Role of probiotics in preventing Clostridioides difficile infection in older adults: an integrative review

Barbosa, Maria Lucianny Lima; Albano, M; Martins, Conceição da Silva; Warren, Cirle A.; Brito, Gerly Anne de Castro

doi:10.3389/fmed.2023.1219225

Cited by 5 publications

(1 citation statement)

References 29 publications

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“…Probiotics have a complex effect on the gastrointestinal tract and its microbiota, including selectively suppressing the growth of certain types of pathogenic and conditionally pathogenic microbiota [18][19][20][21][22]. Among the probiotic microbes of interest are Saccharomyces boulardii, which have already shown an antagonistic effect against Helicobacter pylori [23] and Clostridioides difficile [24,25]. However, they have not yet been tested for the treatment of SIBO, including in cirrhosis.…”

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confidence: 99%

Efficacy and Safety of a Probiotic Containing Saccharomyces boulardii CNCM I-745 in the Treatment of Small Intestinal Bacterial Overgrowth in Decompensated Cirrhosis: Randomized, Placebo-Controlled Study

Efremova,

Maslennikov,

Zharkova

et al. 2024

JCM

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(1) Background: The aim was to evaluate the effectiveness of the probiotic containing Saccharomyces boulardii in the treatment of small intestinal bacterial overgrowth (SIBO) in patients with decompensated cirrhosis. (2) Methods: This was a blinded, randomized, placebo-controlled study. (3) Results: After 3 months of treatment, SIBO was absent in 80.0% of patients in the probiotic group and in 23.1% of patients in the placebo group (p = 0.002). The patients with eliminated SIBO had decreased frequency of ascites and hepatic encephalopathy, the increased platelets and albumin levels, the decreased blood levels of total bilirubin, biomarkers of bacterial translocation (lipopolysaccharide [LPS]) and systemic inflammation (C-reactive protein), and positive changes in markers of hyperdynamic circulation compared with the state at inclusion. There were no significant changes in the claudin 3 level (the intestinal barrier biomarker) in these patients. No significant changes were observed in the group of patients with persistent SIBO. The serum level of nitrate (endothelial dysfunction biomarker) was lower in patients with eradicated SIBO than in patients with persistent SIBO. One (5.3%) patient with eradicated SIBO and six (42.9%) patients with persistent SIBO died within the first year of follow-up (p = 0.007). (4) Conclusions: SIBO eradication was an independent predictor of a favorable prognosis during the first year of follow-up.

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Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of a Probiotic Containing Saccharomyces boulardii CNCM I-745 in the Treatment of Small Intestinal Bacterial Overgrowth in Decompensated Cirrhosis: Randomized, Placebo-Controlled Study

Efremova,

Maslennikov,

Zharkova

et al. 2024

JCM

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Mucosal Hub Bacteria as Potential Targets for Improving High‐Fat Diet‐Related Intestinal Barrier Injury

Shao,

Zhang,

Song

et al. 2024

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background: Intestinal barrier injury contributes to multiple diseases such as obesity and diabetes, whereas no treatment options are available.Methods: Due to close interactions between mucosal microbiome and intestinal barrier, we evaluated the potential of mucosal bacteria in providing targets for high‐fat diet (HFD)–related intestinal barrier injury. Whole‐genome metagenomics was used to evaluate mucosal microbiome, while intestinal barrier injury was estimated using serum LPS, FITC‐dextran intensity, and ZO‐1 protein.Results: We found that HFD induced significant fat accumulation in epididymal tissue at weeks 4 and 12, while ALT, LDL, and TC increased at week 12. Intestinal barrier injury was confirmed by elevated serum LPS at both weeks, upregulated FITC‐dextran intensity, and decreased ZO‐1 protein at week 12. Fourteen species such as Phocaeicola vulgatus differed in HFD‐fed mice. The co‐occurrence network of mucosal microbiome shifted from scale‐free graph in controls to nearly random graph in HFD‐fed mice. Besides, 10 hub bacteria especially Bacteroides ovatus decreased drastically in both mucosal and fecal samples of HFD‐fed mice, correlated with intestinal permeability, ALT, and KEGG pathways such as “Mitochondrial biogenesis” and “metabolism”. Moreover, Bacteroides ovatus has been confirmed to improve intestinal barrier function in a recent study.Conclusion: Mucosal hub bacteria can provide potential targets for improving HFD‐related intestinal barrier function.

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Clostridioides Difficile: A Concise Review of Best Practices and Updates

Yakout,

Bi,

Harris

2024

J Prim Care Community Health

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Clostridioides difficile infection (CDI) is one of the most common and severe nosocomial infections worldwide. It can also affect healthy individuals in the community. The incidence of CDI has been on the rise globally for the past decade, necessitating a proactive approach to combat its spread; new strategies are being developed to enhance diagnostic accuracy and optimize treatment outcomes. Implementing the 2-step testing has increased diagnostic specificity, reducing the usage of CD-specific antibiotics with no concomitant increase in surgical complication rates. In 2021, the Infectious Diseases Society of America/Society for Healthcare Epidemiology of America (IDSA/SHEA) shifted its preference for initial treatment to fidaxomicin over vancomycin and metronidazole due to its lower recurrence rate. It also prioritized fidaxomicin for the treatment of recurrent CDI. There are new developments on the frontiers of fecal microbiota therapies, with RBX2660 and SER-109 approved recently by the FDA for prevention, with other microbiome-based therapies in various development and clinical trials. This review offers providers an updated and practical guide for CDI management.

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Role of probiotics in preventing Clostridioides difficile infection in older adults: an integrative review

Cited by 5 publications

References 29 publications

Efficacy and Safety of a Probiotic Containing Saccharomyces boulardii CNCM I-745 in the Treatment of Small Intestinal Bacterial Overgrowth in Decompensated Cirrhosis: Randomized, Placebo-Controlled Study

Efficacy and Safety of a Probiotic Containing Saccharomyces boulardii CNCM I-745 in the Treatment of Small Intestinal Bacterial Overgrowth in Decompensated Cirrhosis: Randomized, Placebo-Controlled Study

Mucosal Hub Bacteria as Potential Targets for Improving High‐Fat Diet‐Related Intestinal Barrier Injury

Clostridioides Difficile: A Concise Review of Best Practices and Updates

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