title: Intestinal lactoflora in Estonian and Norwegian patients with antibiotic associated diarrhea.
abstract: The disruption of intestinal microbiota is an important risk factor for the development of Clostridium difficile caused antibiotic associated diarrhea (AAD). The role of intestinal lactoflora in protection against C. difficile is unclear. Fecal samples (n = 74) from AAD patients were investigated for C. difficile and lactobacilli by culture and real-time PCR. Lactobacilli were identified by enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) and sequencing of 16S rRNA. In C. difficile negative cases we found somewhat higher counts of intestinal Lactobacilli (5.02 vs. 2.15 CFU log(10)/g; p = 0.053) by culture and more frequently Lactobacillus plantarum (33.3% vs. 9.4%; p = 0.03) as compared with positive ones. Results of total counts of lactobacilli comparing Estonian and Norwegian samples were conflicting by culture and PCR. We found higher colonization of Norwegian AAD patients with L. plantarum (21% vs. 5%, p = 0.053) and Estonians with Lactobacillus gasseri (19% vs. 2%, p = 0.023). Particular lactobacilli (e.g. L. plantarum) may have a role in protection against C. difficile, whereas the meaning of total counts of lactobacilli remains questionable. In different persons and nations, different lactobacilli species may have a protective role against C. difficile.
authors.affiliation: Department of Microbiology, University of Tartu, Ravila 19, 50411 Tartu, Estonia.
authors.forename: Epp
authors.initials: E
authors.lastname: Sepp
authors.forename: Jelena
authors.initials: J
authors.lastname: Stšepetova
authors.forename: Imbi
authors.initials: I
authors.lastname: Smidt
authors.forename: Merle
authors.initials: M
authors.lastname: Rätsep
authors.forename: Siiri
authors.initials: S
authors.lastname: Kõljalg
authors.forename: Krista
authors.initials: K
authors.lastname: Lõivukene
authors.forename: Reet
authors.initials: R
authors.lastname: Mändar
authors.forename: Liis
authors.initials: L
authors.lastname: Jaanimäe
authors.forename: Iren H
authors.initials: IH
authors.lastname: Löhr
authors.forename: Olav B
authors.initials: OB
authors.lastname: Natås
authors.forename: Paul
authors.initials: P
authors.lastname: Naaber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015373:Bacterial Typing Techniques; D058448:Biota; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000302:isolation & purification*; D016000:Cluster Analysis; D015169:Colony Count, Microbial; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D003967:Diarrhea / Q000139:chemically induced* / Q000382:microbiology*; D004957:Estonia; D005243:Feces / Q000382:microbiology; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans; D007778:Lactobacillus / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D009664:Norway; D016133:Polymerase Chain Reaction; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S