Effect of Saccharomyces boulardii CNCM-I 3799 and Bacillus subtilis CU-1 on Acute Watery Diarrhea: A Randomized Double-Blind Placebo-Controlled Study in Indian Children

PURPOSE

To assess the effect of combination probiotic Saccharomyces boulardii CNCM-I 3799 and Bacillus subtilis CU-1 in outpatient management of acute watery diarrhea in children.

METHODS

A randomized double-blind placebo-controlled study was conducted in 180 participants aged six months to five years with acute mild to moderate diarrhea. All were enrolled from six centers across India and centrally randomized to receive S. boulardii CNCM-I 3799 and B. subtilis CU-1 or a placebo along with oral rehydration salts and zinc supplementation. Each participant was followed up for three months to assess recurrence of diarrhea.

RESULTS

The mean duration of diarrhea in the probiotic and placebo groups were 54.16 hours and 59.48 hours, respectively. The difference in the duration of diarrhea in those administered with probiotic or placebo within 24 hours of diarrhea onset was 25.21 hours. Furthermore, the difference in duration of diarrhea was 13.84 hours (p<0.05) for participants who were administered with probiotics within 48 hours. There were no significant differences in the stool frequencies between the two arms. After three months, 15% in the probiotic group and 18.5% in the placebo group reported episodes of diarrhea. The mean duration of diarrhea was considerably lower in the probiotic group, 31.02 hours versus 48 hours in placebo (p=0.017).

CONCLUSION

S. boulardii CNCM-I 3799 and B. subtilis CU-1 combination was effective in reducing the duration of diarrhea when administered within 48 hours of diarrhea onset. Similarly, it reduced recurrence of diarrhea and its intensity in the subsequent three months.

Modulation of growth performance, non-specific immunity, intestinal morphology, the response to hypoxia stress and resistance to Aeromonas hydrophila of grass carp (Ctenopharyngodon idella) by dietary supplementation of a multi-strain probiotic

The present study was conducted to evaluate a multi-strain probiotic (MP) on growth performance, immune and antioxidant function, response to hypoxia stress and resistance to Aeromonas hydrophila of grass carp (Ctenopharyngodon idella). Based on the viable cell counts of aerobic Bacillus spp., six experimental diets with MP supplemented at 0, 0.34, 1.68, 3.36, 6.72, 10.1 g kg^-1 were formulated and 900 juveniles (7.30 ± 0.01 g) were equally distributed into 30 aquaria with respective diet for 60 days. Results showed that fish with 0.34-1.68 g kg^-1 MP had better growth and feed utilization. Further, plasma total protein, albumin and high-density lipoprotein were remarkably increased with dietary MP at >1.68 g kg^-1. Dietary MP supplementation at 6.72-10.1 g kg^-1 strikingly elevated plasma myeloperoxidase activity and complement C3 content. For fish with MP at 1.68 and 6.72-10.1 g kg^-1, their liver malondialdehyde and glutathione peroxidase were remarkably declined and promoted. After hypoxia stress, fish with 3.36-6.72 g kg^-1 MP showed significantly higher respiratory burst activity. Challenge test by A. hydrophila confirmed the protection effects of MP through the decreased cumulative mortality rates. For intestinal histomorphology and enzymatic analyses, fish with 1.68 g kg^-1 MP displayed significantly higher intestinal villi height, goblet cells and alkaline phosphatase activity. In conclusion, dietary MP supplementation at 1.68 g kg^-1 could promote growth, intestinal morphology and antioxidant capacity, while enhancing host immunity requires higher dosages of MP. Broken-line analysis of weight gain revealed that 1.34 g kg^-1 is the optimum dosage for the growth of grass carp.

A randomized placebo-controlled clinical trial of a multi-strain probiotic formulation (Bio-Kult®) in the management of diarrhea-predominant irritable bowel syndrome

Background

Accumulating evidence supports the view that an imbalance of gut bacteria contributes to IBS, and that increasing the mass of beneficial species may reduce the numbers of pathogenic bacteria and help alleviate symptoms.

Methods

In this double-blind trial 400 adult patients with moderate-to-severe symptomatic diarrhea-predominant IBS (IBS-D) were randomized to treatment with the multi-strain probiotic Bio-Kult® (14 different bacterial strains) or placebo for 16 weeks. The change in severity and frequency of abdominal pain was the primary outcome measure.

Results

Probiotic treatment significantly improved the severity of abdominal pain in patients with IBS-D. A 69% reduction for probiotic versus 47% for placebo (p < 0.001) equates to a 145 point reduction on the IBS-severity scoring system (IBS-SSS). The proportion of patients who rated their symptoms as moderate-to-severe was reduced from 100% at baseline to 14% for the multi-strain probiotic at follow-up (month 5) versus 48% for placebo (p < 0.001). Also, the number of bowel motions per day from month 2 onwards was significantly reduced in the probiotic group compared with the placebo group (p < 0.05). In addition to relieving symptoms, the probiotic markedly improved all dimensions of quality of life in the 34-item IBS-Quality of Life (IBS-QoL) questionnaire. No serious adverse events were reported.

Conclusions

The multi-strain probiotic was associated with significant improvement in symptoms in patients with IBS-D and was well-tolerated. These results suggest that probiotics confer a benefit in IBS-D patients which deserves further investigation.

Trial registration

[Clinicaltrials.gov NCT03251625; retrospectively registered on August 9, 2017].

Electronic supplementary material

The online version of this article (doi:10.1186/s12876-018-0788-9) contains supplementary material, which is available to authorized users.

Evaluation of kefir as a potential probiotic on growth performance, serum biochemistry and immune responses in broiler chicks

This experiment was conducted to evaluate the effect of milk or molasses kefir as a probiotic on growth performance, carcass traits, serum biochemistry and humoral immune responses in broiler chickens. A total of 192 one-d-old as hatched broiler chicks (Ross 308) were randomly allotted to 4 treatments, each with 4 replicate pens of 12 chicks. The following treatments were applied: 1) a basal diet (C) and normal drinking water, 2) 2% milk kefir in drinking water, 3) 2% molasses kefir in drinking water, and 4) the diet C supplemented with commercial probiotic. At d 42, eight birds per treatment were killed for determination of carcass traits. Broilers at 28 days of age were bled for measuring antibody titers against Newcastle disease virus (NDV) and avian influenza virus (AIV), at 30 days of age for antibody titers against sheep red blood cell (SRBC), and at 42 days of age for biochemical analysis. Supplementing 2% milk kefir increased body weight of broilers at 28 and 42 days of age (P < 0.05). Supplementing 2% molasses kefir improved feed conversation ratio (FCR) of broilers during growth period (P < 0.05), but FCR of broilers in other periods was not affected. Daily feed intake, internal organ weights, and carcass traits were not influenced by the treatments except for small intestine and ceca length. Small intestinal length significantly decreased in broilers supplemented with milk and molasses kefir (P < 0.05). Molasses kefir supplementation significantly (P < 0.05) increased antibody titer against SRBC at 31 days of age but other immune related parameters were not statistically different among treatments. Biochemical parameters including serum protein, albumin, and triglyceride concentrations were not statistically (P > 0.05) influenced. Broilers supplemented with molasses kefir, had a significantly lower concentration of serum total cholesterol, low density lipoprotein cholesterol and elevated high density lipoprotein cholesterol at 42 days of age (P < 0.05). In conclusion, the results indicated that inclusion of 2% milk kefir in drinking water would improve growth performance of broiler chickens.