The effects of probiotics, prebiotics and synbiotics on the reduction of IBD complications, a periodic review during 2009-2020.

AIMS: To perform a systematic review on randomized controlled trials to examine the efficacy of probiotics, prebiotics and synbiotics in the treatment of IBD. METHODS AND RESULTS: PubMed, Web of science, Scopus and Google Scholar were systematically searched from January 2009 to January 2020 using the following keywords: 'Inflammatory Bowel Disease', 'Probiotics' and 'Clinical trial'. The statistical analysis was performed using SPSS software version 24.0. A total of 1832 articles were found during the initial search and 21 clinical trials were eligible. Studies comparing the effects of probiotics and placebo among patients with active ulcerative colitis (UC) showed a significant difference in clinical outcomes. Moreover, probiotics improved the overall induction of remission rates among patients with Crohn's disease (CD). Probiotics significantly decreased the IL-1ß, TNF-α and IL-8 levels. Also, the need for systemic steroids, hospitalization, surgery, as well as histological score and disease activity index significantly decreased in patients who used probiotic or pro-/synbiotics. CONCLUSIONS: The use of probiotics, as food supplements, can induce anti-inflammatory reactions, balance the intestinal homeostasis and induce remission in IBD. The efficacy of probiotics on remission induction is more reported in UC rather than CD. Larger well-designed clinical trials are needed to further determine whether probiotics are of clear benefits for remission in IBD.

Prevalence of beta lactamase producing species of pseudomonas and acinetobacter in pediatric burn patients.

Burn wound infection is a major cause of morbidity and mortality in burn victims. Pseudomonas and Acinetobacter species are among the most common organisms complicating burn wounds. Presence of extended spectrum ß-lactamase (ESBL) and metallo-ß-lactamase (MBL) genes plays an important role in spreading ß-lactam resistant strains of these organisms and is a serious condition in the treatment of the affected patients. As a result, we aimed to determine the prevalence of SHV, TEM, PER and VIM ß-lactamases in Pseudomonas and Acinetobacter species isolates from burn wound swabs of children with burn injury. In this descriptive observational study, 107 Pseudomonas and Acinetobacter isolates collected from burn patients were subjected to PCR assay. Using PCR method and DNA sequencing, the existence of SHV-, TEM-, PER- and VIM-type ß-lactamase encoding genes were determined. Out of the 107 Pseudomonas and Acinetobacter isolates, 66 (77.6%) were ESBL positive, 26.2% were positive for SHV gene, 37.4% were positive for TEM gene, 14% were positive for PER gene and 15.9% of them harbored VIM gene. More than half of the Pseudomonas and Acinetobacter strains in our pediatric burn unit harbor ß-lactamase encoding genes that make them resistant to a wide range of ß-lactam antibiotics. Consequently, it is suggested to choose an appropriate antibiotic regimen based on the antibiogram pattern of the strains.

Les infections cutanées sont une cause majeure de morbidité et de mortalité chez les brûlés. Pseudomonas et Acinetobacter sont parmi les micro-organismes les plus communs chez les brûlés. La présence des gènes codant les ß-lactamases à spectre étendu (BLSE) et métallo-ß-lactamases (MBL) joue un rôle important dans la dissémination des souches résistantes et obère le traitement des patients infectés. Nous avons étudié la prévalence des gènes encodant pour des enzymes des groupes SHV, TEM, PER et VIM dans des isolats de Pseudomonas et Acinetobacter chez les brûlés pédiatriques, grâce à des techniques de PCR. Dans cette étude observationnelle descriptive, 107 isolats de Pseudomonas et Acinetobacter, obtenus chez des patients brûlés ont été étudiés. Plus des 3/4 des souches de Pseudomonas et Acinetobacter expriment une BLSE (26.2% SHV; 37.4% TEM; 14% PER; 15.9% VIM), ce qui les rend résistants à de nombreuses ß-lactamines. Il est donc suggéré de choisir un traitement antibiotique approprié, basé sur l'antibiogramme des souches infectantes.

Comparison of Antimicrobial Sensitivity to Older and Newer Quinolones versus Piperacillin-Tazobactam, Cefepime and Meropenem in Febrile Patients with Cancer in two Referral Pediatric Centers in Tehran, Iran.

BACKGROUND: Infection in pediatric cancer patients has become a concerning problem due to increasing antimicrobial resistance. The goal of this study was to determine the antimicrobial resistance patterns of blood isolates from pediatric oncology patients in Iran to determine if there was significant resistance to quinolones. METHODS: Children with cancer who were admitted with or developed fever during admission to Aliasghar Children's Hospital or Mahak Hospitals July 2009 through June 2011 were eligible for enrollment. Two blood cultures were obtained. Antimicrobial sensitivity test was performed for ciprofloxacin, moxifloxacin, gatifloxacin, meropenem, cefepime, and piperacillin-tazobactam on isolates from children who were bacteremic. RESULTS: Blood cultures were positive for 38 episodes in 169 enrolled children but 9 episodes were excluded as blood cultures were thought to be contaminated, yielding a bacteremia rate of 29/160 (18%). The mean age of children and the stage of malignancy did not differ between those with and without bacteremia. Meropenem was the most likely antibiotic to cover isolates (97%) with cefepime having the lowest coverage rate (21%). Quinolone coverage ranged from 63% to 76%. CONCLUSION: Quinolones may not be suitable for use as empiric therapy in febrile pediatric oncology patients in Iran.