Clinical experience with probiotics in the elderly on total enteral nutrition.
BACKGROUND
Recent data support that after 2 years of age, intestinal microflora remains relatively constant over time, except in elderly people, who harbor fewer bifidobacteria and a higher population of fungi and enterobacteria than young adults. Diet supplementation with probiotics may improve the nutritional status and reduce the impaired immunity associated with aging. The goal of this study was to establish the effect on bifidobacteria fecal counts, and some clinical parameters, of bifidobacteria supplementation to elderly patients in total parenteral nutrition.


METHODS
Thirteen patients (6 men and 7 women; mean age, 69 years; range, 65-76 years) affected by permanent vegetative status (PVS) and fed by total enteral nutrition (TEN) were studied. Bifidobacteria and clostridia were investigated by microbiologic and molecular biology methods in stool specimens collected twice at basal time (T-2 and T0) and after 12 and 15 days (T12 and T15, respectively). Seven patients with basal bifidobacteria counts less than 10 were supplemented with Bifidobacterium longum W 11 for 12 days. The remaining 6 patients were used as control subjects. For 1 month diarrhea and fever episodes, use of antibiotics, and nutritional status (BMI) were assessed.


RESULTS
In the 7 patients with bifidobacteria counts less than 10, the administration of B. longum W 11 resulted in a 1 log increase in 6 of 7 patients at T12. No statistically significant difference in episodes of fever or diarrhea, use of antibiotics, or BMI was observed between the treatment and control groups.


CONCLUSIONS
The administration of B. longum W11 in PVS patients fed by TEN is effective in increasing the population of bifidobacteria. Larger studies with longer follow-up could demonstrate the influence of these microbiologic changes in a clinical setting.
Del Piano
Mario
M
Gastroenterology Unit, Azienda Ospedaliera Maggiore della Carità, Novara, Italy. jdelp@tin.it
Ballarè
Marco
M
Montino
Franco
F
Orsello
Marco
M
Garello
Enrico
E
Ferrari
Patrizio
P
Masini
Cinzia
C
Strozzi
Gian Paolo
GP
Sforza
Filomena
F
D000368:Aged; D001644:Bifidobacterium; D016009:Chi-Square Distribution; D015169:Colony Count, Microbial; D004750:Enteral Nutrition; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D018458:Persistent Vegetative State; D016133:Polymerase Chain Reaction; D019936:Probiotics / Q000008:administration & dosage*