Probiotics, mechanisms of action, and clinical perspectives for diarrhea management in children

Abstract

Infectious diarrhea is the second most common cause of morbidity and mortality in children under 5 years of age in the underdeveloped areas of the world. Conventional treatment consists of rehydration, which may be coupled with antimicrobial agents in more severe bacterial infections or with antiprotozoal agents. In the last few decades, research on the use of probiotic strains, such as Lactobacillus rhamnosus GG ATCC 53013 (LGG), Lactobacillus reuteri DSM 17938 and Saccharomyces boulardii, has gained much attention to prevent and treat diarrheal diseases. However, they are rarely used in the clinical routine, perhaps because there are still gaps in the knowledge about the effective benefit to the patient in terms of the reduction of the duration of diarrhea and its prevention. Furthermore, only a few probiotic strains are safely indicated for usage in pediatric practice. This review summarizes the current knowledge on the antimicrobial mechanisms of probiotics on distinct enteropathogens and their role in stimulating host defense mechanisms against intestinal infections. In addition, we highlight the potential of probiotics for the treatment and prevention of diarrhea in children. We conclude that the use of probiotics is beneficial for both the treatment and prevention of diarrhea in children and that the identification of other candidate probiotics might represent an important advance to a greater reduction in hospital stays and to prevent infectious diarrhea in a larger portion of this population.

In Vitro Antimicrobial Activity and Probiotic Potential of Bifidobacterium and Lactobacillus against Species of Clostridium

“…Various species of Lactobacillus are able to produce compounds with antimicrobial activities, including organic (acetic and lactic) acids, low-molecular-weight compounds, antifungal peptides, and antibacterial peptides (bacteriocins) [53,54]. It appears, however, that the inhibition of Clostridium growth exhibited by the probiotic strains was not the result of the overproduction of acids, since the addition of buffer to the MRS media did not affect the inhibitory activity of the majority of these species.…”

Lactobacillus acidophilus Antimicrobial Peptide Is Antagonistic to Aeromonas hydrophila

“…Therefore, we conclude that L. acidophilus and LABS may be suitable candidates for the long-term control of A. hydrophila infections and can be introduced into fish feed, which is the best way to administer drug candidates. Live probiotics are known to cause health problems (possibly by antibiotic resistance gene transfer); however, the products of Lactobacillus do not cause any adverse effects, such as non-specific killing ( Gareau et al, 2010 ; do Carmo et al, 2018 ). The presence of excessive amounts of antimicrobial agents of L. acidophilus does not cause environmental pollution, and does not create resistant bacteria.…”

Perspectives on Probiotics and Bronchopulmonary Dysplasia

“…In vitro experiments showed antibacterial activity of Bifidobacterium and Lactobacillus against Clostridium (67), which was probably mediated by bacteriocins, microcins, and short-chain fatty acids (SCFAs) (68). Bacteriocins change the permeability of the inner membrane of pathogenic bacteria, affecting cell wall synthesis (69), whereas microcins directly impair the activity of enzymes required by pathogens in the process of gene replication and transcription (70).…”