Zearalenone Adsorbent Based on a Lyophilized Indigenous Bacterial Lactobacillus plantarum Strain as Feed Additive for Pigs: A Preliminary Study In Vivo.

Feed contamination with naturally occurring mycotoxins is an unavoidable condition of significant concern in intensive productions. The presence of high concentrations of zearalenone >1 ppm in the diet can cause major reproductive disorders, particularly in swine. In order to reduce the consequences of intoxication, mycotoxin adsorbents are incorporated into feed. In the present study, zearalenone adsorption capacity of a lyophilized indigenous strain of Lactobacillus plantarum (L4; previously isolated from pig's rectal swabs) was first evaluated in vitro. A preliminary study in vivo was then performed in which the indigenous Lactobacillus plantarum strain was lyophilized and the powder obtained (L-L4) was incorporated into the diet of gilts two gilts received basal diet (control) and two received basal diet containing 2 g/kg L-L4 (treated). After an adaptation period, all the feed was contaminated with zearalenone at a dose of 0.93 mg ZEA/kg. Results from in vitro assay showed that L-L4 adsorbed 87.9% (SD 3.97) of zearalenone in 0.9% NaCl solution. In the in vivo exploratory study, higher daily weight gain and lower vulva area were observed in gilts that incorporated L-L4 to the diet. Additionally, higher zearalenone concentrations were eliminated in faeces from treated animals. The use of a product based on a lyophilized indigenous Lactobacillus strain to protect gilts from detrimental effects of zearalenone consumption has shown promising results so far. However, further studies are required in order to accurately assess its impact and evaluate doses according to different degrees of mycotoxins contamination.

Zearalenone adsorption capacity of lactic acid bacteria isolated from pigs

ABSTRACT The ability to adsorb zearalenone by five strain of lactic acid bacteria was evaluated: four strains of Lactobacillus spp. isolated from pig rectal swabs and one commercial strain (Lactobacillus rhamnosus). Several factors affecting the adsorption capacity were evaluated in order to improve the adsorption of the mycotoxin by bacteria. The stability of the zearalenone-bacteria complex was analyzed. In every case, bacterial adsorption capacity was higher than 40.0%. The strain showing the highest adsorption (68.2%) was selected for the following steps of this research. The adsorption percentages obtained after processing 6.5 and 7.5 mL MRS broth were 57.40% + 3.53 and 64.46% + 0.76, respectively. The stability of zearalenone-bacteria complex was evaluated by successively rinsing. In the first rinsing step 42.26% + 0.414 was still bound. In the second rinsing step 25.12% + 0.664 was still bound, whereas 15.82% + 0.675 remained in the pellet after the third rinse. Results obtained demonstrated that Lactic Acid Bacteria has capacity to adsorb zearalenone. Finally adsorption was increased using a higher volume of initial broth. These results could be used to design a new lyophilized powder for detoxification, using lactic acid bacteria as potential zearalenone adsorbents.(AU)

Zearalenone adsorption capacity of lactic acid bacteria isolated from pigs

ABSTRACT The ability to adsorb zearalenone by five strain of lactic acid bacteria was evaluated: four strains of Lactobacillus spp. isolated from pig rectal swabs and one commercial strain (Lactobacillus rhamnosus). Several factors affecting the adsorption capacity were evaluated in order to improve the adsorption of the mycotoxin by bacteria. The stability of the zearalenone-bacteria complex was analyzed. In every case, bacterial adsorption capacity was higher than 40.0%. The strain showing the highest adsorption (68.2%) was selected for the following steps of this research. The adsorption percentages obtained after processing 6.5 and 7.5 mL MRS broth were 57.40% + 3.53 and 64.46% + 0.76, respectively. The stability of zearalenone-bacteria complex was evaluated by successively rinsing. In the first rinsing step 42.26% + 0.414 was still bound. In the second rinsing step 25.12% + 0.664 was still bound, whereas 15.82% + 0.675 remained in the pellet after the third rinse. Results obtained demonstrated that Lactic Acid Bacteria has capacity to adsorb zearalenone. Finally adsorption was increased using a higher volume of initial broth. These results could be used to design a new lyophilized powder for detoxification, using lactic acid bacteria as potential zearalenone adsorbents.

Zearalenone adsorption capacity of lactic acid bacteria isolated from pigs.

The ability to adsorb zearalenone by five strain of lactic acid bacteria was evaluated: four strains of Lactobacillus spp. isolated from pig rectal swabs and one commercial strain (Lactobacillus rhamnosus). Several factors affecting the adsorption capacity were evaluated in order to improve the adsorption of the mycotoxin by bacteria. The stability of the zearalenone-bacteria complex was analyzed. In every case, bacterial adsorption capacity was higher than 40.0%. The strain showing the highest adsorption (68.2%) was selected for the following steps of this research. The adsorption percentages obtained after processing 6.5 and 7.5mL MRS broth were 57.40%+3.53 and 64.46%+0.76, respectively. The stability of zearalenone-bacteria complex was evaluated by successively rinsing. In the first rinsing step 42.26%+0.414 was still bound. In the second rinsing step 25.12%+0.664 was still bound, whereas 15.82%+0.675 remained in the pellet after the third rinse. Results obtained demonstrated that Lactic Acid Bacteria has capacity to adsorb zearalenone. Finally adsorption was increased using a higher volume of initial broth. These results could be used to design a new lyophilized powder for detoxification, using lactic acid bacteria as potential zearalenone adsorbents.

Decrease in lactobacilli in the intestinal microbiota of celiac children with a gluten-free diet, and selection of potentially probiotic strains.

The intestinal microbiota would be implicated in pathology associated with celiac disease caused by an abnormal immune system reaction against gluten present in cereal grains. The objectives of this work were to detect through basic methods the changes in the composition of the most common genera of bacteria from the intestinal microbiota of symptom-free celiac disease children with a gluten-free diet compared with healthy children from Tucumán and to select lactobacilli (Lb) strains with probiotic potential from the feces of healthy children. Results demonstrated that the feces of celiac children with a gluten-free diet showed significantly lower counts of Lb (P < 0.05) compared with healthy children, while enterobacteria tended to increase in celiac children. On the basis of these results, isolation of some Lb from the feces of healthy children was carried out. Thus, 5 Lb strains were selected because of their high resistance percentages to gastrointestinal tract conditions. In addition, their autoaggregation and hydrophobicity properties were evaluated: Lactobacillus rhamnosus (LC4) showed the highest percentage of autoaggregation while Lactobacillus paracasei (LC9) showed high hydrophobicity. Based on these results, LC4 and LC9 were selected, and their use as potential probiotic strains to improve signs and symptoms associated with celiac disease is discussed. This is the first study performed in Argentina concerning the relationship between intestinal microbiota and celiac disease in celiac children with a gluten-free diet. In addition, the development of a probiotic food addressed towards celiac patients and designed with Lb isolated from the feces of healthy children from our province represents a promising alternative to improve the quality of life of celiac patients.

Microbiological culture broth designed from food waste.

The current trend of increasing air, water, and soil pollution is, in part, due to inadequate management of municipal solid waste (MSW). The relationship between public health and the collection, storage and improper disposal of solid waste has encouraged several studies and the results were attributed to the spread of over twenty human and animal diseases due to this interrelationship. The term "single cell protein" (SCP) refers to microbial biomass used as a dietary additive. It has high nutritional value because of its high content of vitamins, lipids, and proteins of biological quality (the presence of all essential amino acids) (Lal, 2005). The aim of this work was to design a culture media for microbiological assays and to produce SCP for animal feeding, using nutrients contained in organic waste. In order to compare the effectiveness of food waste (FW) and LAPTg media, different strains of Lactobacillus, Enterococcus, Staphylococcus, Shigella, Salmonella, Saccharomyces and Schizosaccharomyces were studied. In all cases, the growth obtained from FW and LAPTg culture media were not significantly different (p > 0.05). In addition, the growth of Saccharomyces cerevisiae was studied in order to produce SCP for animal feeding. Comparative experiments involving molasses broth, FW broth, and basal broth were carried out. The biomass yield calculated at 24 h from FW broth was 13% lower than from molasses broth. The FW broth provided a significantly lower biomass yield; however, it can be very useful in areas where molasses are not available. FW broth can be elaborated at low cost, in any populated region of the world because its ingredients are wastes generated by humans. It has great versatility, allowing the development of a wide variety of microorganisms, both Gram negative and Gram positive bacteria as well as yeasts. The production of safe protein additives, with high biological quality and low cost, is necessary due to the increasing global demand for food for humans and animals.

Parasitic prevalence in a suburban school of famaillá, tucumán, Argentina.

Prevalence of intestinal parasites was investigated in rural primary school children in Famaillá city, Tucumán province, Argentina. Stool specimens from 149 school children were collected. The prevalence rate of intestinal parasite infections was 86.6%. No significant differences were observed in the distribution by age or by sex. Blastocystis hominis was the most commonly found protozoan parasite (54.4%), followed by Entamoeba coli (35.6%), Giardia lamblia (24.8%), and others (16.7%). Enterobius vermicularis was the most prevalent intestinal helminth (27.5%), followed by Ascaris lumbricoides (20.8%), Trichuris trichiura (12.8%), and others (5.4%). Most of the patients had polyparasitism (62.4%), and protozoan infections prevailed over helminthic infections. These results show high rates of parasitism in the school children of Famaillá, which would be associated with socioeconomic factors and poor environmental sanitation conditions in this area.

Effect of functional buffalo cheese on fatty acid profile and oxidative status of liver and intestine of mice.

The objective of this study was to determine the influence of administration of buffalo dairy products on lipid content and conjugated linoleic acid (CLA) incorporation on liver and intestine of mice. Buffalo cheeses were selected according to nutritional properties and CLA content. Cheeses were previously manufactured using as adjunct culture bacteria with probiotic or technological properties. BALB/c mice were fed for 28 days, and then a single dose of 1,2-dimethylhydrazine (DMH) as oxidant agent was administered before the influence of diet and DMH on antioxidant status in tissues was evaluated. Mice fed buffalo cheese showed the highest body weight gain (P < .05). Polyunsaturated fatty acid (PUFA) content in foods was very different, but total PUFA incorporation was similar in mouse tissues. CLA was only detected in fat tissues of mice fed dairy products, with cis-9, trans-11 being the major isomer. A higher linolenic (C(18:3)) acid content was found in tissues of mice fed commercial diet (control group), and it was partially replaced by CLA in groups receiving buffalo milk or cheese. Lipoperoxides (thiobarbituric acid-reactive substances) were higher in tissues of the control group with or without DMH administration, and DMH had a cytotoxic effect on colon cells (P < .05). Superoxide dismutase (SOD) and catalase activities in liver and intestine were similar among animals, with a slight increase of SOD detected after DMH treatment. Consumption of buffalo dairy products did not affect the oxidative status of mice tissues even after DMH application. In the present study, a protective effect of buffalo cheese and milk on intestine cells was determined.

Contribution of lactic acid bacteria esterases to the release of fatty acids in miniature ewe's milk cheese models.

The present work evaluates the contribution of esterase activities of lactic acid bacteria isolated from ewe's dairy products to the release of free fatty acids (FFA) in ewe's milk cheese models. At 60 days of ripening, single-strain cheeses Ov 409 and Ov 421 showed high levels of total FFA (3075 and 2494.62 mg/kg, respectively). Cheeses Ov 227-Ov 409 and Ov 421-Ov 409 presented high percentages of short-chain fatty acids (SCFA). The highest levels of volatile free fatty acids (VFFA) were detected in cheeses Ov 409, Ov 421-Ov 409, and Ov 421-Ov 227. Studies on esterase activities showed that these strains hydrolyzed alpha-naphthyl derivatives of fatty acids from C2 to C6, mainly associated with the wall-membrane fraction. The results showed that the strains studied contributed to the release of FFA during ripening of ewe's milk cheese models. The increase of SCFA throughout ripening involves the action of esterases of starter strains.

Citrate metabolism by Enterococcus faecium and Enterococcus durans isolated from goat's and ewe's milk: influence of glucose and lactose.

Citrate metabolism by Enterococcus faecium ET C9 and Enterococcus durans Ov 421 was studied as sole energy source and in presence of glucose or lactose. Both strains utilized citrate as the sole energy source. Enterococcus faecium ET C9 showed diauxic growth in the presence of a limiting concentration of glucose. Neither strain used citrate until glucose was fully metabolized. The strains showed co-metabolism of citrate and lactose. Lactate, acetate, formate, and flavour compounds (diacetyl, acetoin, and 2,3-butanediol) were detected in both strains. The highest production of flavour compounds was detected during growth of E. durans Ov 421 in media supplemented with citrate-glucose and citrate-lactose. Citrate lyase was inducible in both strains. Acetate kinase activities presented the highest values in LAPTc medium, with E. faecium ET C9 displaying a specific activity 2.4-fold higher than E. durans. The highest levels of alpha-acetolactate synthase specific activity were detected in E. durans grown in LAPTc+g, in accordance with the maximum production of flavour compounds detected in this medium. Diacetyl and acetoinreductases displayed lower specific activity values in the presence of citrate. Enterococcus faecium and E. durans displayed citrate lyase, acetate kinase, alpha-acetolactate synthase, and diacetyl and acetoin reductase activities. These enzymes are necessary for conversion of citrate to flavour compounds that are important in fermented dairy products.

Lactobacillus casei CRL 431 and Lactobacillus rhamnosus CRL 1224 as biological controls for Aspergillus flavus strains.

The effect of two species of lactobacilli, Lactobacillus casei CRL 431 and Lactobacillus rhamnosus CRL 1224, on growth of different Aspergillus flavus strains was determined. A. flavus strains (Ap, TR2, or CF80) were grown in LAPTg broth at 37 degrees C for 7 days as a single culture and in association with L. casei CRL 431 or L. rhamnosus CRL 1224 at initial inoculum ratios of 1:1, 1:10, and 1:100. In most cases, the mixed cultures had a lower fungal growth and a lower pH than the control cultures. Mycelial dry weight was reduced to 73 and 85% using L. casei CRL 431 and L. rhamnosus CRL 1224, respectively. The pH decrease in mixed cultures when the fungal mycelial dry weight is reduced may play an important role in inhibition. The number of viable bacteria was variably affected by fungal growth. These results indicate that L. casei CRL 431 and L. rhamnosus CRL 1224 may be useful as potential biocontrol agent against A. flavus.

Technological properties of Enterococcus faecium isolated from ewe's milk and cheese with importance for flavour development.

Eight Enterococcus faecium strains isolated from ewe milk and artisanal cheese from northwest Argentina were screened for biotechnological properties relevant to flavour development. The API ZYM test showed absence of proteases, presence of high amounts of peptidases, and high esterase-lipase activities. Low extracellular proteolytic activity was observed. Most strains produced diacetyl in milk, with E. faecium OvL 214 and OvL 254 being the best producers. Biomass and growth rate increased when citrate was added to the medium, suggesting that these strains could use citrate as a main energy source. After 24 h of incubation, citrate was completely consumed in complex medium supplemented with glucose and citrate. An average of 17% residual citrate was detected in complex media supplemented with citrate. For all strains, esterase activity was detected up to alpha-naphthyl-caproate. They hydrolyzed alpha-naphthyl derivatives of fatty acids in this order: C3 > C6 > C4 > C8 > C2. Post-electrophoretic detection of esterase activities revealed the presence of multiple esterases. Hydrolysis of tributyrin, tricaprylin, and milk fat was observed in cell-free extracts. Enterococcus faecium strains isolated from ewe milk and artisanal cheese from northwest Argentina present the metabolic potential to contribute to cheese flavour development.

Effect of Lactobacillus strains and Saccharomyces boulardii on persistent diarrhea in children.

The efficacy of probiotics on persistent diarrhea remains uncertain. The purpose of this study was to evaluate the effect of Lactobacillus sp and Saccharomyces boulardii on persistent diarrhea in children. In a double-blind trial eighty-nine children, aged 6-24 months were randomly distributed to receive pasteurized cow milk containing 2 viable lyophilized strains Lactobacillus casei and Lactobacillus acidophillus strains CERELA, (10(10)-10(12) colony-forming units per g) (n = 30), or lyophilized S. boulardii, (10(10)-10(12) colony forming units per g) (n = 30) or pasteurized cow milk as placebo (n = 29); on each diet 175 g was given twice a day for a 5 day period. Number of depositions, duration of illness and frequency of vomiting were considered. Enteric pathogens were isolated from stools in 40% of the patients, 27% had rotavirus. Lactobacillus and S. boulardii significantly reduced the number of depositions (p < 0.001) and diarrheal duration (p < 0.005). Similarly both significantly (p < 0.002) reduced vomiting as compared with placebo. There was no difference between treatments depending on rotavirus status. In conclusion, L. casei and L. acidophillus strains CERELA and S. boulardii are useful in the management of persistent diarrhea in children.

Effect of Lactobacillus strains and Saccharomyces boulardii on persistent diarrhea in children

The efficacy of probiotics on persistent diarrhea remains uncertain. The purpose of this study was to evaluate the effect of Lactobacillus sp and Saccharomyces boulardii on persistent diarrhea in children. In a double-blind trial eighty-nine children, aged 6-24 months were randomly distributed to receive pasteurized cow milk containing 2 viable lyophilized strains Lactobacillus casei and Lactobacillus acidophillus strains CERELA, (10(10)-10(12) colony-forming units per g) (n = 30), or lyophilized S. boulardii, (10(10)-10(12) colony forming units per g) (n = 30) or pasteurized cow milk as placebo (n = 29); on each diet 175 g was given twice a day for a 5 day period. Number of depositions, duration of illness and frequency of vomiting were considered. Enteric pathogens were isolated from stools in 40 of the patients, 27 had rotavirus. Lactobacillus and S. boulardii significantly reduced the number of depositions (p < 0.001) and diarrheal duration (p < 0.005). Similarly both significantly (p < 0.002) reduced vomiting as compared with placebo. There was no difference between treatments depending on rotavirus status. In conclusion, L. casei and L. acidophillus strains CERELA and S. boulardii are useful in the management of persistent diarrhea in children

Effect of Lactobacillus strains and Saccharomyces boulardii on persistent diarrhea in children.

The efficacy of probiotics on persistent diarrhea remains uncertain. The purpose of this study was to evaluate the effect of Lactobacillus sp and Saccharomyces boulardii on persistent diarrhea in children. In a double-blind trial eighty-nine children, aged 6-24 months were randomly distributed to receive pasteurized cow milk containing 2 viable lyophilized strains Lactobacillus casei and Lactobacillus acidophillus strains CERELA, (10(10)-10(12) colony-forming units per g) (n = 30), or lyophilized S. boulardii, (10(10)-10(12) colony forming units per g) (n = 30) or pasteurized cow milk as placebo (n = 29); on each diet 175 g was given twice a day for a 5 day period. Number of depositions, duration of illness and frequency of vomiting were considered. Enteric pathogens were isolated from stools in 40

of the patients, 27

had rotavirus. Lactobacillus and S. boulardii significantly reduced the number of depositions (p < 0.001) and diarrheal duration (p < 0.005). Similarly both significantly (p < 0.002) reduced vomiting as compared with placebo. There was no difference between treatments depending on rotavirus status. In conclusion, L. casei and L. acidophillus strains CERELA and S. boulardii are useful in the management of persistent diarrhea in children.

Effect of Lactobacillus strains and Saccharomyces boulardii on persistent diarrhea in children

The efficacy of probiotics on persistent diarrhea remains uncertain. The purpose of this study was to evaluate the effect of Lactobacillus sp and Saccharomyces boulardii on persistent diarrhea in children. In a double-blind trial eighty-nine children, aged 6-24 months were randomly distributed to receive pasteurized cow milk containing 2 viable lyophilized strains Lactobacillus casei and Lactobacillus acidophillus strains CERELA, (10(10)-10(12) colony-forming units per g) (n = 30), or lyophilized S. boulardii, (10(10)-10(12) colony forming units per g) (n = 30) or pasteurized cow milk as placebo (n = 29); on each diet 175 g was given twice a day for a 5 day period. Number of depositions, duration of illness and frequency of vomiting were considered. Enteric pathogens were isolated from stools in 40 of the patients, 27 had rotavirus. Lactobacillus and S. boulardii significantly reduced the number of depositions (p < 0.001) and diarrheal duration (p < 0.005). Similarly both significantly (p < 0.002) reduced vomiting as compared with placebo. There was no difference between treatments depending on rotavirus status. In conclusion, L. casei and L. acidophillus strains CERELA and S. boulardii are useful in the management of persistent diarrhea in children (AU)

Effect of Lactobacillus strains (L. casei and L. Acidophillus Strains cerela) on bacterial overgrowth-related chronic diarrhea.

Small bowel bacterial overgrowth and related diarrhea is a condition that frequently accompanies anatomic disorders, surgically created blind loops or strictures with partial small bowel obstruction and although it is often controlled with antimicrobial therapy, alternative treatment may be needed. The aim of this study was to evaluate the efficacy of an oral probiotic preparation of 2 viable lyophilized strains of lactobacilli (1.5 g each) compared with placebo. Twenty two patients with proven overgrowth and chronic diarrhea are described. In random order and double-blind fashion, 2 groups of patients received identical capsules with both Lactobacillus casei and L. acidophillus strains CERELA (12 patients) (LC) and placebo (10 patients) (P) during three consecutive periods of 7 days each followed by a similar three periods of control after withdrawal. At the end of each period the mean daily number of stools, glucose breath H2 test, and symptoms were considered. Lactobacillus were investigated in feces in both groups at day 0 (baseline), on day 21 of treatment with LC and P and on day 21 after withdrawal. Compared with P a significant reduction in mean daily number of stools was achieved with LC (p < 0.005) at 15 days, and (p < 0.0005) at 21 days and the effect was sustained at 7 days and 15 days (p < 0.005) after withdrawal. With respect to breath H2 level a significant decrease in H2 concentration was noted at 7 days (p < 0.005) at 15 days, and 21 days (p < 0.0001) with LC and only a significant decrease (p < 0.005) was observed at 7 days after withdrawal. No significant changes were observed with respect to symptoms. The Lactobacillus CERELA strains were isolated from the feces in all patients LC (n = 12) on day 21, and by contrast no Lactobacillus were observed except in two patients out of seven patients after withdrawal. In summary, this study provides evidence that LC are effective for treatment of bacterial overgrowth--related chronic diarrhea, and suggest that probiotics must be used with continuity.

Adhesion of dairy propionibacteria to intestinal epithelial tissue in vitro and in vivo.

Adhesion to the intestinal mucosa is a desirable property for probiotic microorganisms and has been related to many of their health benefits. In the present study, 24 dairy Propionibacterium strains were assessed with regard to their hydrophobic characteristics and their autoaggregation and hemagglutination abilities, since these traits have been shown to be indicative of adherence in other microorganisms. Six strains were further tested for their capacity to adhere to ileal epithelial cells in vitro and in vivo. The results of the study showed that propionibacteria were highly hydrophilic, and hemagglutination and autoaggregation were properties not commonly found among these microorganisms. No relationship was found between surface characteristics and adhesion ability, since hemagglutinating, autoaggregating, and nonautoaggregating bacteria were able to adhere to intestinal cells both in vitro and in vivo. Microscopic examination revealed that autoaggregating cells adhered in clusters, with adhesion being mediated by only a few bacteria, whereas the hemagglutinating and nonautoaggregating strains adhered individually or in small groups making contact with each epithelial cell with the entire bacterial surface. The in vitro assessment of adhesion was a good indication of the in vivo association of propionibacteria with the intestinal epithelium. Therefore, the in vitro method presented here should be valuable in screening routinely adhesive properties of propionibacteria for probiotic purposes. The adhesion ability of dairy propionibacteria would prolong their maintenance in the gut and increase the duration of their provision of beneficial effects in the host, supporting the potential of Propionibacterium in the development of new probiotic products.

Effect of Lactobacillus strains (L. casei and L. Acidophillus Strains cerela) on bacterial overgrowth-related chronic diarrhea.

Small bowel bacterial overgrowth and related diarrhea is a condition that frequently accompanies anatomic disorders, surgically created blind loops or strictures with partial small bowel obstruction and although it is often controlled with antimicrobial therapy, alternative treatment may be needed. The aim of this study was to evaluate the efficacy of an oral probiotic preparation of 2 viable lyophilized strains of lactobacilli (1.5 g each) compared with placebo. Twenty two patients with proven overgrowth and chronic diarrhea are described. In random order and double-blind fashion, 2 groups of patients received identical capsules with both Lactobacillus casei and L. acidophillus strains CERELA (12 patients) (LC) and placebo (10 patients) (P) during three consecutive periods of 7 days each followed by a similar three periods of control after withdrawal. At the end of each period the mean daily number of stools, glucose breath H2 test, and symptoms were considered. Lactobacillus were investigated in feces in both groups at day 0 (baseline), on day 21 of treatment with LC and P and on day 21 after withdrawal. Compared with P a significant reduction in mean daily number of stools was achieved with LC (p < 0.005) at 15 days, and (p < 0.0005) at 21 days and the effect was sustained at 7 days and 15 days (p < 0.005) after withdrawal. With respect to breath H2 level a significant decrease in H2 concentration was noted at 7 days (p < 0.005) at 15 days, and 21 days (p < 0.0001) with LC and only a significant decrease (p < 0.005) was observed at 7 days after withdrawal. No significant changes were observed with respect to symptoms. The Lactobacillus CERELA strains were isolated from the feces in all patients LC (n = 12) on day 21, and by contrast no Lactobacillus were observed except in two patients out of seven patients after withdrawal. In summary, this study provides evidence that LC are effective for treatment of bacterial overgrowth--related chronic diarrhea, and suggest that probiotics must be used with continuity.

Effect of Lactobacillus strains (L. casei and L. Acidophillus Strains cerela) on bacterial overgrowth-related chronic diarrhea

Small bowel bacterial overgrowth and related diarrhea is a condition that frequently accompanies anatomic disorders, surgically created blind loops or strictures with partial small bowel obstruction and although it is often controlled with antimicrobial therapy, alternative treatment may be needed. The aim of this study was to evaluate the efficacy of an oral probiotic preparation of 2 viable lyophilized strains of lactobacilli (1.5 g each) compared with placebo. Twenty two patients with proven overgrowth and chronic diarrhea are described. In random order and double-blind fashion, 2 groups of patients received identical capsules with both Lactobacillus casei and L. acidophillus strains CERELA (12 patients) (LC) and placebo (10 patients) (P) during three consecutive periods of 7 days each followed by a similar three periods of control after withdrawal. At the end of each period the mean daily number of stools, glucose breath H2 test, and symptoms were considered. Lactobacillus were investigated in feces in both groups at day 0 (baseline), on day 21 of treatment with LC and P and on day 21 after withdrawal. Compared with P a significant reduction in mean daily number of stools was achieved with LC (p < 0.005) at 15 days, and (p < 0.0005) at 21 days and the effect was sustained at 7 days and 15 days (p < 0.005) after withdrawal. With respect to breath H2 level a significant decrease in H2 concentration was noted at 7 days (p < 0.005) at 15 days, and 21 days (p < 0.0001) with LC and only a significant decrease (p < 0.005) was observed at 7 days after withdrawal. No significant changes were observed with respect to symptoms. The Lactobacillus CERELA strains were isolated from the feces in all patients LC (n = 12) on day 21, and by contrast no Lactobacillus were observed except in two patients out of seven patients after withdrawal. In summary, this study provides evidence that LC are effective for treatment of bacterial overgrowth--related chronic diarrhea, and suggest that probiotics must be used with continuity.