• Pediatric Infection and Vaccine
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• v.19 no.1
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• pp.12-18
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• 2012

Purpose : This study attempted to investigate the frequency, duration, and risk factors of antibiotic-associated diarrhea (AAD) in infants hospitalized due to febrile urinary tract infection (UTI). This is a basic research on the probiotics used in the prevention and treatment of AAD in infants. Methods : Medical records of the infants aged 3-6 months hospitalized in Gachon University Gil Hospital from January 2008 to September 2010 due to the febrile UTI were retrospectively reviewed. The episodes of loose or watery stool were investigated for frequency, onset, and duration. Those who had AAD and those who did not (non-AAD) were compared. The antibiotic regimens and the episodes of diarrhea were investigated in AAD group. Result : Total 147 infants were included. Fifty-four (36.7%) showed AAD. Intravenous third-generation cephalosporin ($3^{rd}$ CS) single therapy was used for 102 patients (69.4%), the $3^{rd}$ CS and non-$3^{rd}$ CS combination therapy for 24 (16.3%), and non-$3^{rd}$ CS combination therapy for 21 (14.3%). There was no significant difference in the dose of cefotaxime between AAD and non-AAD group (P=0.601). According to the antibiotic therapies above, in AAD group, there was no significant difference in the onset and duration of diarrhea respectively (P=0.717, P=0.830). Although the frequency of diarrhea was higher for the $3^{rd}$ CS and non-$3^{rd}$ CS combination therapy subgroup with $9.25{\pm}5.30$ times/day than the other two subgroups ($7.58{\pm}2.97$ times/day in $3^{rd}$ CS single therapy subgroup, $6.75{\pm}4.40$ times/day in non-$3^{rd}$ CS combination therapy subgroup), there was no statistical significance (P=0.078). Conclusion : AAD seems common to the infants aged 3-6 months with febrile UTI, regardless of regimen and amount of antibiotics in usual dosage. Further research on the effects of probiotics used in the prevention and treatment of AAD in infants is warranted.

• Journal of Dairy Science and Biotechnology
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• v.30 no.2
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• pp.139-143
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• 2012

For human including newborn baby, the intestinal microbiota can play an important role in the development of the intestinal mucosa and in maintaining the balance of the immune cells. Important functions of the intestinal microbiota include the inhibition of the colonization of the intestine by potentially pathogenic microorganisms. Thus, the research of probiotics have been focused on the prevention and treatment of disorders associated with the gastrointestinal tract (GIT), including pathogen infection, traveler's diarrhea, antibiotic-associated diarrhea, and constipation. Probiotics have also been suggested as therapeutic agents against irritable bowel syndrome and inflammatory bowel diseases. An increasing amount of evidence from clinical studies suggests that they are effective in the prevention of atopic allergies and may have potential anti-carcinogenic effects. Until recent years many scientific research for this use has been based on empirical observations. Therefore, probiotics in the form of fermented milk products have been long part of attempts to maintain good health in world wide.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.3
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• pp.139-146
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• 2017

The number of papers discussing probiotics increases tremendously that limits the possibility for primary care physicians and clinicians to stay updated. Therefore, the aim of this paper will be to summarize available evidence of probiotic use in well-defined clinical indications of importance for pediatricians. Based on currently available evidence certain probiotic strains (Lactobacillus rhamnosus GG [LGG] and Saccharomyces boulardii) have proven effect in the treatment of acute gastroenteritis and prevention of antibiotic associated diarrhea. Furthermore, LGG was proven to be effective in prevention of nosocomial diarrhea and respiratory tract infection in day care centers. In conclusion, not all probiotic strains have same efficacy for all clinical indications, therefore, only strains with proven efficacy and safety should be recommended.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.691-695
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• 2005

There is scientific evidence that administration of probiotics is effective in the treatment of acute infectious diarrhea in children and the prevention of antibiotic associated diarrhea and nosocomial/community acquired diarrhea. Probiotics prevent relapse of recurrent pouchitis and decrease the initial onset of pouchitis in ulcerative colitis. Probiotic organisms suppress growth of pathogens as well as their epithelial attachment and/or invasion either directly by secreting antimicrobial substances or by stimulating host expression of protective molecules. Additionally, probiotics enhance mucosal barrier function and can stimulate host production of immunosuppressive molecules that downregulate inflammatory responses or allergic immune response. Mechanisms of action explain therapeutic effects and randomized controlled trials are warranted before recommendations for therapeutic or preventive use can be given.

• The Journal of the Korean Society for Microbiology
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• v.22 no.2
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• pp.155-162
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• 1987

To determine the prevalence of antibiotic resistance in fecal E. coli and to investigate possible associations between antibiotic resistance and other plasmid-mediated virulence properties, antibiotic disk susceptibility tests for nine antibiotics were done on 141 strains of E. coli isolated from diarrheal children and well controls. Eighty two percent of the test strains were resistant to one or more antibiotics. Antibiotics to which the test strains were most resistant in descending order were ampicillin (85%), trimethoprim/sulfamethoxazol (60%), and cephalothin (55%). Seventy nine percent of these resistant strains were resistant to two or more antibiotics. All 141 test strains were sorted into enterotoxigenic E. coli (ETEC), enteropathogenic E. coli (EPEC), enteroadherent E. coli (EAEC) and non-pathogenic E. coli and the percentages of strains resistant to multiple antibiotics were compared. Among ETEC regardless of its source, multiple drug resistance was more frequent in strains producing heatstable enterotoxin (ST) only than in strains producing only heat-labile enterotoxin (LT) or both. In EAEC, multiple resistance was more frequently associated with strains isolated from diarrheal patients than with those from well controls. The major antibiotic resistance patterns possessed by multiple resistant enteropathogenic strains were $SXT^R$ $AM^R$, $CR^R$, and $SXT^R$ $AM^R$ $CR^R$. Of 28 ST- producing $SXT^R$ ETEC, 26(96%) were also resistant to ampicillin and 17 (61%) were resistant to cephalothin. The similar pattern was observed in EAEC and EPEC as well. This study has important implications for the treatment of E. coli diarrhea with antibiotics because it is possible that dissemination of virulence could occur under the force of selective antibiotic pressure. In addition, this study suggests that the in vivo efficacy of SXT in treating diarrheal illness be reevaluated.

• The Journal of the Korea Contents Association
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• v.10 no.5
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• pp.259-266
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• 2010

Clostridium difficile-associated disease (CDAD) is an important nosocomial infectious diarrhea and is associated with antibiotic use. Recently, incidence of C. difficile has been increasing in hospitals. A total of 1,329 stool specimens were examined from January, 2005 to December, 2008. This study analyzed the incidence and clinical characteristics of C. difficile infections on them. Out of 1,329 stool specimens, 283 specimens showed toxin A/B positive, using EIA. The positive rate was 21.2%; with the highest incidence among and above the 70years old. On endoscopy, psedo membranous colitis was found in 57.7%, and 19.5% of patients were normal. Pathologic finding showed PMC in 26.8% of patients, AAC in 52.2%. C. difficile was associated with PMC, however, endoscopic and pathologic findings tests showed normal to PMC.

• Microbiology and Biotechnology Letters
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• v.46 no.4
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• pp.334-345
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• 2018

Spore-forming Bacillus species are commercially available probiotic formulations for application in humans. They have health benefits and help prevent disease in hosts by combating entero-pathogens and ameliorating antibiotic-associated diarrhea. However, the molecular and cellular mechanisms of these benefits remain unclear. Here, we report the draft genome of a potential probiotic strain of Bacillus clausii B106. We mapped and compared the probiotic profile of B106 with other reference genomes. The draft genome analysis of B106 revealed the presence of ADI pathway genes, indicating its ability to tolerate acidic pH and bile salts. Genes encoding fibronectin binding proteins, enolase, as well as a gene cluster involved in the biosynthesis of exopolysaccharides underscored the potential of B106 to adhere to the intestinal epithelium and colonize the human gut. Genes encoding bacteriocins were also detected, indicating the antimicrobial ability of this isolate. The presence of genes encoding vitamins, including Riboflavin, Folate, and Biotin, also indicated the health-promoting ability of B106. Resistance of B106 to multiple antibiotics was evident from the presence of genes encoding resistance to chloramphenicol, ${\beta}$-lactams, Vancomycin, Tetracycline, fluoroquinolones, and aminoglycosides. The findings indicate the significance of B. clausii B106 administration during antibiotic treatment and its potential value as a probiotic strain to replenish the health-promoting and disease-preventing gut flora following antibiotic treatment.

• The Journal of the Society of Stroke on Korean Medicine
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• v.8 no.1
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• pp.58-62
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• 2007

Objective : Stroke patients tend to take antibiotics due to infection resulting from complication. One of many side effects from using antibiotics is diarrhea, which infact causes anaerobic organism dysfunction resulting Pseudo-Membranous Colitis (P.M.C). To treat P.M.C, antibiotics and antibacterial agents are usually used. But they may cause other side effects, therefore extreme caution must be taken. Methods : We treated an antibiotic induced P.M.C patient who diagnosed by sigmoid scopy with only Yijoong-tang (Lizhong-tang) without antibiotics and observed patients stool aspects. Results and Conclusion : Patiensts symptom was improved after 7days, and we can see the improvement by follow-up sigmoid scopy. This case may give us a possibility of that oriental medical treatments as complementary and alternative medicine to standard antibiotic treatment.

• Food Science and Biotechnology
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• v.17 no.2
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• pp.402-407
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• 2008

The synergistic antimicrobial effect of Achyranthes japonica Nakai (AJN) and Bifidobacterium extracellular factors against Clostridium difficile were measured using a turbidity method. Each broth supernatant of Bifidobacterium infantis ($68.8{\pm}0.02%$) and Bifidobacterium adolescentis ($33.2{\pm}0.2%$) obtained by adding ethyl acetate soluble fractionate from A. japonica Nakai ethanolic extracts (AJNEA, 100 ppm, no inhibition) showed high synergistic antimicrobial activity against C. difficile. In addition, the antimicrobial activity in a laboratory medium and yogurt products against C. difficile were evaluated. In yogurt prepared with a starter 5 (Lactobacillus acidophilus: Streptococcus thermophilus: B. adolescentis =1 : 1 : 1) and a starter 4 (L. acidophilus: S. thermophilus: B. infantis=1 : 1 : 1) and 0.5% AJNEA powder, high antimicrobial effects were recorded that measured 79.0 and 65.2%, respectively. The results indicated the potential of AJN extract for use as an antimicrobial agent. In addition, the efficiency of the antimicrobial activity of the extracts was further improved in combination with lactic acid bacteria, which suggests that they have the potential to be used as a highly effective antibiotic-tolerant microorganism prevention system. Such a strategy can be used for alternative drugs or functional food additives for treatment of antibiotic-associated diarrhea.

• Journal of Microbiology and Biotechnology
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• v.30 no.1
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• pp.54-61
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• 2020

Saccharomyces boulardii is the only probiotic yeast with US Food and Drug Administration approval. It is routinely used to prevent or treat acute diarrhea and other gastrointestinal disorders, including the antibiotic-associated diarrhea caused by Clostridium difficile infections. The formation of reactive oxygen species (ROS), specifically H₂O₂ during normal aerobic metabolism, contributes to programmed cell death and represents a risk to the viability of the probiotic microbe. Moreover, a loss of viability reduces the efficacy of the probiotic treatment. Therefore, inhibiting the accumulation of ROS in the oxidant environment could improve the viability of the probiotic yeast and lead to more efficacious treatment. Here, we provide evidence that supplementation with a non-reducing disaccharide, namely trehalose, enhanced the viability of S. boulardii exposed to an oxidative environment by preventing metacaspase YCA1-mediated programmed cell death through inhibition of intracellular ROS production. Our results suggest that supplementation with S. boulardii together with trehalose could increase the viability of the organism, and thus improve its effectiveness as a probiotic and as a treatment for acute diarrhea and other gastrointestinal disorders.