Efficacy of Bacillus clausii in Pediatric Functional Constipation: A Pilot of a Randomized, Double-Blind, Placebo-Controlled Trial

Purpose: To evaluate the efficacy of Bacillus clausii in the treatment of pediatric constipation. Methods: A randomized, double-blind, placebo-controlled trial was conducted from January, 2021 to January, 2022 in children aged 1-5 years diagnosed with functional constipation according to Rome IV criteria. They were assigned to receive either B. clausii or placebo, once daily for four weeks. The primary out-come was treatment success (defined as ?3 spontaneous stools per week and stool consistency grade ?3 on Bristol stool chart). The secondary outcome was a comparison of stool frequency, consistency (defined by Bristol stool grade), and constipationrelated symptoms. Results: This trial enrolled 38 children (B. clausii, n=20 and placebo, n=18). At 4 weeks, no significant difference was noted in the treatment success between B. clausii and placebo groups [45% vs 56%; P=0.52). On within-group analyses, the mean (SD) of Bristol stool grade increased in both the B. clausii [1.7 (0.5) to 2.8 (1.2); P=0.003] and placebo [1.8 (0.5) to 2.8 (1.2); P=0.01] groups. Significant increases in the treatment success rate (22% to 56%, P=0.01) and mean stool frequency per week [3 (0.9) to 4.2 (1.7), P=0.01] were pronounced only in the placebo group. The frequency of painful defecation and large fecal mass were also significantly decreased in both the groups. No serious adverse events were observed. Conclusion: A 4-week course of B. clausii as the sole treatment was not more effective than a placebo for the management of functional constipation in children aged 1-5 years.

Willingness and influencing factors of multitarget stool DNA testing among individuals receiving colonoscopy screening / 预防医学

Abstract@#Objective To investigate the willingness to receiving multitarget stool DNA (MT-sDNA) testing and factors affecting the payment among individuals receiving colonoscopy screening, so as to provide the evidence for the formulation and health economic evaluation of colorectal cancer screening strategies. @*Methods@# Individuals at ages of 40 to 75 years that received colonoscopy screening in The Affiliated Hospital of Ningbo University Medical School from August 2021 to March 2022 were sampled. Participants' demographics, living behaviors, family history, willingness to receive MT-sDNA testing and willingness to pay for MT-sDNA testing were collected using questionnaire surveys, and factors affecting the willingness to receive and pay for MT-sDNA testing were analyzed using a multivariable logistic regression model.@*Results @#A total of 546 respondents were enrolled, with a mean age of (56.25±8.66) years and including 282 men (51.65%). There were 504 respondents that were willing to receiving MT-sDNA testing (92.31%) and 480 that were willing to pay for the MT-sDNA testing (88.24%). Multivariable logistic regression analysis showed that a family history of colorectal cancer in first-degree relatives (OR=0.246, 95%CI: 0.068-0.888), history of hemorrhoids (OR=0.300, 95%CI: 0.109-0.826) resulted in low willingness to receive MT-sDNA testing, and recognizing the reliability of MT-sDNA testing (OR=5.749, 95%CI: 1.480-22.323), considering no difficulty in sampling for MT-sDNA testing (OR=32.042, 95%CI: 6.666-154.021) and considering a difficulty in sampling for MT-sDNA testing (OR=20.278, 95%CI: 4.405-93.354) resulted in high willingness to receive MT-sDNA testing, while recognizing the reliability of MT-sDNA testing (OR=5.003, 95%CI: 1.761-14.216), concern about the reliability of MT-sDNA testing (OR=4.166, 95%CI: 1.285-13.501), considering no difficulty in sampling for MT-sDNA testing (OR=6.558, 95%CI: 2.105-20.428) and considering a difficulty in sampling for MT-sDNA testing (OR=5.820, 95%CI: 1.810-18.720) resulted in high willingness to pay for the MT-sDNA testing among individuals receiving colonoscopy screening.@*Conclusion @#A family history of colorectal cancer in first-degree relatives, history of hemorrhoids and awareness of MT-sDNA testing are factors affecting the willingness to receive and pay for the MT-sDNA testing among individuals receiving colonoscopy screening.

Genome of a husavirus from Southern Brazil

ABSTRACT New viruses of the Picornavirales order have been discovered with the increase in the number of sequences obtained by high-throughput sequencing, as well as human stool-associated RNA virus (husavirus [HuV]), found in human stool samples. However, there is much to be clarified about HuV. Its cellular host, evolutionary history, and other biological characteristics are still unknown. Therefore, samples collected from human beings and environmental samples in a watershed in Southern Brazil were processed for the metagenomic library. Upon metagenomic analysis, we identified a HuV (husavirus LMM_67754 OP019707) genome with 8,846 bp, which was reported for the first time in Southern Brazil. The new genome presents only 37% of nucleotide identity with Brazilian strains and more than 90% with genomes from China, Vietnam, Venezuela, and the Netherlands. The HuV phylogeny presents significant differences among genomes, probably because multiple introductions of the virus may have occurred. Many questions still need to be answered about HuV. Therefore, more sequences and studies on this virus are necessary to improve the comprehension of the unknown origin of Picornavirales.

¿Reconocemos adecuadamente la acolia/ hipocolia en los lactantes?

Objetivo: El objetivo de este estudio fue valorar el nivel de acierto del personal de salud en la identificación de hipocolia/acolia en un escenario simulado. Con respecto a esto afirmamos que la hipocolia/acolia son signos clínicos que indican obstrucción biliar, relacionándose con enfermedades colestásicas obstructivas, siendo la atresia de vías biliares una de las principales causas en los primeros meses de vida; en esta, el pronóstico del manejo quirúrgico depende del diagnóstico temprano. Métodos: Estudio descriptivo/ prospectivo basado en la realización de una prueba virtual al personal de salud de Medellín, dividiéndose según sitio de trabajo, edad, sexo y profesión. Fueron utilizadas cinco imágenes de la tabla de colores de materia fecal, utilizada en Taiwán, previa autorización de sus autores. Se consideró reconocimiento adecuado cuando el participante identificaba como anormales las tres imágenes que representaban la acolia/hipocolia. Resultados: Se obtuvo respuesta de 442 participantes (se excluyeron 53) y solo 253 (65 %) lograron reconocimiento adecuado. En el análisis por subgrupos se encontró que hubo un mayor acierto en los participantes del Hospital Pablo Tobón Uribe con respecto a otras instituciones (69 y 54.6 %, respectivamente - p. 0.005). Los participantes con menor porcentaje de acierto fueron los médicos generales en un (45 %). Conclusión: Durante la valoración simulada sobre la identificación adecuada de acolia/hipocolia se encontró que solo el 65 % de la población participante acertó en la identificación correcta de este signo clínico, lo que sugiere una mayor atención en cuanto al entrenamiento para la identificación de acolia/hipocolia.

Objetive: The objective of this study was to assess the level of success of healthcare worker in the identification of hypocholia / acholia in a simulated scenario. With respect to this, we affirm that hypocholia/acholia are clinical signs indicative of biliary obstruction, related to obstructive cholestatic diseases, being bile duct atresia one of the main causes in the first months of life. In this, the prognosis of surgical management depends on the early diagnosis. Methods: Descriptive and prospective study, based on the analysis of a virtual survey to Medellín's healthcare workers, subgroup analysis was done according to workplace, age, sex and profession. Five images were used from the Taiwan Stool Color Card, with the authorization from their authors. Adequate recognition was considered when the participant identified the three images representing acholia / hypocholia as abnormal. Results: a response was obtained from 442 participants (53 were excluded), and only 253 (65 %) achieved adequate recognition. In the analysis by subgroups, it was found that there was a greater success in the Pablo Tobón Uribe Hospital participants with respect to other institutions (69 % and 54.6 %, respectively - p. 0.005). The participants with the lowest percentage of correct answers were general practitioners (45%). Conclusion: During the simulated assessment on the adequate identification of acholia / hypocolia, it was found that only 65% of the participating population was correct in the right identification of this clinical sign, which suggests greater attention in training for the identification of acholia / hypocolia.

Escalas validadas para avaliação das fezes: revisão integrativa / Validated scales for stool assessment: integrative review

Introdução: A eliminação intestinal é uma necessidade fisiológica humana básica, que deve ser considerada e avaliada em toda a assistência prestada pelos profissionais de saúde. Objetivo: identificar as escalas validadas utilizadas na atualidade para avaliação das fezes em adultos e idosos. Método: revisão integrativa, protocolada na plataforma Open Science Framework, cujo registro está disponível sob o DOI https://doi.org/10.17605/OSF.IO/9CTMB, que incluiu estudos primários publicados na íntegra, que utilizaram escalas para avaliação de fezes, publicados nos idiomas inglês, português ou espanhol, no período de janeiro de 2001 a julho de 2021. As buscas foram realizadas nas bases de dados eletrônicas PubMed, LILACS, CINAHL e EMBASE em 16 de julho de 2021. Em seguida, as referências identificadas foram exportadas para o aplicativo Rayyan para remoção das duplicatas, seleção e avaliação dos estudos por dois revisores de forma independente e mascarada; os casos de divergência foram avaliados por um terceiro revisor. As evidências foram sintetizadas de forma descritiva. Resultados: a busca nas bases de dados resultou em 1.567 estudos. Após o processo de seleção e leitura na íntegra, 353 estudos foram considerados nesta revisão, dos quais 339 utilizaram escalas validadas (333 estudos utilizaram a Escala de Bristol e seis outras escalas) e 14 escalas não validadas. Também se verificou aumento na quantidade de publicações que avaliaram a consistência das fezes a partir do ano de 2015. Após a leitura dos 353 estudos, foram identificadas cinco escalas validadas: Escala de Forma das Fezes de Bristol, King's Stool Chart, Escala de consistência das fezes segundo Anastasi e Capili (2001) e Hansen (1981), Escala pictórica validada do Diarrhea Questionnaire e a ferramenta de avaliação fecal de Ohno. Conclusão: foram identificadas cinco escalas validadas e utilizadas nos últimos 20 anos para avaliação das fezes. Adicionalmente, os dados mostraram aumento mundial do uso das escalas e a necessidade de desenvolvimento de uma escala para avaliação das fezes com estudos de validação mais robustos

Introduction: Bowel elimination is a basic human physiological need, which must be considered and evaluated in all care provided by health professionals. Aim: to identify the validated scales used to assess stool in adults and the elderly. Method: an integrative review, registered on the Open Science Framework platform and available under DOI 10.17605/OSF.IO/9CTMB, which included primary studies published in full that used scales for stool assessment, published in English, Portuguese or Spanish, between January 2001 and July 2021. Searches of the PubMed, LILACS, CINAHL, and EMBASE electronic databases were performed on July 16, 2021. Afterward, the identified references were exported to the Rayyan application for removal of duplicates, selection, and independent and masked evaluation of studies by two reviewers; cases of divergence were evaluated by a third reviewer. The evidence was synthesized descriptively. Results: the database search resulted in 1,567 studies. After the selection process and reading in full, 353 studies were considered in this review. Of these 353, 339 used validated scales (333 studies used the Bristol Scale and six studies used other scales) and 14 studies used non-validated scales. There was also an increase in the number of publications that evaluated stool consistency from the year 2015. After reading the 353 studies, five validated scales were identified: Bristol Stool Form Scale, King's Stool Chart, Stool Consistency Scale according to Anastasi and Capili (2001) and Hansen (1981), the Diarrhea Questionnaire's validated pictorial scale, and Ohno's fecal assessment tool. Conclusion: Five validated scales were identified and used in the last 20 years for stool assessment. Additionally, the data showed a worldwide increase in the use of scales and the need to develop a scale to assess stool with more robust validation studies

Helicobacter Pylori Treatment Eradication in Egypt: Standard Clarithromycin-based Triple versus Quadruple Regimen Therapy

Absence of adequate treatment for Helicobacter pylori (H. pylori) infection leads to prolonged life time colonization which is responsible for complications. Antibiotics resistance is the main cause of eradication failure in H. pylori infection, thus our study aimed to evaluate the efficiency and tolerability of standard triple therapy vs. quadruple regimen therapy in H. pylori eradication in Egypt.

The Effect of Stool Transplantation on Weight Control in Obese Rats / O efeito do transplante de fezes no controle de peso em ratos obesos

Abstract Introduction Obesity is defined as a multifactorial metabolic syndrome in which there is an excessive number of fat cells within the tissues. It is discussed that intestinal microbiota might have a relevant relation with obesity, since it is relevantly altered in obese patients. Objectives To assess the effect of stool transplantation (ST) in the condition of obesity and its outcomes in an experimental model of cafeteria diet by analyzing histology and weight gain. Methods Forty male Wistar rats were randomly assigned to 5 groups: control (CO), control with antibiotics (CO+ATB), obesity (CAF+ATB), stool transplantation (ATB+ ST) and obesity with stool transplantation (CAF+ATB+ST). During the experiment, obesity induction groups received cafeteria diet, whereas the remaining groups had normal diet ad libitum. After 3 months, daily ST was carried out for 8 weeks by gavage procedure. The animals were euthanized, and the small intestine was harvested for further analysis. Results It was observed that before starting the ST, the cafeteria and normal diet groups had significant weight difference (p<0,0001). In the comparison between CAF+ATB and CAF+ATB+ST during the gavage period, the CAF+ATB+ST group presented lower weight gain (p=0.0017). The histopathological evaluation show that the ATB+ST group did not present intestinal crypt distortion. Conclusion Cafeteria diet resulted in an expected weight gain. In relation to the ST, it has been shown that the procedure is effective in reducing weekly weight gain. Apparently, there was no induction of disabsortive syndrome in nonobese animals that received ST.

Resumo Introdução A obesidade é definida como uma síndrome metabólica multifatorial, na qual existe um número excessivo de células de gordura nos tecidos. Discute-se que a microbiota intestinal pode estar relacionada com a obesidade, uma vez que ela é alterada de forma relevante em pacientes obesos. Objetivos Avaliar o efeito do transplante de fezes (TF) na obesidade induzida por um modelo experimental de dieta de cafeteria. Métodos Quarenta ratos Wistar foram distribuídos aleatoriamente em 5 grupos: controle (CO), controle com antibióticos (CO+ATB), obesidade (CAF+ATB), transplante de fezes (ATB+TF) e obesidade com transplante de fezes (CAF+ATB+TF). Durante o experimento, os grupos de indução de obesidade receberam dieta de cafeteria, enquanto os demais grupos tiveram dieta ad libitum normal. Após 3 meses, o TF diário foi realizado por 8 semanas por meio de gavagem intragástrica. Os animais foram sacrificados e o intestino delgado foi colhido para análise posterior. Resultados Observou-se que antes de iniciar o TF, os grupos de dieta de cafeteria e dieta normocalórica apresentavam diferença significativa de peso (p<0,0001). Ao comparar os grupos CAF+ATB e CAF+ATB+TF durante o período de gavagem, o grupo CAF+ATB+TF apresentou menor ganho de peso (p=0,0017). A avaliação histopatológica mostra que nenhum dos animais do grupo TF+ATB apresentou distorções nas criptas intestinais. Conclusão A dieta da cafeteria resultou em um ganho de peso esperado. Em relação ao TF, demonstrou-se que o procedimento é eficaz na redução do ganho de peso semanal. Aparentemente, não houve indução da síndrome disabsortiva em animais não obesos que receberam TF.

Effects of probiotics on stool frequency in term newborns

Background: Probiotics are live micro-organisms, which if given in the right doses, can be beneficial to their host. They are known for their ability to promote the growth of other micro-organisms and to increase the activity of bacteria in the intestinal microflora. Supplementing infants with probiotics was shown to regulate gastrointestinal motility. They can stimulate intestinal peristalsis, which promotes elimination of bilirubin. Probiotics have been shown to increase intestinal transit time.Methods: This study was conducted in Shri Guru Ram Das Institute of Health Sciences and Research involving 150 term healthy newborns. They were divided into two groups. Group 1 was given probiotics with 10ml distilled water and group 2 was given only 10ml distilled water from 1st to 3rd day of life. Total number of stools passed in a day were recorded from 1st to 7th day of life in both the groups.Results: The mean frequency of stools were 3.76'1.08, 3.72'0.95, 4.02'0.92 in group 1 whereas the mean frequency of stools were 3.31'1.10, 3.39'0.98, 3.45'0.99 on 1st, 2nd, 3rd' day of life respectively.Conclusions: Statistically significant increase in frequency of stools were observed in group 1(probiotic group) than group 2 (only distilled water group) on 1st to 3rd day of life.

Prevalence of Carbapenem-Resistance among Enterobacteriaceae Isolated from Patients Attending Uduth Sokoto, North West Nigeria

Themajorproblemthreateningthecontinuedsuccessofantimicrobialdrugsisthedevelopmentofresistantorganisms.Thisstudywasdesignedtodeterminetheoccurrenceandprevalenceofcarbapenemresistanceamongenterobacteriaceaeisolatedfromin-patientsattendingUsmanuDanfodiyoUniversityTeachingHospital(UDUTH)Sokoto,andalsotodeterminetheantimicrobialsusceptibilitypatternsoftheorganismsisolated.TheMethodologyinvolvestheuseoftrypticasesoybrothcontaining10μgofcarbapenem(imipenem)forprimaryisolation.ThesecondaryisolationinvolvestheuseofMacConkeyagarandbiochemical(SimmoncitrateAgar)foridentification,andthenantimicrobialsusceptibilitytestingbythediskdiffusionmethod.Atotalof191stoolsamplesfrommaleandfemalein-patientswithintherangeof2-60yearswerescreenedforthe gastrointestinalcolonizationofCarbapenemResistanceEnterobacteriacea(CRE).DatawereanalysedusingStatisticalPackageforSocialSciences(SPSS)windowsversion21.Theoverallprevalencewas15.7%Theprevalenceratewasfoundexclusivelyinmales.Thehighestprevalencewasfoundwithintheagegroupof30-40years.Escherichiacoli,Klebsiellaspecies,Pseudomonasspeciesandsalmonellaspecieswerethebacteriaisolated.ThemostpredominantbacteriaisolatedwereEscherichiacoli,accountingfor85(9.4%)resistantstrains,Klebsiellaspeciesaccountingfor50(8%)resistantstrain,Pseudomonasaeruginosa21%andSalmonellaspeciesaccountingfor42(0%)noresistantstrainisolated.Themisuseofantibioticsisamajorfactorresponsibleforthehighrateofbacterialresistance.Improvementonthemanagementandpersonalhygiene,aswellastheappropriateuseofantibioticswouldreducetheprevalenceofNosocomialCarbapenemResistance(NCR)especiallyamongprolongedhospitalizedpatients

Caracterización de agentes bacterianos aislados en brotes de enfermedades transmitidas por alimentos / Characterization of bacterial agents isolated in diseases outbreaks transmitted by foods

Introducción: Las enfermedades transmitidas por alimentos se producen por ingestión de un alimento, incluido el agua, que puede estar contaminado por diversos agentes. Objetivo: Caracterizar los agentes bacterianos aislados en brotes de enfermedades transmitidas por alimentos. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 100,0 % de los brotes de enfermedades transmitidas por alimentos en la provincia de Santiago de Cuba, desde enero de 2018 hasta diciembre de 2019, para lo cual se seleccionaron muestras de alimentos y heces fecales. La caracterización de las bacterias aisladas se basó en los resultados del crecimiento y otras pruebas bioquímicas-metabólicas. Se utilizaron resultados del aislamiento y confirmación de los agentes identificados en cada uno de los brotes a partir de las muestras antes citadas. Entre las variables analizadas figuraron: número de brotes, muestras de alimentos, de heces fecales y resultados de pruebas bioquímicas y metabólicas. Resultados: Se obtuvo un aislamiento de agentes bacterianos en 100,0 % de las muestras de alimentos. Hubo una mayor frecuencia de bacterias Gram negativas (82,0 %) y la menor correspondió a microorganismos Gram positivos (18,0 %). La Salmonella D fue el microorganismo más frecuente. Conclusiones: Este resultado representa un instrumento para el diagnóstico etiológico de los brotes de enfermedades transmitidas por alimentos en Santiago de Cuba.

Introduction: Diseases transmitted by foods are produced due to ingestion of a food, including water that can be contaminated by diverse agents. Objective: To characterize the bacterial agents isolated in diseases outbreaks transmitted by foods. Methods: An observational, descriptive and cross-sectional study of 100.0 % of the diseases outbreaks transmitted by foods in Santiago de Cuba, from January, 2018 to December, 2019 was carried out, for which samples of foods and stools were selected. The characterization of the isolated bacterias was based on the results of growth and other biochemical-metabolic tests. Results of the isolation and confirmation of agents identified in each one of the outbreaks from the samples mentioned above were used. Among the analyzed variables we can mention: number of outbreaks, samples of foods, samples of stools and results of biochemical and metabolic tests. Results: An isolation of bacterial agents was obtained in 100.0 % of foods samples. There was a higher frequency of Gram negative bacterias (82.0 %) and the lower corresponded to Gram positive microorganisms (18.0 %). Salmonella D was the most frequent microorganism. Conclusions: This result represents an instrument for the etiological diagnosis of diseases outbreaks transmitted by foods in Santiago de Cuba.

Strongyloides hyperinfection in a patient with solid malignant tumor a case report

Strongyloides stercoralis is unique among the nematodes, in which it completes its life cycle inside a single human host by causing autoinfection in the host, and it causes hyperinfection leading to persistent and fatal disseminated infections in immunocompromised hosts. The present case report is about strongyloidiasis fatal hyperinfection in a patient with malignant tumor of the tongue on radiotherapy treatment, to highlight the need for clinical suspicion of strongyloidiasis in an immunocompromised host. As per the Centers for Disease Control and Prevention, the mortality in strongyloides hyperinfection syndrome is alarmingly high, a case fatality rate that is almost 90%. Hence, the clinicians should be well equipped to diagnose, treat, and also prevent the fatal consequences of this lethal nematode. Detailed workup for this parasitic infection is crucial, and this case report emphasizes that a simple wet mount stool microscopic examination can clinch the diagnosis.

Standardizing Diagnosis of Helicobacter pylori Infection to Improve Diagnostic Accuracy / 胃肠病学

Eradication of Helicobacter pylori (Hp) is important for the prevention and treatment of chronic gastritis, peptic ulcer and gastric cancer. The Chinese consensus on the management of Hp infection has taken "confirmed Hp infection" as an indication for eradication. The World Gastroenterology Organisation global guideline states the "test-and-treat strategy" for Hp infection. Accurate diagnosis of Hp infection is a prerequisite for standardized eradication. There are many methods to diagnose Hp infection. Each has its advantages and disadvantages. Different methods are suitable for different diseases and patients, and each method has strict requirements for reagents, equipment, testers and patients. Therefore, increasing the awareness of physicians and testers about the standardized diagnosis of Hp infection is essential to improve the diagnostic accuracy.

Three cases of novel coronavirus pneumonia with viral nucleic acids still positive in stool after throat swab detection turned negative / 中华消化杂志

The novel coronavirus pneumonia (NCP) has spread from Wuhan to all parts of China since December 2019, and the prevention and control of NCP is a top priority for medical staff. Now report three cases of NCP patients, whose viral nucleic acids still positive in stool after throat swab detection turned negative. In view of the highly homologous and similar clinical manifestations between the 2019 novel coronavirus (2019-nCoV) and the severe acute respiratory syndrome(SARS) related coronaviruses, it is recommended to attach great importance to the detection of the viral nucleic acids in stool, with the reference of SARS prevention and control experience. In order to minimize the risks of gastrointestinal spread, the detection of 2019-nCoV nucleic acids in stool may be recommended as the reference standard of disisolation and discharge.

Variations of gut microbiome composition under different preservation solutions and periods / 生物工程学报

Gut microbiota is closely related to human health, and its composition can give us health information. The large-scale population sampling is required on gut microbiome research; however, fresh feces samples are not easy to obtain, and rapid low-temperature freezing is difficult to achieve. With the development of technology, preservation solutions are widely used for sample collection, storage, and transport under normal temperature conditions. Preservation solutions can be used in large scale sample collection, wide geographical distribution, diverse on-site sampling conditions, heavy workload, and poor transportation conditions. In this study, five healthy volunteers were recruited. After collecting their fresh stool samples, effect of 5 different commercial preservation solutions was evaluated at room temperature. Samples in different preservation solutions after placing fresh stool samples at the 0, 1, 3, 7, 15, and 30 days were collected. All samples were tested by 16S rRNA V3-V4 high-throughput sequencing to analyze the influence of microbiome composition in different preservation solutions. The results show that different preservation solutions had distinct effects on the gut microbiome composition. Compared with the control, different preservation solutions had little effect on the amount of OUTs; preservation solutions A, B and C were closer to the control in the composition of the gut microbiota, but preservation solution D significantly changed the composition by increasing Actinobacteria and Firmicutes abundance. With the time, all solutions tended to reduce the diversity of the microbiota. Preservation solution E significantly reduced the diversity of the flora; on the 30th day, all five solutions changed the composition; the individual differences in the composition of the gut microbiome were the main factors affecting the similarity of each sample, and were derived from different stools donors. The same samples, no matter which storage solution and storage time, were directly closer to each other. Different storage solutions had different effects on the content of Gram-positive bacilli, Gram-positive cocci and Gram-negative bacteria. Storage solutions C and E reduced the abundance of Bifidobacterium, whereas storage solution D increased; except that preservation solution E relatively reduced the abundance of Lactobacillus, but the preservation solution A, B, C, and D were all closer to the control. Except for the greater difference in preservation solution D, preservation solution C was the closest to the control group on Streptococcus; preservation solution D reduced Ruminococcaceae UCG 003 than the control group. However, other preservation solutions were not much different from the control group; different preservation solutions increased the abundance of Escherichia-Shigella than the control group, and preservation solutions A and B increased the abundance of Klebsiella, but preservation solution C, D, and E were closer to the control group. Overall, preservation solution C performed better in stabilizing the composition of the gut microbiota. This study provides reference for standardized microbiome projects. Subsequent research can choose a targeted preservation solution and preservation time based on this study.

Evaluating Diagnostic Tests for Helicobacter pylori Infection Without a Reference Standard: Use of Latent Class Analysis

Evaluation of diagnostic tests requires reference standards, which are often unavailable. Latent class analysis (LCA) can be used to evaluate diagnostic tests without reference standards, using a combination of observed and estimated results. Conditionally independent diagnostic tests for Helicobacter pylori infection are required. We used LCA to construct a reference standard and evaluate the capability of non-invasive tests (stool antigen test and serum antibody test) to diagnose H. pylori infection compared with the conventional method, where histology is the reference standard. A total of 96 healthy subjects with endoscopy histology results were enrolled from January to July 2016. Sensitivity and specificity were determined for the LCA approach (i.e., using a combination of three tests as the reference standard) and the conventional method. When LCA was used, sensitivity and specificity were 83.8% and 99.4% for histology, 80.0% and 81.9% for the stool antigen test, and 63.6% and 89.3% for the serum antibody test, respectively. When the conventional method was used, sensitivity and specificity were 75.8% and 71.1% for the stool antigen test and 77.7% and 60.7% for the serum antibody test, respectively. LCA can be applied to evaluate diagnostic tests that lack a reference standard.

Diagnostic performance of mini parasep® solvent-free foecal parasite concentrator for the diagnosis of intestinal parasitic infections

Introduction: Various stool concentration techniques have been used to increase the microscopic detection of parasites. We assessed the enclosed, single-vial, Mini Parasep® technique in comparison to the currently used coprodiagnosis procedures. Materials and Methods: A total of 150 stool samples were collected. Samples concentrated by formol–ether method (FEM) and Mini Parasep® SF foecal concentrator and unconcentrated samples were subjected to wet mount, iodine mount microscopy and smear examination by modified acid-fast staining. Results: Direct wet mount detected 72 positive samples (48.6%), whereas 77 (51.3%) and 80 (53.3%) samples were detected by FEM and Mini Parasep® SF methods, respectively. The sensitivity of detection of parasites was 98.7%, 95% and 90.1% with Mini Parasep®, FEM and direct microscopy, respectively. A clearer background with less foecal debris and a better yield of Hymenolepis nana, Trichuris trichiura, Entamoeba coli and Giardia lamblia were noted with Mini Parasep®. Conclusion: Mini Parasep® SF technique is simple, rapid and less cumbersome than conventional diagnostics, making it suitable for routine use. In addition, it offers higher sensitivity and better background clearance than both direct stool examination and FEM.

A Retrospective Study of Intestinal Parasite among Patients in the Ho Teaching Hospital, Ghana

Aim:To assess the prevalence of intestinal parasite infections among patients who visit the Ho Teaching Hospital for stool examination from 2012 to 2016.Study Design:Retrospective study. Place and Durationof Study:Ho Teaching Hospital, August 2017 to January 2018.Methodology:The hospital’s laboratory records were reviewed. Patients’ data were recorded using a well-designed data collection tool. Data was analyzed with Statistical Package for Social Science (SPSS) version 20.0.Results:A total of 7045 patients visited the Ho Teaching Hospital laboratory for routine stool examination within the five-year period. From the 7045 patients, 703 of them were infected with at least one of the intestinal parasites. The overall prevalence of intestinal parasite infection for the five-year period was 10.0%. Intestinal flagellates (90.0%) were the most predominant intestinal parasites, and Entamoeba histolyticarecorded 5.7%. Hookworm (0.9%) was the most prevailing soil-transmitted helminth. Ascaris lumbricoides(0.1%) and Schistosoma mansoni(0.1%) were the least recorded parasites. Highest infection was among patients within age group 20 to 29 years. However, age groups below 10 years recorded low infection. This study showed that age was a risk factor for acquiring intestinal parasite infection (P≤0.001).Original ResearchArticle Conclusion:Intestinal parasitic infections were recorded among patients who visited the Ho Teaching Hospital. However, most of the patients were infected with intestinal flagellates. Various stakeholders should provide advance techniques in laboratory investigation of stool samples to enhance accurate diagnosis. Sensitization of the public about the dangers of intestinal parasites should also be undertaken by the stakeholders

Investigation of Norovirus genogroups (GI, GII and GIV) in stool of pet dogs with diarrhea / Investigação de genogrupos de norovírus (GI, GII e GIV) nas fezes de cães de estimação com diarréia

In this study, we searched the existence of human norovirus (NoV) GI, GII and GIV in the stool of 128 pet dogs with diarrhea, of different sex, age and breed, in Burdur, Turkey, using Real-Time PCR method. Human NoV GII was found in only 5 of the 128 dog stool samples (3.91%). It was discovered that human NoV existed most in crossbreed, female and aged 24 months or over dogs. These dogs found with human NoV GII were either bought from pet shops, stray dogs or taken as puppy of another pet dog. The sheltering conditions of these dogs were moderate and they were fed with home food residue and dry food. It was also found that most of them were vaccinated and had certain walking sites. The owners of the animals detected with infection generally did not have the habit of washing their hands or changing their clothes before or after caring their pets. We strongly advice that dog owners' personal hygiene, the necessity of changing their clothes during their contact with animals, the environment provided for the dog, the sensitivity in caring, use of strong and effective disinfectant, keeping the dogs away from toilets and sewerage systems, as well as not feeding them with food residues are crucial issues in dogs' care. Owners of the dogs with NoV GII were middle aged or elderly people, male, and there were no children in their houses. As these dogs are treated like the owner's child, it is assumed that they could be transmitted with NoV GII as a result of close interaction with their owner.(AU)

Neste estudo pesquisamos a existência de norovírus humano (NoV) GI, GII e GIV nas fezes de 128 cães com diarréia, de diferentes sexos, idades e raças, em Burdur, Turquia, utilizando o método de PCR em tempo real. NoV GII humano foi encontrado em apenas 5 das 128 amostras de fezes de cães (3,91%). Foi descoberta NoV humana, principalmente em cruzamentos, fêmeas e cães com idade igual ou superior a 24 meses. Os cães encontrados com NoV GII humano foram comprados de lojas de animais, eram vira-latas ou foram tomados como filhotes de outro cão de estimação. As condições de abrigo desses cães eram moderadas. Os cães foram alimentados com restos de comida caseira e comida seca. Verificou-se também que a maioria dos animais foi vacinada e tinham locais adequados para caminhada. Os donos dos animais detectados com infecção geralmente não tinham o hábito de lavar as mãos ou trocar de roupa antes ou depois de cuidar de seus animais de estimação. Aconselhamos que a higiene pessoal dos donos, a necessidade de trocar de roupa durante o contato com animais, o ambiente fornecido para o cão, a sensibilidade no cuidado, o uso de desinfetantes eficazes, manter os cães longe de banheiros e esgotos, assim como evitar alimentá-los com resíduos alimentares, são questões cruciais no cuidado dos cães. Os proprietários dos cães com NoV GII são de meia-idade ou idosos, a maioria do sexo masculino, e não havia crianças em suas casas. Como esses cães são tratados como um filho, presume-se que eles foram infectados com o NoV GII como resultado de uma interação próxima com o proprietário.(AU)

Prevalencia de parásitos intestinales en niños de 2-5 años en hogares comunitarios de Cartagena de Indias, Colombia / Presence of intestinal parasites in children 2-5 years of age in community homes in Cartagena de Indias, Colombia

RESUMEN Las enteroparasitosis constituyen un importante problema de salud pública a nivel global, afectando principalmente a la población infantil de los países tropicales. Nuestro objetivo fue determinar la prevalencia de parásitos intestinales en niños de 2 a 5 años en 17 hogares comunitarios del Instituto Colombiano de Bienestar Familiar (ICBF) en la Zona Industrial y Bahía de Cartagena de Indias. Para ello, se realizó un estudio descriptivo de corte transversal; se analizaron muestras mediante coprología de 207 niños de ambos sexos. No hubo diferencias significativas asociadas al sexo y edad (p>0,05). La frecuencia de enteroparasitos en la población infantil de 2 a 5 años fue de un 70,5%, donde el 59,5%, presentó una sola especie de parásito, el 34,2% dos y 6,1% tres y cuatro especies. Los principales protistas (86,3%) encontrados fueron Blastocystis hominis (60,2%) y Giardia lamblia (24,6%). En el grupo de Helmintos (13,7%) se destacaron Ascaris lumbricoides (9,6%) e Hymenolepis nana (6,2%). Las enteroparasitosis continúan como un importante problema de salud pública en condiciones del trópico Colombiano, especialmente en población infantil de zonas vulnerables de Cartagena - Colombia. Evidenciando la necesidad de revisar las políticas dirigidas a reducir la frecuencia del parasitismo intestinal.

ABSTRACT Intestinal parasites constitute an important public health problem at a global level, mainly affecting the pediatric population of tropical countries. The objective of this study was to determine the prevalence of intestinal parasites in children 2 to 5 years of age in 17 community homes of the Colombian Institute of Family Welfare (ICBF) in the Industrial Zone and Cartagena de Indias Bay, Colombia. A descriptive cross-sectional study was carried out among 207 children of both sexes. Samples were analyzed by coprology. There were no significant differences associated with sex and age (p>0.05). The frequency of enteroparasites in children aged 2 to 5 was 70.5 %, where 59.5% presented a single species of parasite, 34.2% two and 6.1% three and four species. The main protists (86.3%) found were Blastocystis hominis (60.2%) and Giardia lamblia (24.6%). In the group of Helminths (13.7%), Ascaris lumbricoides (9.6%) and Hymenolepis nana (6.2%) were observed. Intestinal parasites continue to be an important public health problem in the Colombian tropics, especially among children in vulnerable areas of Cartagena, Colombia. There is a need to review policies aimed at reducing the frequency of intestinal parasitism.

Analyzing Patterns for Stool Culture Requests by Physicians to Improve Quality

Although international clinical guidelines generally recommend bacterial stool cultures for patients with acute diarrhea, stool cultures are frequently being requested by physicians regardless of the likelihood of a bacterial infection. This study was conducted to improve the practice of requesting stool cultures by analyzing patterns for stool culture requests by physicians. We retrospectively reviewed 235 stool cultures of patients who visited Gyeongsang National University Hospital from January to February 2017. We analyzed the period of time after which the stool culture was requested after admission, stool characteristics, wet smear, and concomitant tests performed. 38.7% of stool culture requests were made within 3 days of admission. Stool form analysis showed that 36.6% of stools were watery and loose, and 18.8% were firm. Furthermore, >20 leukocytes per high-power field were found only in 0.4% of the wet smears. Among the stool culture requests, 78.7% were prescribed Clostridium difficile culture or toxin tests at the same time. In addition, 13.6% were prescribed diarrhea-causing viral tests as well. Only stool cultures were requested in 10.2% of the cases. Physicians rarely ensure that the adequate criteria are met when requesting for stool cultures. It is necessary to decrease unnecessary diagnostic practices to maintain the quality of care by establishing reliable rejection criteria and the physicians have valid reasons for requesting stool cultures.