Bibliografia sobre diarréia e reidrataçäo oral / Bibliography on diarrhea and oral rehydration

Bibliografia sobre diarréia e reidrataçäo oral, contendo referências de documentos brasileiros, de outros países da América Latina e de organismos internacionais, editados entre os anos de 1975 a 1982. As referências, em sua maior parte, contêm resumos e estäo organizadas alfabeticamente pelo nome do autor

La biopsia intestinal en el diagnostico de la diarrea cronica en niños: Hospital Vicente Corral Moscoso, Departamento de Pediatria

Se realizaron 17 biopsias intestinales en pacientes con diarrea crónica, para estudiar el tipo y grado de lesiones de la mucosa: establecer un diagnóstico definitivo; incrementar la búsqueda de parásitos en el líquido duodenal y las complicaciones. El estudio demuestra que el 88.2% de los pacientes presentaron mucosa normal o ligeramente alterada; en tanto que 11.8%, tuvieron lesión grave de la misma. Relacionando las alteraçöes de la mucosa intestinal con el tipo y grado de desnutrición, el comportamiento del daño de la mucosa es similar, lo que determinaría la necesidad de usar una dieta normal en la mayor parte de los pacientes con diarrea crónica y dietas especiales en un número reducido de pacientes, limitando así los costos del tratamiento. No hemos podido demonstrar parásitos en el líquido duodenal, estableciéndose además que el procedimiento es sencillo de ejecutar y sus complicaciones son poco frecuentes (AU)

Amebiasis fulminante / Invasive amebiasis

La amebiasis constituye una parasitosis de alta prevalencia en nuestro país; una de sus presentaciones clínicas es la colitis amebiana fulminante, con una mortalidad de 100% en casos no tratado quirúrgicamente y de más de 50% en los casos con tratamiento quirúrgico. Se analiza la casuística de colitis aguda necrosante amebiana en el Hospital Eugenio Espejo, en un período de cinco años (1980-1985) encontrándose una mortalidad del 100% en nueve casos operados y tres sin cirugía. Sólo en dos casos el coproparasitario fue positivo para ameba histolítica; el síntomas más común fue síndrome disenterico. Al examen patológico se observó vulcus confluentes especialmente en ciego y colon. En todos los casos las lesiones abarcaron toda la extensión del colon y se encontró mayor compromiso en los casos tratados quirúrgicamente (AU)nte amebiana en el Hospital Eugenio Espejo, en un período de cinco años (1980-1985) encontrándose una mortalidad del 100% en nueve casos operados y tres sin cirugía. Sólo en dos casos el coproparasitario fue positivo para ameba histolítica; el síntomas más común fue síndrome disenterico. Al examen patológico se observó vulcus confluentes especialmente en ciego y colon. En todos los casos las lesiones abarcaron toda la extensión del colon y se encontró mayor compromiso en los casos tratados quirúrgicamente (AU)

Memórias do Instituto Evandro Chagas

62 Salmonellas foram isoladas de casos de Diarréia aguda, em Santarém. -sses germens foram tipados em nosso laboratório em Santarém, sendo esta a primeira vez que estas enterobactérias são tipadas no Norte do país. Os tipos mais comumente isolados foram S. oranienburg e S. newport, que foram isolados de 27 e 19 casos de Diarréia aguda, respectivamente(AU)

Memórias do Instituto Evandro Chagas

An outbreak of Salmonellosis within a family is described. The family sought the service of the laboratory when four of the 15 persons in the house were taken severely ill with desentery after having eating row turtle eggs. Stool cultures of 14 members of this family were positive for S. newport it was not possible to secure a sample of the same group of eggs for laboratory information. However examination of other eggs revealed the presence of S. salford. It is believed that the row turtle eggs were responsible for this outbreak for the following reasons: 1) food of family in previous days had been practically the same from day and consisted of item well cooked; 2) onset symptoms after eating row turtle eggs; 3) the one member who did not partake of the eggs was the only member having a negative culture; 4) relative in another city were sent some of the same group of eggs and after eating presents symptoms of Salmonellosis; 5) isolation of Salmonella from other turtle eggs demonstrating the fact that these eggs can be infected with Salmonella(AU)

Memórias do Instituto Evandro Chagas

Foram estudados 320 casos de Diarréia aguda primária em Santarém, sendo isoladas Shigellas de 153 deles, ou 48 porcento. Dos casos graves com febre e sangue nas fezes, foram isoladas Shigellas em 75 porcento deles. O isolamento de Shigellas esteve relacionado com a severidade dos casos, não se tendo observado relação acentuada entre a gravidade dos sintomas e o isolamento de Salmonellas. Dos casos de Diarréia ligeira, com outros sintomas gastrintestinais de menor importância, foram isoladas Shigellas de 11 indivíduos, ou 18 porcento. Salmonellas foram isoladas de 8 porcento dos 320 casos. Dada a alta incidência de entéricos patogênicos encontrada nos casos de Diarréia aguda primária, urge atomada de medidas sanitárias para controlar o problema (AU)

Memórias do Instituto Evandro Chagas

The rectal swab and the stool culture were compared in order to verfy their relative efficacies in the isolation of Shigella. A total of 320 cases were included in this study. triplicate examinations by swab and stool were attempted in each case but this was not alwais possible. There was a total of 652 examinations either by swab or stool(AU)

Identification and antimicrobial resistance of members from the Enterobacteriaceae family isolated from canaries (Serinus canaria) / Identificação e resistência antimicrobiana de membros da família Enterobacteriaceae isolados de canários (Serinus canaria)

The Enterobacteriaceae family contains potentially zoonotic bacteria, and their presence in canaries is often reported, though the current status of these in bird flocks is unknown. Therefore, this study aimed to identify the most common genera of enterobacteria from canaries (Serinus canaria) and their antimicrobial resistance profiles. From February to June of 2013, a total of 387 cloacal swab samples from eight domiciliary breeding locations of Fortaleza city, Brazil, were collected and 58 necropsies were performed in canaries, which belonged to the Laboratory of Ornithological Studies. The samples were submitted to microbiological procedure using buffered peptone water and MacConkey agar. Colonies were selected according to their morphological characteristics on selective agar and submitted for biochemical identification and antimicrobial susceptibility. A total of 61 isolates were obtained, of which 42 were from cloacal swabs and 19 from necropsies. The most isolated bacteria was Escherichia coli with twenty five strains, followed by fourteen Klebsiellaspp., twelve Enterobacterspp., seven Pantoea agglomerans, two Serratiaspp. and one Proteus mirabilis. The antimicrobial to which the strains presented most resistance was sulfonamides with 55.7%, followed by ampicillin with 54.1% and tetracycline with 39.3%. The total of multidrug-resistant bacteria (MDR) was 34 (55.7%). In conclusion, canaries harbor members of the Enterobacteriaceae family and common strains present a high antimicrobial resistance rate, with a high frequency of MDR bacteria.(AU)

A família Enterobacteriaceae possui bactérias com potencial zoonótico e a presença destas bactérias em canários é relatada na literatura, porém a realidade dos plantéis de criadores de canários é desconhecida. Portanto, este trabalho teve como objetivo isolar enterobactérias de canários belga (Serinus canarius) com o intuito de conhecer os gêneros mais comuns nestas aves e suas respectivas resistências a antimicrobianos. De fevereiro a junho de 2013 foram coletadas 387 amostras de swabs cloacais de canários de oito propriedades da cidade de Fortaleza, Brasil e de 58 necropsias de aves do acervo próprio do Laboratório de Estudos Ornitológicos. As amostras foram submetidas a isolamento microbiológico utilizando-se água peptonada e ágar MacConkey. As colônias foram selecionadas de acordo com suas características morfológicas nas placas, submetidas à tipificação bioquímica para identificação e ao teste de sensibilidade a antimicrobianos. Foram isoladas 61 cepas, sendo 42 de suabes cloacais e 19 de necropsias. A bactéria mais isolada foi Escherichia coli com vinte e cinco cepas, seguida por catorze Klebsiella spp., doze Enterobacter spp., sete Pantoea agglomerans, duas Serratiaspp. e uma cepa de Proteus mirabilis. As cepas apresentaram maior resistência a sulfonamidas com 55,7%, seguidas por ampicilina com 54,1% e tetraciclina com 39,3%. Além disso, o total de cepas resistentes a múltiplas drogas (RMD) foi 34 (55,7%). Portanto, conclui-se que os canários albergam enterobactérias e que as cepas apresentam alto índice de resistência a antimicrobianos, com alta frequência de cepas RMD.(AU)

Caracterização filogenética molecular e resistência antimicrobiana de escherichia coli isoladas de caprinos neonatos com diarreia / Molecular-phylogenetic characterization and antimicrobial resistance of Escherichia coli isolated from goats with diarrhea

Neonatal diarrhea determines significant changes in feed conversion, causing productivity loss in caprine herds. The antimicrobial resistance in bacteria is characterized as an important public healthissue; therefore, Escherichia coli may be characterized as an important pathogen due to expressingvirulence mechanisms responsible for significant clinical conditions in humans and animals. Thepresent study evaluated the presence of E. coli among 117 caprine fecal samples and analyzed theisolates for antimicrobial resistance. Suggestive colonies were submitted to biochemical screeningfollowed by genotypic group determination and phylogenetic analysis; further, the sampleswere submitted to antimicrobials susceptibility test. E. coli, Salmonella spp, Shigella sonnei andEnterobacter aerogenes were identified. E. coli isolates were phylogenetically classified as B2 (9/39),D (19/39), B1 (7/39) e A (4/29) groups. The analysis of the isolates also revealed the presence of K99(04/39) and Stx (02/39) virulence factors. Antimicrobial susceptibility test revealed sensitive isolatesto Chloramphenicol, Streptomycin, Amoxicillin and Ciprofloxacin, being all resistant to Lincomycin,Vancomycin and Penicillin. The results support the need of establishing restricted protocols forantimicrobial use, a fundamental procedure for health improvement in Brazilian caprine herds.(AU)

A diarreia neonatal determina alterações significativas na conversão alimentar, resultando na queda daprodutividade de caprinos. A resistência antimicrobiana em bactérias caracteriza-se como importanteproblema de saúde pública, assim, a Escherichia coli pode ser caracterizada como importantepatógeno por expressar mecanismos de virulência responsáveis por significativas afecções clínicasem seres humanos e animais. O presente estudo avaliou a presença de E. coli em 117 amostrasfecais de caprinos e analisou a resistência antimicrobiana dos isolados. Colônias sugestivas foramsubmetidas a testes bioquímicos, seguido de determinação do grupo genotípico e análise filogenética;posteriormente foram submetidas à prova de suscetibilidade a antimicrobianos. Foram identificadosisolados de E. coli, Salmonella spp, Shigella sonnei e Enterobacter aerogenes. Isolados de E. coliforam classificados filogeneticamente em B2 (9/39), D (19/39), B1 (7/39) e A (4/29). Os fatores devirulência identificados foram K99 (04/39) e Stx (02/39). À prova de suscetibilidade antimicrobiana,os isolados foram sensíveis a Cloranfenicol, Estreptomicina, Amoxicilina e Ciprofloxacina, sendotodos resistentes à Lincomicina, Vancomicina e Penicilina. Os resultados reforçam a necessidade deestabelecimento de protocolos criteriosos para o uso de antimicrobianos, medida fundamental para oaprimoramento da sanidade dos rebanhos caprinos brasileiros.(AU)

[Bile Acid Diarrhea].

Diarrhea is a very common gastrointestinal symptom, and the presence of higher concentrations of bile acid in the colon leads to bile acid diarrhea (BAD). In BAD patients, a portion of bile from the small intestine that is normally controlled by enterohepatic circulation is present at a high concentration in the lumen of the large intestine, resulting in increased motility and secretion of the large intestine. The prevalence of BAD is estimated to be 1-2% of the general population, and it comprises one-third of the instances of diarrhea-predominant irritable bowel syndrome. The clinical symptoms of BAD include chronic diarrhea, increased frequency of defecation, urgency to defecate, fecal incontinence, and cramping abdominal pain. The pathophysiology of BAD has not yet been fully elucidated. However, recent studies have reported increased intestinal permeability, shortened intestinal transit time, and changes in the intestinal microbial community to be the possible causes of BAD. Although fecal and serum bile acid tests are widely used for diagnosis, new test methods that are non-invasive, inexpensive, and have high sensitivity and specificity are needed at various institutions to facilitate the diagnosis. The selenium homo-tauro-cholic acid (SeHCAT) test is the gold standard for BAD diagnosis and severity assessment. The validation of several other serum markers, such as 7-hydroxy-4-cholesten-3-one (serum 7αC4) and the fibroblast growth factor 19 (FGF19) for use in clinical practice is ongoing. Although bile acid sequestrants are the mainstay of treatment, the development of drugs that are more effective and have better compliance is required. Farnesoid X receptor (FXR) agonists are showing promising results.

Probiotics, prebiotics, and synbiotics in childhood diarrhea.

Acute diarrhea is the second leading cause of morbidity and mortality attributed to infections in children under five years of age worldwide, with 1.7 million annual estimated cases and more than 500,000 deaths. Although hydroelectrolytic replacement is the gold standard in treating diarrhea, it does not interfere with the restoration of the intestinal microbiota. Several studies have searched for an adequate alternative in restructuring intestinal homeostasis, finding that treatments based on probiotics, prebiotics, and synbiotics are effective, which made such treatments increasingly present in clinical practice by reducing illness duration with minimal side effects. However, there are still controversies regarding some unwanted reactions in patients. The diversity of strains and the peculiarities of the pathogens that cause diarrhea require further studies to develop effective protocols for prevention and treatment. Here, we provide a descriptive review of childhood diarrhea, emphasizing treatment with probiotics, prebiotics, and synbiotics.

Enterococcus faecium supplementation prevents enteritis caused by Escherichia coli in goats.

The probiotic Enterococcus faecium is a gut microbe with immunomodulatory effects, which has been widely used to prevent diarrhoea in pigs and birds. Escherichia coli is a common pathogen that causes inflammatory bowel disease in animals. The aim of this study was to investigate the protective effects of E. faecium on enteritis in goats. Forty goats were randomly divided into 4 treatment groups: control, E. faecium, E. coli, and E. faecium + E. coli. The changes of physiological indicators and diarrhoea scoring were evaluated on days -4, -2, 0, 2, 4, 6, and 8. The pathological examination, inflammatory cytokines mRNA expression and bacterial counts in jejunum and caecum were detected on day 4 and 8. The results showed that body temperature, respiratory rate, heart rate and leukocyte counts all increased from the 2nd to the 6th day after feeding with E. coli, and the diarrhoea score was significantly increased. However, E. faecium-pretreated goats had lower body temperatures and fewer leukocytes than E. coli-treated goats on day 2, as well as decreased diarrhoea scores. E. coli treatment caused histopathological damage and morphological changes in the jejunum and caecum, while pretreatment with E. faecium significantly alleviated these injuries. E. faecium pretreatment can reduce the load of E. coli and increase the prevalence of Lactobacillus, thereby balancing the microbiota in the intestine. Furthermore, E. coli-infected goats pretreated with E. faecium showed obvious inhibition of Toll-like receptor 4, interleukin (IL)-1ß, IL-6, IL-8 and tumour necrosis factor-α mRNA expression in the jejunum and caecum compared to that in the E. coli treatment group. In conclusion, the addition of E. faecium to goat feed is beneficial for improving clinical symptoms, maintaining intestinal mucosa integrity, balancing the microbiota and decreasing inflammatory responses in E. coli-induced intestinal injury.

Spatial disparity and associated factors of diarrhea among under-five children in Rwanda: a multilevel logistic regression analysis.

BACKGROUND: Diarrhea, defined as three or more loose stool per day, is a major cause of child mortality. Exploring its spatial distribution, prevalence, and influencing factors is crucial for public health decision and targeted interventions. This study aimed to investigate these aspects using 2019 Rwanda demographic health survey data. METHOD: A total 7,978 (weighted) under-five children were included in this study. Spatial clustering (hotspots areas) were mapped using ArcGIS and SaTscan software. A multilevel logistic regression model was fitted to assessed factors associated with diarrhea, reporting significance at p < 0.05 and a 95% confidence interval. RESULTS: diarrheal diseases in Rwanda showed a clustered spatial pattern (Moran's I = 0.126, p = 0.001), with the primary cluster in west and north provinces. Under-five diarrhea prevalence was 14.3% (95% CI: 13.55, 15.08). Factors increasing likelihood included maternal age 15-34 years, child age 7-24 months, while full immunization was protective (aOR = 0.74, 95% CI: 0.56, 0.98). CONCLUSION: Spatial clustering of diarrheal diseases is found in west and north provinces of Rwanda. Being born to a young mother, being a child aged 7-24 months, being fully immunized, being born to a low-educated mother and belonging to a community having low level education are factors associated with diarrheal diseases in Rwanda. Developing interventional plans based on identified clusters and approaching children based on their immunization status, maternal education and age could be cost-effective in reducing diarrheal diseases in Rwanda. Location based intervention could allow for the efficient allocation of resources by focusing on areas with higher prevalence and need.

Evaluation of different genomic regions of rotavirus B and rotavirus C for development of real-time RT‒PCR assays.

BACKGROUND: The causative agents of diarrhea, rotavirus B (RVB) and rotavirus C (RVC) are common in adults and patients of all age groups, respectively. Due to the Rotavirus A (RVA) vaccination program, a significant decrease in the number of gastroenteritis cases has been observed globally. The replacement of RVA infections with RVB, RVC, or other related serogroups is suspected due to the possibility of reducing natural selective constraints due to RVA infections. The data available on RVB and RVC incidence are scant due to the lack of cheap and rapid commercial diagnostic assays and the focus on RVA infections. The present study aimed to develop real-time RT‒PCR assays using the data from all genomic RNA segments of human RVB and RVC strains available in the Gene Bank. RESULTS: Among the 11 gene segments, NSP3 and NSP5 of RVB and the VP6 gene of RVC were found to be suitable for real-time RT‒PCR (qRT‒PCR) assays. Fecal specimens collected from diarrheal patients were tested simultaneously for the presence of RVB (n = 192) and RVC (n = 188) using the respective conventional RT‒PCR and newly developed qRT‒PCR assays. All RVB- and RVC-positive specimens were reactive in their respective qRT‒PCR assays and had Ct values ranging between 23.69 and 41.97 and 11.49 and 36.05, respectively. All known positive and negative specimens for other viral agents were nonreactive, and comparative analysis showed 100% concordance with conventional RT‒PCR assays. CONCLUSIONS: The suitability of the NSP5 gene of RVB and the VP6 gene of RVC was verified via qRT‒PCR assays, which showed 100% sensitivity and specificity. The rapid qRT‒PCR assays developed will be useful diagnostic tools, especially during diarrheal outbreaks for testing non-RVA rotaviral agents and reducing the unnecessary use of antibiotics.

Endoscopic manifestation of intestinal transplant-associated microangiopathy after stem cell transplantation.

BACKGROUND: Endoscopic features of intestinal transplant-associated microangiopathy (iTAM) have not been comprehensively investigated. This study aimed to examine the endoscopic characteristics of patients diagnosed with iTAM. METHODS: This retrospective analysis included 14 patients pathologically diagnosed with iTAM after stem cell transplantation for hematolymphoid neoplasms (n = 13) or thalassemia (n = 1). The sex, age at diagnosis, endoscopic features, and prognosis of each patient were assessed. Serological markers for diagnosing transplant-associated thrombotic microangiopathy were also evaluated. RESULTS: The mean age at the time of iTAM diagnosis was 40.2 years. Patients diagnosed based on the pathognomonic pathological changes of iTAM presented with diverse symptoms at the times of endoscopic examinations, including diarrhea (n = 10), abdominal pain (n = 5), nausea (n = 4), appetite loss (n = 2), bloody stools (n = 2), abdominal discomfort (n = 1), and vomiting (n = 1). At the final follow-up, six patients survived, while eight patients succumbed, with a median time of 100.5 days (range: 52-247) post-diagnosis. Endoscopic manifestations included erythematous mucosa (n = 14), erosions (n = 13), ulcers (n = 9), mucosal edema (n = 9), granular mucosa (n = 9), and villous atrophy (n = 4). Erosions and/or ulcers were primarily observed in the colon (10/14, 71%), followed by the ileum (9/13, 69%), stomach (4/10, 40%), cecum (5/14, 36%), duodenum (3/10, 30%), rectum (4/14, 29%), and esophagus (1/10, 10%). Cytomegalovirus infection (n = 4) and graft-versus-host disease (n = 2) coexisted within the gastrointestinal tract. Patients had de novo prolonged or progressive thrombocytopenia (6/14, 43%), decreased hemoglobin concentration (4/14, 29%), reduced serum haptoglobin level (3/14, 21%), and a sudden and persistent increase in lactate dehydrogenase level (2/14, 14%). Peripheral blood samples from 12 patients were evaluated for schistocytes, with none exceeding 4%. CONCLUSIONS: This study provides a comprehensive exploration of the endoscopic characteristics of iTAM. Notably, all patients exhibited erythematous mucosa throughout the gastrointestinal tract, accompanied by prevalent manifestations, such as erosions (93%), ulcers (64%), mucosal edema (64%), granular mucosa (64%), and villous atrophy (29%). Because of the low positivity for serological markers of transplant-associated thrombotic microangiopathy in patients with iTAM, endoscopic evaluation and biopsy of these lesions are crucial, even in the absence of these serological features.

Efficacy evaluation of hydrogen peroxide disinfectant based zinc oxide nanoparticles against diarrhea causing Escherichia coli in ruminant animals and broiler chickens.

Different strains of Escherichia coli that exhibit genetic characteristics linked to diarrhea pose a major threat to both human and animal health. The purpose of this study was to determine the prevalence of pathogenic Escherichia coli (E. coli), the genetic linkages and routes of transmission between E. coli isolates from different animal species. The efficiency of disinfectants such as hydrogen peroxide (H2O2), Virkon®S, TH4+, nano zinc oxide (ZnO NPs), and H2O2-based zinc oxide nanoparticles (H2O2/ZnO NPs) against isolated strains of E. coli was evaluated. Using 100 fecal samples from different diarrheal species (cow n = 30, sheep n = 40, and broiler chicken n = 30) for E. coli isolation and identification using the entero-bacterial repetitive intergenic consensus (ERIC-PCR) fingerprinting technique. The E. coli properties isolated from several diarrheal species were examined for their pathogenicity in vitro. Scanning electron microscopy (SEM), high-resolution transmission electron microscopy (HR-TEM), Fourier-transform infrared spectrum (FT-IR), X-ray diffraction (XRD), zeta potential, and particle size distribution were used for the synthesis and characterization of ZnO NPs and H2O2/ZnO NPs. The broth macro-dilution method was used to assess the effectiveness of disinfectants and disinfectant-based nanoparticles against E. coli strains. Regarding the results, the hemolytic activity and Congo red binding assays of pathogenic E. coli isolates were 55.3 and 44.7%, respectively. Eleven virulent E. coli isolates were typed into five ERIC-types (A1, A2, B1, B2, and B3) using the ERIC-PCR method. These types clustered into two main clusters (A and B) with 75% similarity. In conclusion, there was 90% similarity between the sheep samples' ERIC types A1 and A2. On the other hand, 89% of the ERIC types B1, B2, and B3 of cows and poultry samples were comparable. The H2O2/ZnO NPs composite exhibits potential antibacterial action against E. coli isolates at 0.04 mg/ml after 120 min of exposure.

Lactic acid bacteria reduce bacterial diarrhea in rabbits via enhancing immune function and restoring intestinal microbiota homeostasis.

BACKGROUND: Numerous previous reports have demonstrated the efficacy of Lactic acid bacteria (LAB) in promoting growth and preventing disease in animals. In this study, Enterococcus faecium ZJUIDS-R1 and Ligilactobaciiius animalis ZJUIDS-R2 were isolated from the feces of healthy rabbits, and both strains showed good probiotic properties in vitro. Two strains (108CFU/ml/kg/day) were fed to weaned rabbits for 21 days, after which specific bacterial infection was induced to investigate the effects of the strains on bacterial diarrhea in the rabbits. RESULTS: Our data showed that Enterococcus faecium ZJUIDS-R1 and Ligilactobaciiius animalis ZJUIDS-R2 interventions reduced the incidence of diarrhea and systemic inflammatory response, alleviated intestinal damage and increased antibody levels in animals. In addition, Enterococcus faecium ZJUIDS-R1 restored the flora abundance of Ruminococcaceae1. Ligilactobaciiius animalis ZJUIDS-R2 up-regulated the flora abundance of Adlercreutzia and Candidatus Saccharimonas. Both down-regulated the flora abundance of Shuttleworthia and Barnesiella to restore intestinal flora balance, thereby increasing intestinal short-chain fatty acid content. CONCLUSIONS: These findings suggest that Enterococcus faecium ZJUIDS-R1 and Ligilactobaciiius animalis ZJUIDS-R2 were able to improve intestinal immunity, produce organic acids and regulate the balance of intestinal flora to enhance disease resistance and alleviate diarrhea-related diseases in weanling rabbits.