Are probiotics useful for therapy of Helicobacter pylori diseases?

Chronic infection with Helicobacter pylori (H. pylori) is a known risk factor for gastric cancer. Eradication rate of H. pylori infection by the classic triple treatment of PPIs and antibiotics is low. Therefore, probiotics are a useful tool for improving the rate of eradication and reduction of side effects. Several studies in animal models showed that Lactobacillus spp. alone and in combination with other probiotic strains have inhibitory effects on growth and suppression of inflammatory responses in H. pylori infections. However, some studies showed significant effects of Pediococcus strains on suppression, survival, and eradication of H. pylori infections. Therefore, it is suggested that in the treatment of H. pylori infections along with the usual probiotic strains, different strains of Pediococcus could be used. Recent studies showed that Lactobacillus reuteri and Lactobacillus gasseri alone with PPIs in human have a high eradication effect on H. pylori infections and it is suggested as the probiotic treatment of patient's in future therapeutic protocols. In relation to the probiotic treatment process, it should not be recommended that probiotics could be used as a single treatment for H. pylori eradication. However, use of probiotics as a supplement will increase eradication and reduce side effects associated with treatment. It is widely believed that probiotics could improve the eradication of H. pylori and reduce side effects during standard treatment, but some probiotic bacterial species could be useful with drug therapy. Generally, probiotic supplements could increase the eradication rate of H. pylori infections and reduced the side effects of antibiotics.

Prevalence of Virulence-Related Determinants in Clinical Isolates of Staphylococcus epidermidis.

BACKGROUND: Staphylococcus epidermidis, a member of the human flora, is recognized as an opportunistic pathogen and cause of nosocomial infections. Staphylococcus epidermidis surface components are able to establish bacteria on the host surface, and cause infection. OBJECTIVES: The frequency of icaA, IS256, aap, fbe and bhp in clinical isolates of S. epidermidis were investigated in this study. MATERIALS AND METHODS: Fifty-nine S. epidermidis isolates were collected from blood (50), wound (1), urine (4) and tracheal (4) samples (Tehran, Iran). Staphylococcus epidermidis isolates were identified with conventional bacteriological tests. Virulence-associated genes were detected by specific polymerase chain reactions (PCRs). RESULTS: Of the 59 S. epidermidis, fbe was found in 89.8%, while aap and bhp were observed in 64.4% and 15.3% of the samples, respectively. Coexistence of aap and fbe was found in 32 isolates, while coexistence of bhp and fbe was observed in five isolates. Two isolates were negative for the investigated genes. CONCLUSIONS: Prevalence of fbe and aap was significantly different from similar studies, yet frequency of bhp was in accordance with other studies. Prevalence of icaA and IS256 was not significantly different from some studies while a significant difference was observed when results were compared with some other studies.

Antibiotic Susceptibility and mecA Frequency in Staphylococcus epidermidis, Isolated From Intensive Care Unit Patients.

BACKGROUND: Coagulase-negative staphylococci (CoNS), especially Staphylococcus epidermidis, are considered as normal flora of human epithelia and also important opportunistic pathogens for nosocomial infections. S. epidermidis can also act as a reservoir for mecA, responsible for high-level resistance to methicillin and transferring it to S. aureus. OBJECTIVES: The aim of this study was to determine the prevalence of S. epidermidis as well as antibiotic susceptibility pattern and mecA prevalence in S. epidermidis isolated from intensive care unit (ICU) patients. MATERIALS AND METHODS: A cross-sectional study was conducted from September 2010 to September 2011 and 184 coagulase-negative staphylococci were collected from different clinical samples in three hospitals. S. epidermidis was identified by conventional bacteriological tests. Antibiotic susceptibility testing was performed using disk diffusion method. Frequency of mecA was detected by specific PCR. RESULTS: Frequency of S. epidermidis was 34.8%, the most susceptibility was seen to linezolid and vancomycin, and the least susceptibility was seen to tetracycline.Majority of the S. epidermidis isolates carried mecA (92.2%). The most common resistant pattern was trimethoprim-sulfamethoxazole, tetracycline, erythromycin, and methicillin resistance, found in 23.4% of the isolates, followed by resistance to methicillin as the second-most common resistant pattern, observed in 20.3% of the isolates. CONCLUSIONS: Frequency of S. epidermidis was significantly lower, compared to other studies. Presence rate of mecA and susceptibility to linezolid and vancomycin did not show significant differences with other investigations, while resistant to trimethoprim-sulfamethoxazole was significantly lower compared to other investigations, and resistance to tetracycline was significantly higher in comparison to other investigations. Presence of methicillin-resistant S. epidermidis in ICU patients, especially in individuals with compromised immune systems, may cause infection and would be more complicated in the case of antibiotic resistance.