Review
The place of probiotics in human intestinal infections

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Abstract

A number of studies have been carried out on the effect of several probiotic species on treatment and prevention of intestinal infections. The most commonly used microorganisms are lactic-acid producing bacteria such as lactobacilli and bifidobacteria belonging to the human normal microflora. In vitro and animal studies have shown that probiotic microorganisms interfere with the colonisation of Helicobacter pylori and of enteropathogenic microorganisms. In humans the significance is more uncertain. Clinically significant benefits of probiotics have been demonstrated in the treatment of rotavirus induced diarrhoea and of Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea (AAD). In patients suffering from inflammatory bowel disease, several probiotic strains have been shown to be as effective as traditional medication in preventing relapses. Standardised and well performed studies are needed to elucidate further the mechanisms of action and the clinical significance of probiotics.

Section snippets

Background

Probiotics were initially used as growth-promoting animal feed supplements in the 1970s and it was considerably later that the definition, ‘a live microbial feed supplement which beneficially affects the host animal by improving its intestinal microbial balance’ was formulated by Fuller [1]. A redefinition of the concept to ‘a mono- or mixed culture of live microorganisms which, applied to animal or man, affects beneficially the host by improving the properties of the indigenous microflora’,

Helicobacter pylori

H. pylori is a Gram-negative spiral-shaped, microaerophilic rod colonizing the human gastric mucosa. The organism is associated with the development of chronic gastritis, peptic ulcers and gastric cancer. Urease is an important product produced by H. pylori. Urease hydrolyses urea to ammonium, leading to increased pH in the stomach which promotes colonization of the microorganism. Treatment of this infection involves proton pump inhibitors in combination with one or two antimicrobial agents [13]

Conclusions

The clinical applicability and the mechanisms of action of probiotics in prevention and treatment of intestinal infections are still not fully explored. Promising results from in vitro and animal studies have been obtained but results from human trials are often inconsistent. One explanation is that several different strains have been used in the search for clinically useful biotherapeutic agents but studies on specific strains like Lactobacillus GG have also yielded conflicting results. Lack

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