Benefits of Frequent HIV Testing in the THRIVE Demonstration Project: United States, 2015-2020.

Objectives. To describe HIV testing among clients in the Targeted Highly Effective Interventions to Reverse the HIV Epidemic (THRIVE) demonstration project and evaluate testing frequency. Methods. We identified factors associated with an average testing frequency of 180 days or less compared with more than 180 days using adjusted Poisson regression models. We performed the Kaplan-Meier survival analysis to compare time to diagnosis by testing frequency. Results. Among 5710 clients with 2 or more tests and no preexposure prophylaxis (PrEP) prescription, 42.4% were tested frequently. Black/African American clients were 21% less likely and Hispanic/Latino clients were 18% less likely to be tested frequently than were White clients. Among 71 Black/African American and Hispanic/Latino cisgender men who have sex with men and transgender women with HIV diagnoses, those with frequent testing had a median time to diagnosis of 137 days, with a diagnostic testing yield of 1.5% compared with those tested less frequently, with 559 days and 0.8% yield. Conclusions. HIV testing at least every 6 months resulted in earlier HIV diagnosis and was efficient. Persons in communities with high rates of HIV who are not on PrEP can benefit from frequent testing, and collaborative community approaches may help reduce disparities. (Am J Public Health. 2023;113(9):1019-1027. https://doi.org/10.2105/AJPH.2023.307341).

A review of caregiver distress in epilepsy in India: Current issues and future directions for research.

India is home to a large number of individuals with epilepsy, with many of these patients having high care needs. Owing to limited infrastructural support and prevalent cultural attitudes, most of these individuals are cared for by their families. Such informal caregiving is often associated with poor physical and psychological outcomes, but the state of caregivers of people with epilepsy in India remains largely ignored. This review summarizes currently available research on distress among caregivers for people with epilepsy in India. A review of 20 studies published till July 2020 revealed significant burden in this population. Caregiving was reported to negatively impact one's physical and mental health, overall family functioning, and financial status. A range of seizure-related variables were found to be associated with greater perceived burden, with the impact of patient characteristics and psychosocial factors on burden being relatively unexplored. Much of the research identified was characterized by methodological limitations such as small sample sizes, exclusion of patients with comorbidities, and a failure to distinguish between carers of adult and pediatric populations, thus overshadowing the specific needs of each group. There is a need for larger, well-designed studies that focus on culture-specific psychological and social factors in the Indian context of caregiving for people with epilepsy.

The effect of moving to East Village, the former London 2012 Olympic and Paralympic Games Athletes' Village, on mode of travel (ENABLE London study, a natural experiment).

BACKGROUND: Interventions to encourage active modes of travel (walking, cycling) may improve physical activity levels, but longitudinal evidence is limited and major change in the built environment / travel infrastructure may be needed. East Village (the former London 2012 Olympic Games Athletes Village) has been repurposed on active design principles with improved walkability, open space and public transport and restrictions on residential car parking. We examined the effect of moving to East Village on adult travel patterns. METHODS: One thousand two hundred seventy-eight adults (16+ years) seeking to move into social, intermediate, and market-rent East Village accommodation were recruited in 2013-2015, and followed up after 2 years. Individual objective measures of physical activity using accelerometry (ActiGraph GT3X+) and geographic location using GPS travel recorders (QStarz) were time-matched and a validated algorithm assigned four travel modes (walking, cycling, motorised vehicle, train). We examined change in time spent in different travel modes, using multilevel linear regresssion models adjusting for sex, age group, ethnicity, housing group (fixed effects) and household (random effect), comparing those who had moved to East Village at follow-up with those who did not. RESULTS: Of 877 adults (69%) followed-up, 578 (66%) provided valid accelerometry and GPS data for at least 1 day (≥540 min) at both time points; half had moved to East Village. Despite no overall effects on physical activity levels, sizeable improvements in walkability and access to public transport in East Village resulted in decreased daily vehicle travel (8.3 mins, 95%CI 2.5,14.0), particularly in the intermediate housing group (9.6 mins, 95%CI 2.2,16.9), and increased underground travel (3.9 mins, 95%CI 1.2,6.5), more so in the market-rent group (11.5 mins, 95%CI 4.4,18.6). However, there were no effects on time spent walking or cycling. CONCLUSION: Designing walkable neighbourhoods near high quality public transport and restrictions on car usage, may offer a community-wide strategy shift to sustainable transport modes by increasing public transport use, and reducing motor vehicle travel.

Loneliness and sleep in older adults.

PURPOSE: The present analysis aims to examine if loneliness is associated with sleep problems and duration over a 4-year period in a sample of older adults aged 50 years and over. METHODS: Data on loneliness, sleep duration, sleep problems and covariates were obtained from 5698 participants from the English Longitudinal Study of Ageing at baseline (wave 4) and follow up (wave 6). RESULTS: Following adjustment for covariates, baseline loneliness was associated with an increase in the odds of reporting short sleep, and more sleep problems at follow up. CONCLUSIONS: Short sleep may represent an important mechanism through which loneliness affects health.

Objectively Measured Daily Physical Activity and Postural Changes as Related to Positive and Negative Affect Using Ambulatory Monitoring Assessments.

OBJECTIVE: The aim of the study was to determine whether objectively measured daily physical activity and posture of sitting, standing, and sit-to-stand transitions are associated with daily assessments of affect. METHODS: Participants (N = 51, 49% female) wore ActivPal accelerometers for 24 h/d for seven consecutive days. Time spent sitting, standing, and being physically active and sit-to-stand transitions were derived for each day. Participants also completed a mood inventory each evening. Multilevel models examined within- and between-person associations of daily physical activity with positive and negative affect, adjusting for age, sex, body mass index, education, and sleep duration. RESULTS: Within-person associations showed that a 1-hour increase in daily physical activity was associated with a decrease in negative affect over the same day (B = -0.11, 95% confidence interval [CI], -0.21 to -0.01). Between-person associations indicated a borderline significant association between higher average daily physical activity levels and higher positive affect (B = 1.85, 95% CI = -0.25 to 3.94). There were no between- or within-person associations between sitting, standing, and sit-to-stand transitions with affect. CONCLUSIONS: Promoting physical activity may be a potential intervention strategy to acutely suppress negative affective states.

Effect of major school playground reconstruction on physical activity and sedentary behaviour: Camden active spaces.

BACKGROUND: The physical school environment is a promising setting to increase children's physical activity although robust evidence is sparse. We examined the effects of major playground reconstruction on physical activity and sedentary time in primary schools using a quasi-experimental design (comparison group pre-test/post-test design). METHODS: Five experimental and two control schools from deprived areas of inner city London were recruited at baseline. Main outcome was physical activity and sedentary time measured from objective monitoring (Actigraph accelerometer) at one year follow up. Pupils' impressions of the new playground were qualitatively assessed post construction. RESULTS: A total of 347 pupils (mean age = 8 years, 55% boys; 36% Caucasian) were recruited into the study at baseline; 303 provided valid baseline Actigraph data. Of those, 231 (76%) completed follow-up (n = 169 intervention; n = 62 control) and 77.4% of the sample recorded at least 4 days of Actigraph wear. In mixed models adjusted for age, sex, ethnicity, ratio activity or sedentary/wear time at baseline, wear time at follow up, and school, no differences were observed in total moderate - vigorous activity (B = -1.4, 95% CI, -7.1, 4.2 min/d), light activity (B = 4.1, 95% CI, -17.9, 26.1), or sedentary time (B = -3.8, 95% CI, -29.2, 21.6 min/d) between groups. There were significant age interactions for sedentary (p = 0.002) and light intensity physical activity (p = 0.008). We observed significant reductions in total sedentary (-28.0, 95% CI, -1.9, -54.1 min/d, p = 0.037) and increases in total light intensity activity (24.6, 95% CI, 0.3, 48.9 min/d, p = 0.047) for children aged under 9 yrs. old in the intervention. CONCLUSION: Major playground reconstruction had limited effects on physical activity, but reduced sedentary time was observed in younger children. Qualitative data suggested that the children enjoyed the new playgrounds and experienced a perceived positive change in well-being and social interactions.

Informal caregiving transitions, subjective well-being and depressed mood: Findings from the English Longitudinal Study of Ageing.

OBJECTIVES: To prospectively investigate the impact of transitions in informal caregiving on emotional well-being over two years in a large population study of older people. METHODS: Information on provision of unpaid care in 2004/2005 and 2006/2007 was available for 6571 participants in the English Longitudinal Study of Ageing. Three well-being domains were also assessed on each occasion: life satisfaction (measured with the Satisfaction with Life Scale); quality of life (assessed with the CASP-19 scale); and depression symptoms (measured using the Centers for Epidemiologic Studies Depression Scale). Multivariable analyses of the impact on well-being of two-year caregiving transitions (caregiving entry and caregiving exit, or continued caring) were conducted separately for spousal/child carers and carers of other family/non-relatives. RESULTS: Compared to non-caregiving, entry into spousal/child caregiving was associated with decline in quality of life (B = -1.60, p < .01) whereas entry into caregiving involving other kin relations increased life satisfaction (B = 1.02, p < .01) and lowered depression symptoms (B = -0.26, p < .05). Contrary to expectations, caregiving exit was related to increased depression in both spousal/child (B = 0.44, p < .01) and non-spousal/child (B = 0.25, p < .05) carers. Continued spousal/child caregiving was also related to decline in quality of life (B = -1.24, p < .05). Other associations were suggestive but non-significant. CONCLUSION: The emotional impact of different caregiving transitions in later life differs across kin relationships; notably, spousal and child carers' well-being was consistently compromised at every stage of their caregiving career over the two-year study period.

Association of after school sedentary behaviour in adolescence with mental wellbeing in adulthood.

OBJECTIVE: Sedentary behaviour is associated with poorer mental health in adolescence but no studies have followed participants into mid-life. We investigated the association between after-school sedentary behaviours (screen time and homework) in adolescence with mental wellbeing in adulthood when participants were aged 42. METHODS: Participants (n=2038, 59.2% female) were drawn from The 1970 British Cohort Study (BCS70). At age 16 respondents were asked separate questions about how long they spent in three types of screen based activities (TV, video films, computer games) and homework 'after school yesterday'. Mental well-being and psychological distress were assessed at the age 42 sweep in 2012 using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and Malaise Inventory, respectively. RESULTS: After adjustment for all covariates, participants reporting more than 3h of after school screen time as an adolescent had -1.74 (95% CI, -2.65, -0.83) points on the WEMWBS compared with adults reporting less than 1h screen time as an adolescent. Participants that reported high screen time both at age 16 (≥3h/d) and age 42 (≥3h/d TV viewing) demonstrated even lower scores (-2.91; -4.12, -1.69). Homework was unrelated to wellbeing after adjustment for covariates. The longitudinal association between adolescent screen time and adult psychological distress was attenuated to the null after adjustment for covariates. CONCLUSIONS: Screen time in adolescence was inversely associated with mental wellbeing in adulthood.

Social isolation, loneliness, and all-cause mortality in older men and women.

Both social isolation and loneliness are associated with increased mortality, but it is uncertain whether their effects are independent or whether loneliness represents the emotional pathway through which social isolation impairs health. We therefore assessed the extent to which the association between social isolation and mortality is mediated by loneliness. We assessed social isolation in terms of contact with family and friends and participation in civic organizations in 6,500 men and women aged 52 and older who took part in the English Longitudinal Study of Ageing in 2004-2005. A standard questionnaire measure of loneliness was administered also. We monitored all-cause mortality up to March 2012 (mean follow-up 7.25 y) and analyzed results using Cox proportional hazards regression. We found that mortality was higher among more socially isolated and more lonely participants. However, after adjusting statistically for demographic factors and baseline health, social isolation remained significantly associated with mortality (hazard ratio 1.26, 95% confidence interval, 1.08-1.48 for the top quintile of isolation), but loneliness did not (hazard ratio 0.92, 95% confidence interval, 0.78-1.09). The association of social isolation with mortality was unchanged when loneliness was included in the model. Both social isolation and loneliness were associated with increased mortality. However, the effect of loneliness was not independent of demographic characteristics or health problems and did not contribute to the risk associated with social isolation. Although both isolation and loneliness impair quality of life and well-being, efforts to reduce isolation are likely to be more relevant to mortality.

Reciprocal associations between smoking cessation and depression in older smokers: findings from the English Longitudinal Study of Ageing.

BACKGROUND: Depression is a particular problem in older people and it is important to know how it affects and is affected by smoking cessation. AIMS: To identify reciprocal, longitudinal relationships between smoking cessation and depression among older smokers. METHOD: Across four waves, covering six years (2002-2008), changes in smoking status and depression, measured using the 8-item Centre for Epidemiologic Studies Depression Scale, were assessed among recent ex-smokers and smokers (n = 2375) in the English Longitudinal Study of Ageing. RESULTS: In latent growth curve analysis, smoking at baseline predicted depression caseness longitudinally and vice versa. When both processes were modelled concurrently, depression predicted continued smoking longitudinally (B(ß) = 0.21 (0.27); 95% CI = 0.08-0.35) but not the other way round. This was the case irrespective of mental health history and adjusting for a range of covariates. CONCLUSIONS: In older smokers, depression appears to act as an important barrier to quitting, although quitting has no long-term impact on depression.

A meta-analysis of ventriculostomy-associated cerebrospinal fluid infections.

BACKGROUND: Ventriculostomy insertion is a common neurosurgical intervention and can be complicated by ventriculostomy-associated cerebrospinal fluid infection (VAI) which is associated with increased morbidity and mortality. This meta-analysis was aimed at determining the pooled incidence rate (number per 1000 catheter-days) of VAI. METHODS: Relevant studies were identified from MEDLINE and EMBASE and from reference searching of included studies and recent review articles on relevant topics. The Newcastle-Ottawa Scale was used to assess quality and risk of bias. A random effects model was used to pool individual study estimates and 95% confidence intervals (CI) were calculated using the exact Poisson method. Heterogeneity was assessed using the heterogeneity χ2 and I-squared tests. Subgroup analyses were performed and a funnel plot constructed to assess publication bias. RESULTS: There were a total of 35 studies which yielded 752 infections from 66,706 catheter-days of observation. The overall pooled incidence rate of VAI was 11.4 per 1000 catheter days (95% CI 9.3 to 13.5), for high quality studies the rate was 10.6 (95% CI 8.3 to 13) and 13.5 (95% CI 8.9 to 18.1) for low quality studies. Studies which had mean duration of EVD treatment of less than 7 days had a pooled VAI rate of 19.6 per 1000 catheter-days, those with mean duration of 7-10 days had VAI rate of 12.8 per 1000 catheter-days and those with mean duration greater than 10 days had VAI rate of 8 per 1000 catheter-days. There was significant heterogeneity for the primary outcome (p = 0.004, I-squared = 44%) and most subgroups. The funnel plot did not show evidence for publication bias. CONCLUSIONS: The incidence rate of VAI is 11.4 per 1000 catheter-days. Further research should focus on analysis of risk factors for VAI and techniques for reducing the rate of VAI.

Gender-specific associations of objective and perceived neighborhood characteristics with body mass index and waist circumference among older adults in the English longitudinal study of ageing.

OBJECTIVES: We sought to determine whether objective and perceived neighborhood characteristics are independently associated with obesity indicators among older adults and whether associations differ by gender. METHODS: Linear regression was used to examine mutually adjusted associations of objective area-level neighborhood deprivation and perceived individual-level neighborhood disorder in 2002-2003 with body mass index (BMI) and waist circumference (WC) 2 years later among 6297 community-dwelling older adults in the English Longitudinal Study of Ageing. RESULTS: Associations between neighborhood characteristics and obesity indicators were evident for women only. Being in the most deprived quintile of neighborhood deprivation was associated with a BMI that was 1.18 kilograms per meters squared higher (95% confidence interval [CI] = 0.54, 1.83) and a WC that was 2.42 centimeters higher (95% CI = 0.90, 3.94) at follow-up in women after adjustment for baseline health status, socioeconomic factors, and neighborhood disorder. Neighborhood disorder was not independently associated with BMI or WC. CONCLUSIONS: Among women, greater objective neighborhood deprivation was independently associated with higher BMI and WC after 2 years. Public efforts to reduce obesity among community-dwelling older women may benefit most from addressing objective residential characteristics, over and above subjective perceptions.

Loneliness Among Older Indian Workers: Findings From the Longitudinal Ageing Study in India.

The number of adults aged 60 years and over who work is growing. However, there has been relatively limited research assessing the determinants of wellbeing in this cohort. Given the known relationship between loneliness and socioeconomic disadvantage, the present analysis assessed the role of working conditions and food security on loneliness among employed Indians aged 60 years and over (N = 9035), using data from wave 1 of the Longitudinal Ageing Study in India. Just over 11% of participants reported being lonely most or all of the time. Food insecurity and work that involved exposure to unpleasant conditions was associated with increased loneliness, while work requiring more mental effort was associated with lower loneliness. Policies that ensure skills training to support job transitions for older adults working in unpleasant conditions, and greater food security in later life are important to ensure wellbeing in this group.

Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English Longitudinal Study of Ageing.

OBJECTIVE: This study aims to evaluate the impact of social isolation and loneliness, individually and simultaneously, on cognitive function in older adults during a 4-year period, using data from the English Longitudinal Study of Ageing, and to evaluate if these associations are moderated by educational level. METHODS: Data on social isolation, loneliness, and cognitive function (verbal fluency, immediate recall, and delayed recall) were obtained at baseline. Follow-up measures on cognitive function were obtained 4 years later for 6034 participants (mean age at baseline=65.6 years). Regression analyses were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Interactions between social isolation, loneliness, and educational level were also evaluated. RESULTS: Baseline isolation was significantly associated with decreases in all cognitive function measures at follow-up (ß=-.05 to -.03, p<.001), independently of baseline scores, whereas loneliness was associated with poorer immediate recall (ß=-.05, p<.001) and delayed recall (ß=-.03, p=.02). There was a significant interaction between educational level and both isolation (p=.02) and loneliness (p=.01) for delayed recall, such that isolation and loneliness were associated with poorer recall only among those with low levels of education. CONCLUSIONS: Loneliness and isolation are associated with poorer cognitive function among older adults. Interventions to foster social connections may be particularly beneficial for individuals with low levels of education.

Deciphering the effect of maternal postpartum antibiotic prophylaxis on the infant gut microbiome: a whole metagenomic analysis.

Aim: To analyze the impact of postpartum antibiotic (Ab) prophylaxis on the infant gut microbiome. Materials & methods: Whole metagenomic analysis was performed on breast milk and infant fecal samples collected from mother-infant pairs who belonged to two groups: an Ab group comprising mothers who had received a single course of Abs in the immediate postpartum period and a non-Ab group comprising mothers who had not received Abs. Results: The characteristic presence of Citrobacter werkmanii, an emerging multidrug-resistant uropathogen, and a higher relative abundance of genes encoding resistance to specific Abs were noted in samples from the Ab group compared with those from the non-Ab group. Conclusion: Policies regarding prophylactic Ab prescription across government and private health sectors in the postpartum period need to be strengthened.

We studied the impact of antibiotics (Abs) that were taken by mothers as a preventive measure in the immediate postdelivery period on the bacterial diversity of the infant gut. All mother­infant pairs who participated in the study had undergone 'low-risk', normal delivery and practiced exclusive breastfeeding. Stool samples of the infants and breast milk samples of the corresponding mothers were collected for analysis of the pattern of microbial composition. On analysis, it was found that stool samples of the infants in the Ab group comprised opportunistic pathogens and harbored genes encoding resistance to specific Abs. There was a relatively higher abundance of beneficial bacteria in infant stool samples of the non-Ab group. This study highlights the need to reconsider the existing practice of taking Abs as a preventive measure after normal delivery to maintain health and reduce the spread of antimicrobial resistance in this particular region.

Consent to DNA collection in epidemiological studies: findings from the Whitehall II cohort and the English Longitudinal Study of Ageing.

PURPOSE: Epidemiological studies increasingly include DNA sampling in their protocols, but participation may vary by demographic, psychological, or health characteristics. This analysis explored sociodemographic (age, gender, religion, and education), health-related, and psychological predictors of participation in genetic data collection in two large epidemiological studies: the Whitehall II cohort and the English Longitudinal Study of Ageing. DNA consent in both studies was not obtained on initial enrollment, but after long-standing participation in the study. METHODS: Study participants who accepted or declined DNA sampling were compared. RESULTS: Very few participants declined DNA sampling; 1.6% in Whitehall II and 1.0% in English Longitudinal Study of Ageing. In both cohorts, participants who declined were more likely to be female, nonwhite, and involved in religious activities; although only the ethnic effect consistently survived multivariate analyses. Decliners also felt less in control of events in their lives than those who consented, and this remained significant in multivariate analysis in the English Longitudinal Study of Ageing sample. CONCLUSION: Consent to DNA sampling was very high in two established UK cohort studies. Differences between the subset of the population unwilling to provide DNA samples and those who consented were modest, although this may be due to the highly selected populations in these cohorts. However, our findings suggest that a greater proportion of decliners would create an important source of selection bias.

Loneliness in Older Indian Dyads.

BACKGROUND: Loneliness has been recognised as a major public health concern in older adults in developed nations, with little focus on low- and middle-income countries such as India. While the protective nature of social relationships on loneliness has been explored in the context of marriage, typically these benefits are examined in individual spouses rather than within the marital dyad. METHODS: A sample of 398 opposite-sex married Indian couples (mean age 54.8 years) was obtained from the pilot wave of the Longitudinal Aging Study in India (LASI) conducted in 2010. These cross-sectional data were analysed using the Actor-Partner Interdependence Model, with one's own and one's partner's cognitive function, functional limitations, depressive symptoms, employment status and contact with friends included as predictors of loneliness. RESULTS: There were no gender differences in the pattern of associations. Depression was positively associated with loneliness with actor and partner effects being significant. One's partner being employed was associated with less loneliness. CONCLUSIONS: The sample showed low levels of depression, loneliness, and reduced functionality; however, depression still predicted one's own and one's partner's loneliness. Future work using longitudinal data could examine the role of employment in loneliness, particularly within the context of gender roles.

Insights into Peptide Mediated Antibiofilm Treatment in Chronic Wound: A Bench to Bedside Approach.

Chronic wound biofilm infections are a threat to the population with respect to morbidity and mortality. The presence of multidrug-resistant bacterial pathogens in chronic wound renders the action of antibiotics and antibiofilm agents difficult. Therefore an alternative therapy is essential for reducing bacterial biofilm burden. In this scenario, the peptide-based antibiofilm therapy for chronic wound biofilm management seeks more attention. A synthetic peptide with a broad range of antibiofilm activity against preformed and established biofilms, having the ability to kill multispecies bacteria within biofilms and possessing combinatorial activity with other antimicrobial agents, provides significant insights. In this review, we portray the possibilities and difficulties of peptide-mediated treatment in chronic wounds biofilm management and how it can be clinically translated into a product.

Relationships between cardiac resynchronization therapy and N-terminal pro-brain natriuretic peptide in patients with heart failure and markers of cardiac dyssynchrony: an analysis from the Cardiac Resynchronization in Heart Failure (CARE-HF) study.

AIMS: The Cardiac Resynchronization in Heart Failure (CARE-HF) study showed that cardiac resynchronization therapy (CRT) reduces mortality in HF patients with markers of dyssynchrony. Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) might predict which patients benefit most from CRT. We evaluated whether the prognostic value of NT-proBNP was influenced by CRT and the effects of CRT stratified according to NT-proBNP. METHODS AND RESULTS: A total of 813 patients were enrolled in CARE-HF. Baseline log-transformed NT-proBNP independently predicted all-cause mortality, sudden death, and death from pump failure. In a multivariable model including log-transformed NT-proBNP, assignment to CRT remained independently associated with better prognosis without evidence of interaction. Stratifying patients according to the median NT-proBNP and to CRT treatment allocation, all-cause mortality was 12% if or= median + CRT, and 51% if >or= median + control group. There was no evidence of a difference in the relative effect of CRT across different values of NT-proBNP. CONCLUSION: NT-proBNP retains its prognostic value in HF patients with CRT. Deploying CRT before the patients have reached end-stage HF may maximize the benefit of treatment.

Critical insights into antibiotic resistance transferability in probiotic Lactobacillus.

Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host, with respect to metabolism, immune function, and nutrition. Any perturbation of these beneficial microbes leads to gut dysbiosis, which triggers the development of various disorders in the gastrointestinal system. Probiotics play a key role in resolving the dysbiosis posed by external factors such as antibiotics, other substances, or interventions. Supplementing probiotics with antibiotics is favorable in reducing the harmful effects of antibiotics on gut flora. These microbes also possess specific intrinsic drug resistance mechanisms that aid their survival in the internal environment. According to US Food and Drug Administration reports, species belonging to Lactobacillus and Bifidobacterium genera are the most common probiotics consumed by humans through commercial products. However, various studies have reported the tendency of microbes to acquire specific drug resistance, in recent years, through various mechanisms. The reports on transferable resistance among probiotics are of major concern, of which minimal information is available to date. The aim of this review was to describe the pros and cons of drug resistance among these beneficial microorganisms with emphasis on the recommended selection criteria for specific probiotics, devoid of transferable drug resistance genes, suitable for human consumption.