line were fed and divided into 2 groups (treated and control groups) for the experiment from day 1. The control group was fed with the basic diet, while the treated group was fed with the basic diet adding P. pentosaceus microcapsule with the bacterial concentration of 1 g/kg in the feed and bacterial counts 2.5 × 109 CFU/g. All the birds were given with 0.5 ml of S. enteritidis bacterial suspension (109 CFU/ml) through oral cavity at day 9. The number of dead birds was recorded and used in the analysis. The bacterial culture method and quantitative real-time PCR analysis were used to evaluate the effects of P. pentosaceus on chickens infected with S. enteritidis and to ascertain the mechanism of the effect. The results showed that the P. pentosaceus could restrain the pathogenicity of S. enteritidis and reduce the death rate from 44.4% to 23.3%. The flora in the caecum exhibited “rising-declining” trends, and the gene (TLR4, MyD88, TRAF6 NF-κB, IFN-β, TNF-a, IL6, and IL8) expression pattern was different between the experimental and control group. P. pentosaceus as a probiotic may competitively inhibit the growth of S. enteritidis and control the inflammatory response through regulating the gene expression which involved in the toll-like receptor pathway and inflammation pathway.
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Abstract
Antibiotic growth promoters (AGPs) have been used for many years as supplements in various livestock diets, including those for poultry. However, the use of AGPs in feed was also associated with an increasing number of antibiotic-resistant bacteria in livestock. In this study, the in vitro antibacterial efficacies of eight commercially available non-AGPs suitable for use in poultry were investigated. Assessments included a combination of antibacterial activity assays and estimations of the minimal inhibitory and bactericidal concentrations along with scanning electron microscopy analysis. The results showed that the probiotic, CloStat® exerted a bacteriostatic effect against all tested bacteria, namely Salmonella Typhimurium, Escherichia coli, Staphylococcus aureus, and Clostridium perfringens, whereas Gallipro Tect® and Bacillus Blend® demonstrated bacteriostatic activity towards most of the pathogens tested. Other commercial non-AGPs, Sangrovit®, Fysal®, and Mix oil blend® showed a stronger or equal antibacterial activity compared to the positive control (AGP Maxus® G100) againsts all bacteria tested, except C. perfringens. Nor-Spice AB® and Varium™ did not show any significant effect against the tested bacteria. Several of the tested AGP substitutes exhibited good antibacterial efficiency against pathogenic bacteria and thus may be good candidates for second-stage in vivo investigations into reducing pathogen colonization in broilers.
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Cutting Edge: Probiotics and Fecal Microbiota Transplantation in Immunomodulation. J Immunol Res 2019; 2019:1603758. [PMID: 31143780 PMCID: PMC6501133 DOI: 10.1155/2019/1603758] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 04/01/2019] [Indexed: 12/19/2022] Open
Abstract
Probiotics are commensal or nonpathogenic microbes that confer beneficial effects on the host through several mechanisms such as competitive exclusion, antibacterial effects, and modulation of immune responses. Some probiotics have been found to regulate immune responses via immune regulatory mechanisms. T regulatory (Treg) cells, T helper cell balances, dendritic cells, macrophages, B cells, and natural killer (NK) cells can be considered as the most determinant dysregulated mediators in immunomodulatory status. Recently, fecal microbiota transplantation (FMT) has been defined as the transfer of distal gut microbial communities from a healthy individual to a patient's intestinal tract to cure some immune disorders (mainly inflammatory bowel diseases). The aim of this review was followed through the recent literature survey on immunomodulatory effects and mechanisms of probiotics and FMT and also efficacy and safety of probiotics and FMT in clinical trials and applications.
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Singhal N, Singh NS, Mohanty S, Singh P, Virdi JS. Evaluation of Probiotic Characteristics of Lactic Acid Bacteria Isolated from Two Commercial Preparations Available in Indian Market. Indian J Microbiol 2019; 59:112-115. [PMID: 30728640 DOI: 10.1007/s12088-018-0762-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 09/21/2018] [Indexed: 11/30/2022] Open
Abstract
The enormous health benefits associated with probiotics has resulted in an increased consumption of probiotic supplements. Several factors like regular sub-culturing, storage, unfavourable conditions etc. might compromise the efficacy and/or safety of lactic acid bacteria which are the major components of many probiotic preparations available in the market. The present study evaluated the probiotic characteristics and safety of probiotic bacteria isolated from two preparations available commercially in India. The products did not specify the genera, species or strains of the bacteria used. These were cultured using standard microbiological methods for cultivation of lactic acid bacteria. Bacteria were identified by PCR amplification and sequence analysis of 16S rRNA gene. Microbiological and molecular analyses revealed that both preparations contained homogenous population of Enterococcus faecium and Pediococcus acidilactici respectively. Assessment for several essential and desirable probiotic properties revealed that both the probiotic strains were safe and resistant to salt, lysozyme, bile salt and common antibiotics. The probiotic preparation containing P. acidilactici was better than that containing E. faecium as it survived in low pH and showed bile salt hydrolase activity. The probiotic preparation containing P. acidilactici also exhibited cholesterol-lowering activity.
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Affiliation(s)
- Neelja Singhal
- Department of Microbiology, University of Delhi South Campus, New Delhi, India
| | | | - Shilpa Mohanty
- Department of Microbiology, University of Delhi South Campus, New Delhi, India
| | - Pooja Singh
- Department of Microbiology, University of Delhi South Campus, New Delhi, India
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Yun B, Song M, Park DJ, Oh S. Beneficial Effect of Bifidobacterium longum ATCC 15707 on Survival Rate of Clostridium difficile Infection in Mice. Korean J Food Sci Anim Resour 2017; 37:368-375. [PMID: 28747822 PMCID: PMC5516063 DOI: 10.5851/kosfa.2017.37.3.368] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 04/29/2017] [Accepted: 05/08/2017] [Indexed: 12/28/2022] Open
Abstract
Clostridium difficile infection (CDI) is the main cause of hospital-acquired diarrhea that can cause colitis or even death. The medical-treatment cost and deaths caused by CDI are increasing annually worldwide. New approaches for prevention and treatment of these infections are needed, such as the use of probiotics. Probiotics, including Bifidobacterium spp. and Lactobacillus, are microorganisms that confer a health benefit to the host when administered in adequate amounts. The effect of Bifidobacterium longum ATCC 15707 on infectious disease caused by C. difficile 027 was investigated in a mouse model. The survival rates for mice given the pathogen alone, and with live cells, or dead cells of B. longum were 40, 70, and 60%, respectively. In addition, the intestinal tissues of the B. longum-treated group maintained structural integrity with some degree of damage. These findings suggested that B. longum ATCC 15707 has a function in repressing the infectious disease caused by C. difficile 027.
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Affiliation(s)
- Bohyun Yun
- Microbial Safety Team, Agro-Food Safety & Crop Protection Department, National Institute of Agricultural Sciences, Rural Development Administration, Wanju 55365, Korea
| | - Minyu Song
- Animal Products Research and Development Division, National Institute of Animal Science, RDA, Wanju 55365, Korea
| | | | - Sejong Oh
- Division of Animal Science, Chonnam National University, Gwangju 61186, Korea
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Yadav R, Puniya AK, Shukla P. Probiotic Properties of Lactobacillus plantarum RYPR1 from an Indigenous Fermented Beverage Raabadi. Front Microbiol 2016; 7:1683. [PMID: 27818658 PMCID: PMC5073146 DOI: 10.3389/fmicb.2016.01683] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 10/07/2016] [Indexed: 12/12/2022] Open
Abstract
Present study documents the potential probiotic Lactobacillus isolated from indigenous fermented beverage Raabadi, consumed during summers in Haryana and Rajasthan regions of India. A total of five Raabadi samples were collected aseptically and 54 isolates were purified using MRS medium. All the isolates were assessed for tolerance to low pH and bile salts. It was observed that out of 54 only 24 isolates could survive the simulated gastric conditions. These isolates were further evaluated in vitro for cell surface hydrophobicity, cell surface hydrophobicity, hypocholesteramic activity, anti-oxidative potential, BSH activity, antagonistic activity, and antibiotic resistance profile. In addition, the confirmation of phenol resistance was also done. On the basis of results obtained, the survival rate of isolates was noted and six isolates were finally selected for further studies. Among them Lactobacillus plantarum RYPR1 and RYPC7 showed good survival at pH 2 which shows good acid tolerance. Moreover, L. plantarum RYPR1 showed the highest hydrophobicity (79.13%) and represented the deconjugation of bile salts, which help in their adhesion to epithelial cells and colonization. Furthermore, RYPR1 also exhibited highest cholesterol reduction (59%) and subsequent analysis of results revealed that the above mentioned isolates further exhibit a good hypocholesterolemic effect and could be possibly used to prevent hypercholesterolemia. The present study divulges that L. plantarum RYPR1 has an excellent probiotic potential.
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Affiliation(s)
- Ruby Yadav
- Enzyme Technology and Protein Bioinformatics Laboratory, Department of Microbiology, Maharshi Dayanand University Rohtak, India
| | - Anil K Puniya
- Division of Dairy Microbiology, ICAR-National Dairy Research InstituteKarnal, India; College of Dairy Science and Technology, Guru Angad Dev Veterinary and Animal Sciences UniversityLudhiana, India
| | - Pratyoosh Shukla
- Enzyme Technology and Protein Bioinformatics Laboratory, Department of Microbiology, Maharshi Dayanand University Rohtak, India
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Yang G, Liu ZQ, Yang PC. Treatment of allergic rhinitis with probiotics: an alternative approach. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2014; 5:465-8. [PMID: 24083221 PMCID: PMC3784923 DOI: 10.4103/1947-2714.117299] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Allergic rhinitis is a skewed immune reaction to common antigens in the nasal mucosa; current therapy is not satisfactory and can cause a variety of complications. In recent decades, the incidence of allergic rhinitis is increasing every year. Published studies indicate that probiotics are beneficial in treating allergic rhinitis. This review aims to help in understanding the role of probiotics in the treatment of allergic rhinitis. We referred to the PubMed database as data source. This review focuses on the following aspects: The types of probiotics using in the treatment of allergic rhinitis, approaches of administration, its safety, mechanisms of action, treating results, and the perspectives to improve effectiveness of probiotics in the treatment of allergic rhinitis. This review reports the recent findings regarding the role of probiotics in the treatment of allergic rhinitis. Probiotics are a useful therapeutic remedy in the treatment of allergic rhinitis, but its underlying mechanisms remain to be further investigated.
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Affiliation(s)
- Gui Yang
- Shenzhen ENT Hospital, Shenzhen ENT Institute, Longgang Central Hospital, Shenzhen, China
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Health benefits of probiotics: are mixtures more effective than single strains? Eur J Nutr 2011; 50:1-17. [PMID: 21229254 DOI: 10.1007/s00394-010-0166-z] [Citation(s) in RCA: 280] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Accepted: 12/28/2010] [Indexed: 12/15/2022]
Abstract
PURPOSE Most studies on probiotics utilise single strains, sometimes incorporated into yoghurts. There are fewer studies on efficacy of mixtures of probiotic strains. This review examines the evidence that (a) probiotic mixtures are beneficial for a range of health-related outcomes and (b) mixtures are more or less effective than their component strains administered separately. RESULTS Mixtures of probiotics had beneficial effects on the end points including irritable bowel syndrome and gut function, diarrhoea, atopic disease, immune function and respiratory tract infections, gut microbiota modulation, inflammatory bowel disease and treatment of Helicobacter pylori infection. However, only 16 studies compared the effect of a mixture with that of its component strains separately, although in 12 cases (75%), the mixture was more effective. CONCLUSION Probiotic mixtures appear to be effective against a wide range of end points. Based on a limited number of studies, multi-strain probiotics appear to show greater efficacy than single strains, including strains that are components of the mixtures themselves. However, whether this is due to synergistic interactions between strains or a consequence of the higher probiotic dose used in some studies is at present unclear.
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Knight DJW, Gardiner D, Banks A, Snape SE, Weston VC, Bengmark S, Girling KJ. Effect of synbiotic therapy on the incidence of ventilator associated pneumonia in critically ill patients: a randomised, double-blind, placebo-controlled trial. Intensive Care Med 2008; 35:854-61. [PMID: 19083199 DOI: 10.1007/s00134-008-1368-1] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2007] [Accepted: 10/28/2008] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the effect of enteral Synbiotic 2000 FORTE (a mixture of lactic acid bacteria and fibre) on the incidence of ventilator associated pneumonia (VAP) in critically ill patients. DESIGN Prospective, randomised, double blind, placebo controlled trial. SETTING Tertiary referral centre, general Adult Intensive Care Unit (ICU). PATIENTS AND PARTICIPANTS 259 enterally fed patients requiring mechanical ventilation for 48 h or more were enrolled. INTERVENTION All patients were enterally fed as per a standard protocol and randomly assigned to receive either synbiotic 2000 FORTE (twice a day) or a cellulose-based placebo for a maximum of 28 days. MEASUREMENTS AND RESULTS Treatment group (n = 130) was well matched with placebo group (n = 129) for age (mean 49.5 and 50 years, respectively) and APACHE II score (median 17 for both). Oropharyngeal microbial flora and colonisation rates were unaffected by synbiotics. The overall incidence of VAP was lower than anticipated (11.2%) and no statistical difference was demonstrated between groups receiving synbiotic and placebo in the incidence of VAP (9 and 13%, P = 0.42), VAP rate per 1,000 ventilator days (13 and 14.6, P = 0.91) or hospital mortality (27 and 33%, P = 0.39), respectively. CONCLUSIONS Enteral administration of Synbiotic 2000 FORTE has no statistically significant impact on the incidence of VAP in critically ill patients.
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Affiliation(s)
- David J W Knight
- Department of Intensive Care, Christchurch Hospital, Christchurch, New Zealand
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