激光共聚焦显微镜观察阴道来源乳杆菌生物膜的形成

目的:采用激光共聚焦显微镜技术动态观察一株女性阴道来源卷曲乳杆菌生物膜的形成过程. 方法:使用体外盖玻片生物膜培养法,培养阴道来源卷曲乳杆菌的生物膜,在培养2、4、8、12、16、20、24、48、72、96、120 h后取出盖玻片,用异硫氰酸荧光素标记的刀豆蛋白A( fluorescein isothiocyanate-conjugatedconcanavalin A,FITC-conA)和碘化丙啶( andpropidium,PI)双重免疫荧光染色,激光共聚焦显微镜( confocal laser scanning microscopy, CLSM)观察卷曲乳杆菌生物膜形成过程与特点. 结果:获得生物膜形成过程不同时间点的CLSM图像,观察到卷曲乳杆菌在4 h即开始有散在的细菌黏附于盖玻片上,为可逆吸附期;8~20 h细菌黏附量逐渐增加,进入不可逆吸附期,20 h细菌聚集成团,生物膜初步形成;24~48 h形成大片的生物膜菌落,细菌镶嵌在大量多糖基质中,结构紧密,形态稳定,生物膜成熟;72 h后生物膜菌落开始解聚. 培养20 h乳杆菌生物膜密度为42. 7 × 10 -3 ± 6. 83 × 10 -3 ,24 h上升为102.5 ×10 -3 ±23.14 ×10 -3,两者相比差异具有统计学意义(P<0.05),表明培养24 h乳杆菌生物膜形成. 结论:该株阴道来源卷曲乳杆菌在体外可形成生物膜,24 h可形成成熟的生物膜,72 h生物膜开始解聚再定植.     

The Effect of Lactobacillus plantarum 299v on the Incidence of Clostridium difficile Infection in High Risk Patients Treated with Antibiotics

Background: Lactobacillus plantarum 299v (LP299v) has been used in order to reduce gastrointestinal symptoms during antibiotic exposure. However, it remains controversial whether or not probiotics are effective in the prevention of Clostridium difficile infections (CDI) among patients receiving antibiotics. The aim of this study was to analyze the CDI among patients receiving antibiotics and hospitalized in the period before and after starting routine use of LP299v as a prevention of this infection. Methods: Among 3533 patients hospitalized in the nephrology and transplantation ward during a two-year period, 23 patients with CDI were diagnosed and enrolled in this retrospective study. Since November 2013, prevention of CDI with oral use of LP299v was performed in all patients treated with antibiotics and who were at a high risk of developing CDI. The observation period was divided into two twelve-month intervals before and after initiation of the use of LP299v as a prophylactic against CDI. Results: A significant (p = 0.0001) reduction of the number of cases of CDI was found after routinely using LP299v (n = 2; 0.11% of all hospitalized patients) compared with the previous twelve-month period of observation (n = 21; 1.21% of all hospitalized patients). Conclusions: Routine use of LP299v during treatment with antibiotics may prevent C. difficile infection in the nephrology and transplantation ward.     

嗜酸乳杆菌联合三联疗法治疗幽门螺杆菌感染的疗效

目的观察嗜酸乳杆菌片联合三联疗法治疗幽门螺杆菌(Hp)感染的疗效。方法 Hp感染患者258例随机分为三组,分别采用雷贝拉唑+克拉霉素+阿莫西林(三联组,86例)、三联组方案+复方嗜酸乳杆菌(益生菌组,85例)和三联组方案+铋剂(四联组,87例)治疗,测定各组胃黏膜IL-8表达,比较Hp根除率和不良反应发生情况。结果益生菌组Hp根除率为80.0%,高于三联组的60.5%(P<0.05)。益生菌组胃黏膜IL-8含量为(60.7±25.1)pg/ml,低于三联组的(73.1±27.7)pg/ml(P<0.05)。益生菌组腹泻、食欲减退、便秘等不良反应发生率低。结论嗜酸乳杆菌联合三联疗法能显著提高Hp根除率,减轻炎症反应,减少抗生素治疗相关不良反应。     

Microbiota That Affect Risk for Shigellosis in Children in Low-Income Countries

Pathogens in the gastrointestinal tract exist within a vast population of microbes. We examined associations between pathogens and composition of gut microbiota as they relate to Shigella spp./enteroinvasive Escherichia coli infection. We analyzed 3,035 stool specimens (1,735 nondiarrheal and 1,300 moderate-to-severe diarrheal) from the Global Enteric Multicenter Study for 9 enteropathogens. Diarrheal specimens had a higher number of enteropathogens (diarrheal mean 1.4, nondiarrheal mean 0.95; p<0.0001). Rotavirus showed a negative association with Shigella spp. in cases of diarrhea (odds ratio 0.31, 95% CI 0.17–0.55) and had a large combined effect on moderate-to-severe diarrhea (odds ratio 29, 95% CI 3.8–220). In 4 Lactobacillus taxa identified by 16S rRNA gene sequencing, the association between pathogen and disease was decreased, which is consistent with the possibility that Lactobacillus spp. are protective against Shigella spp.–induced diarrhea. Bacterial diversity of gut microbiota was associated with diarrhea status, not high levels of the Shigella spp. ipaH gene.     

米氮平联合奥替溴铵及复合乳酸菌胶囊治疗难治性腹泻型肠易激综合征的疗效观察

目的：观察米氮平联合奥替溴铵及复合乳酸菌胶囊治疗难治性腹泻型肠易激综合征（RIBS-D）的临床疗效。方法：82例RIBS-D患者随机分为试验组（43例）与对照组（39例）,两组均给奥替溴铵及复合乳酸菌胶囊,试验组加服米氮平,对照组加服安慰剂,疗程4周。结果：试验组与对照组的总有效率分别为95.35％、12.82％（P＜0.01）;试验组焦虑及抑郁评分较对照组显著降低,生活质量评分较对照组显著升高,差异均有统计学意义（P＜0.01）。结论：米氮平联合奥替溴铵及复合乳酸菌胶囊治疗RIBS-D患者,能明显改善症状、焦虑抑郁状态及生活质量,十分安全。     

Lactobacillus plantarum 299v Inhibits Escherichia coli-Induced Intestinal Permeability

The purpose of this work was to investigate whether a probiotic bacterium, Lactobacillus plantarum 299v, could affect Escherichia coli-induced passage of mannitol across the intestinal wall. Sprague-Dawley rats were pretreated for one week by either tube feeding with L. plantarum 299v twice daily, free access to L. plantarum 299v by adding the bacterium in the drinking water, or negative control receiving regular feeding. Intestinal segments were mounted in Ussing chambers and the mucosa was exposed to control medium, E. coli, and L. plantarum 299v (alone or together). [¹⁴C]Mannitol was added as a marker of intestinal permeability and samples were taken from the serosal side. E. coli exposure induced a 53% increase in mannitol passage across the intestinal wall (P < 0.05). One week of pretreatment with L. plantarum 299v in the drinking water abolished the E. coli-induced increase in permeability. Tube feeding for one week or short-term addition of L. plantarum 299v in the Ussing chambers had no effect on the permeability provoked by E. coli challenge. Notably, L. plantarum 299v itself did not change the intestinal passage of mannitol. These data demonstrate that pretreatment with L. plantarum 299v, which is a probiotic bacterium, protects against E. coli-induced increase in intestinal permeability, and that L. plantarum 299v alone has no influence on the intestinal permeability. Thus, this study supports the concept that probiotics may exert beneficial effects in the gastrointestinal tract.     

复方嗜酸乳杆菌片在幽门螺杆菌根除失败补救方案中作用的研究

幽门螺杆菌(Hp)感染与慢性胃炎、消化性溃疡、胃黏膜相关淋巴样组织淋巴瘤和胃癌等疾病的发生有关。有研究显示,联合使用嗜酸乳杆菌能提高Hp根除率,并降低治疗过程中的不良反应。目的:探讨复方嗜酸乳杆菌片联合含铋剂四联疗法对首次根除失败的Hp感染的疗效。方法:将180例经标准三联疗法首次根除失败的Hp阳性的消化性溃疡患者随机分为试验组和对照组,试验组患者给予复方嗜酸乳杆菌片1 g tid,餐后服用,疗程14 d,然后给予雷贝拉唑10 mg bid+阿莫西林1 000 mg bid+呋喃唑酮100 mg bid+枸橼酸铋钾300 mg qid,疗程10 d。对照组患者给予雷贝拉唑10 mg bid+阿莫西林1 000 mg bid+呋喃唑酮100 mg bid+枸橼酸铋钾300 mg qid,疗程10 d。治疗结束至少4周后行~(13)C-尿素呼气试验,评估Hp根除率和不良反应。结果:试验组PP根除率和ITT根除率与对照组相比均无明显差异(PP:81.2%对78.2%,χ~2=0.241,P=0.623;ITT:76.7%对75.6%,χ~2=0.031,P=0.861)。试验组恶心呕吐(2.4%对11.5%)、腹泻(0对9.2%)的发生率明显低于对照组(P0.05)。结论:复方嗜酸乳杆菌片联合含铋剂四联疗法对首次标准三联疗法根除失败的Hp患者疗效较好,同时可有效减少不良反应。     

益生菌在根除幽门螺杆菌治疗中的作用

幽门螺杆菌(Helicobacter pylori,H.pylori)感染与上胃肠道疾病密切相关。由于H.pylori对抗生素耐药率的增加及根除治疗过程中不良反应的出现,导致标准三联疗法H.pylori根除率逐渐下降。益生菌辅助治疗H.pylori感染已取得一些成果,其在提高H.pylori根除率、降低不良反应中的作用日益受到重视。在H.pylori根除治疗中何时加用益生菌、加用何种益生菌成为国内外研究的热点,益生菌的疗效很大程度上依赖于菌种或菌株类型。益生菌还具有维持胃肠道微生态的稳定、减轻黏膜炎症反应等多种作用,本文对益生菌在根除H.pylori治疗中的作用机制及临床意义、益生菌在降低H.pylori治疗相关不良反应中的作用作一概述。