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Nutrients Sep 2023Irritable bowel syndrome (IBS) is a common gastrointestinal disease. The efficacy of different probiotics in treating IBS remains controversial. This network... (Meta-Analysis)
Meta-Analysis Review
Irritable bowel syndrome (IBS) is a common gastrointestinal disease. The efficacy of different probiotics in treating IBS remains controversial. This network meta-analysis aimed to compare and rank the outcome-specific efficacy of different probiotic strains or combinations in adults with IBS. We searched the literature up to June 2023. Randomized controlled trials (RCTs) that evaluated the efficacy of probiotics in IBS were included. A frequentist framework was used to perform this study. In total, 9253 participants from 81 RCTs were included in the study. Four probiotic strains and five mixtures were significantly superior to placebo in improving IBS Symptom Severity Scale, among which DDS-1 ranked first (surface under the cumulative ranking, SUCRA, 92.9%). A mixture containing five probiotics (SUCRA, 100%) ranked first in improving the IBS-Quality of life. MTCC 5856 (SUCRA, 96.9%) and Unique IS2 (SUCRA, 92.6%) were among the most effective probiotics for improving abdominal pain. Three probiotic strains and two mixtures were effective in alleviating abdominal bloating. Four probiotic strains and a mixture were significantly superior to placebo in reducing the bowel movement frequency in diarrhea-predominant IBS (IBS-D). MTCC 5856 (SUCRA, 99.6%) and CNCM I-3856 (SUCRA, 89.7%) were among the most effective probiotics for improving the Bristol stool form scale of IBS-D. Only some probiotics are effective for particular outcomes in IBS patients. This study provided the first ranking of outcome-specific efficacy of different probiotic strains and combinations in IBS. Further studies are needed to confirm these results.
Topics: Adult; Humans; Irritable Bowel Syndrome; Network Meta-Analysis; Abdominal Pain; Bacillus coagulans; Probiotics; Saccharomyces cerevisiae
PubMed: 37686889
DOI: 10.3390/nu15173856 -
Nutrients Aug 2018Acute diarrhea is a burdensome disease with potentially harmful consequences, especially in childhood. Despite its large use in clinical practice, the efficacy of the... (Meta-Analysis)
Meta-Analysis Review
Acute diarrhea is a burdensome disease with potentially harmful consequences, especially in childhood. Despite its large use in clinical practice, the efficacy of the probiotic in treating acute childhood diarrhea remains unclear. Our objective was to systematically review the efficacy of in the treatment of acute childhood diarrhea. The following electronic databases were systematically searched up to October 2017: MEDLINE (via PubMed/OVID), EMBASE (via OVID), Cochrane Central Database of Controlled Trials (via CENTRAL), Google Scholar, and ClinicalTrials.gov. Only randomized controlled trials were included. The overall effect for the meta-analysis was derived by using a random effects model. Six randomized controlled trials (1298 patients) met the eligibility criteria. Data arising from pooled analysis showed that significantly reduced the duration of diarrhea (mean difference = -9.12 h; 95% confidence interval [CI]: -16.49 to -1.75, = 0.015), and the duration of hospitalization (mean difference = -0.85 days; 95% CI: -1.56 to -0.15, = 0.017), compared with control. There was a trend of decreasing stool frequency after administration compared with the control group (mean difference = -0.19 diarrheal motions; 95% CI: -0.43 to -0.06, = 0.14). may represent an effective therapeutic option in acute childhood diarrhea, with a good safety profile.
Topics: Acute Disease; Age of Onset; Bacillus clausii; Child; Child, Preschool; Diarrhea; Humans; Infant; Length of Stay; Probiotics; Randomized Controlled Trials as Topic; Risk Factors; Time Factors; Treatment Outcome
PubMed: 30103531
DOI: 10.3390/nu10081074 -
Biodegradation Apr 2022Petroleum industry activities worldwide have caused pollution and resulted in environmental degradation. Microorganisms with the potential to reduce pollutant levels by... (Review)
Review
Petroleum industry activities worldwide have caused pollution and resulted in environmental degradation. Microorganisms with the potential to reduce pollutant levels by degradation processes have been reported, and bacteria are among such organisms. The first study on bacterial degradation in Colombia was published in 1996. The study isolated bacteria belonging to the Pseudomonas genus from hydrocarbon-polluted sediments. Since then, different reports on degrading bacteria have been published. The objective of this systematic review is to identify and analyze all the studies on hydrocarbon-degrading bacteria performed in Colombia. To accomplish this goal, a literature search was conducted. Inclusion and exclusion criteria were applied, and 37 relevant articles were obtained. We found that 2018 was the year with the largest number of publications in Colombia, and most frequently identified bacterial genera were Pseudomonas and Bacillus. Some studies showed that the degradation of hydrocarbons is more efficient when bacterial consortia are used rather than pure cultures. This study provides information about bacteria with the potential to degrade hydrocarbons in Colombia, which in turn will be a source of information for future studies in this field.
Topics: Bacillus; Bacteria; Biodegradation, Environmental; Colombia; Hydrocarbons; Pseudomonas
PubMed: 35235111
DOI: 10.1007/s10532-022-09976-z -
Clinical Infectious Diseases : An... Oct 2022Bacillus anthracis can cause anthrax and is a potential bioterrorism agent. The 2014 Centers for Disease Control and Prevention recommendations for medical... (Review)
Review
BACKGROUND
Bacillus anthracis can cause anthrax and is a potential bioterrorism agent. The 2014 Centers for Disease Control and Prevention recommendations for medical countermeasures against anthrax were based on in vitro data and expert opinion. However, a century of previously uncompiled observational human data that often includes treatment and outcomes is available in the literature for analysis.
METHODS
We reviewed treatment outcomes for patients hospitalized with anthrax. We stratified patients by meningitis status, route of infection, and systemic criteria, then analyzed survival by treatment type, including antimicrobials, antitoxin/antiserum, and steroids. Using logistic regression, we calculated odds ratios and 95% confidence intervals to compare survival between treatments. We also calculated hospital length of stay. Finally, we evaluated antimicrobial postexposure prophylaxis (PEPAbx) using data from a 1970 Russian-language article.
RESULTS
We identified 965 anthrax patients reported from 1880 through 2018. After exclusions, 605 remained: 430 adults, 145 children, and 30 missing age. Survival was low for untreated patients and meningitis patients, regardless of treatment. Most patients with localized cutaneous or nonmeningitis systemic anthrax survived with 1 or more antimicrobials; patients with inhalation anthrax without meningitis fared better with at least 2. Bactericidal antimicrobials were effective for systemic anthrax; addition of a protein synthesis inhibitor(s) (PSI) to a bactericidal antimicrobial(s) did not improve survival. Likewise, addition of antitoxin/antiserum to antimicrobials did not improve survival. Mannitol improved survival for meningitis patients, but steroids did not. PEPAbx reduced risk of anthrax following exposure to B. anthracis.
CONCLUSIONS
Combination therapy appeared to be superior to monotherapy for inhalation anthrax without meningitis. For anthrax meningitis, neither monotherapy nor combination therapy were particularly effective; however, numbers were small. For localized cutaneous anthrax, monotherapy was sufficient. For B. anthracis exposures, PEPAbx was effective.
Topics: Adult; Anthrax; Anti-Bacterial Agents; Anti-Infective Agents; Antitoxins; Bacillus anthracis; Biological Warfare Agents; Bioterrorism; Child; Hospitals; Humans; Mannitol; Protein Synthesis Inhibitors; Respiratory Tract Infections; Treatment Outcome
PubMed: 36251553
DOI: 10.1093/cid/ciac536 -
PloS One 2017B. anthracis anti-toxin agents are approved and included in the Strategic National Stockpile based primarily on animal infection trials. However, in the only anthrax... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
B. anthracis anti-toxin agents are approved and included in the Strategic National Stockpile based primarily on animal infection trials. However, in the only anthrax outbreak an approved anti-toxin agent was administered in, survival did not differ comparing recipients and non-recipients, although recipients appeared sicker.
OBJECTIVE
Employ a systematic review and meta-analysis to investigate preclinical studies supporting anthrax anti-toxin agents.
DATA SOURCE
PubMed, EMBASE, and Scopus.
STUDY ELIGIBILITY
Compared survival with an anti-toxin agent versus control in B. anthracis challenged, antibiotic treated animals.
STUDY METHODS
Examine model and study design and the effect of anti-toxin agents on relative risk of death(95%CI) (RR).
RESULTS
From 9 studies, 29 experiments were analyzed which included 4 species (748 animals) and 5 agents; LFI, AIG, AVP-21D9, Raxibacumab, and ETI-204. Only five experiments were blinded and no experiment included the cardiopulmonary support sick B. anthracis patients receive. Only one agent in a single un-blinded experiment reduced RR significantly [0.45(0.22,0.940]. However, in six studies testing an agent in more than one experiment in the same species, agents had consistent survival effects across experiments [I2 = 0, p≥0.55 in five and I2 = 42%, p = 0.16 in one]. Within each species, agents had effects on the side of benefit; in one study testing AVP-21D9 in mice [0.11(0.01,1.82)] or guinea pigs [0.70(0.48,1.03)]; across eight rabbit studies testing LFI, Raxibacumab, AIG or ETI-204 [0.62(0.45,0.87); I2 = 17.4%, p = 0.29]; and across three monkey studies testing Raxibacumab, AIG or ETI-204 [0.66(0.34,1.27); I2 = 25.3%, p = 0.26]. Across all agents and species, agents decreased RR [0.64(0.52,0.79); I2 = 5.3%, p = 0.39].
LIMITATIONS
Incidence of selective reporting not identifiable.
CONCLUSIONS
Although overall significant, individually anti-toxin agents had weak beneficial effects. Lack of study blinding and relevant clinical therapies further weakened studies. Although difficult, preclinical studies with more robust designs and results are warranted to justify the resources necessary to maintain anti-toxin agents in national stockpiles.
Topics: Animals; Anthrax; Anti-Bacterial Agents; Antigens, Bacterial; Antitoxins; Bacillus anthracis; Disease Models, Animal; Humans; Research Design; Treatment Outcome
PubMed: 28797061
DOI: 10.1371/journal.pone.0182879 -
Clinical Infectious Diseases : An... Oct 2022Anthrax is endemic to many countries, including the United States. The causative agent, Bacillus anthracis, poses a global bioterrorism threat. Without effective... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Anthrax is endemic to many countries, including the United States. The causative agent, Bacillus anthracis, poses a global bioterrorism threat. Without effective antimicrobial postexposure prophylaxis (PEPAbx) and treatment, the mortality of systemic anthrax is high. To inform clinical guidelines for PEPAbx and treatment of B. anthracis infections in humans, we systematically evaluated animal anthrax treatment model studies.
METHODS
We searched for survival outcome data in 9 scientific search engines for articles describing antimicrobial PEPAbx or treatment of anthrax in animals in any language through February 2019. We performed meta-analyses of efficacy of antimicrobial PEPAbx and treatment for each drug or drug combination using random-effects models. Pharmacokinetic/pharmacodynamic relationships were developed for 5 antimicrobials with available pharmacokinetic data. Monte Carlo simulations were used to predict unbound drug exposures in humans.
RESULTS
We synthesized data from 34 peer-reviewed studies with 3262 animals. For PEPAbx and treatment of infection by susceptible B. anthracis, effective monotherapy can be accomplished with fluoroquinolones, tetracyclines, β-lactams (including penicillin, amoxicillin-clavulanate, and imipenem-cilastatin), and lipopeptides or glycopeptides. For naturally occurring strains, unbound drug exposures in humans were predicted to adequately cover the minimal inhibitory concentrations (MICs; those required to inhibit the growth of 50% or 90% of organisms [MIC50 or MIC90]) for ciprofloxacin, levofloxacin, and doxycycline for both the PEPAbx and treatment targets. Dalbavancin covered its MIC50 for PEPAbx.
CONCLUSIONS
These animal studies show many reviewed antimicrobials are good choices for PEPAbx or treatment of susceptible B. anthracis strains, and some are also promising options for combating resistant strains. Monte Carlo simulations suggest that oral ciprofloxacin, levofloxacin, and doxycycline are particularly robust choices for PEPAbx or treatment.
Topics: Amoxicillin-Potassium Clavulanate Combination; Animals; Anthrax; Anti-Bacterial Agents; Anti-Infective Agents; Bacillus anthracis; Cilastatin, Imipenem Drug Combination; Ciprofloxacin; Doxycycline; Glycopeptides; Humans; Levofloxacin; Lipopeptides; Models, Animal; Tetracyclines; United States; beta-Lactams
PubMed: 36251546
DOI: 10.1093/cid/ciac591 -
Journal of Food Protection Dec 2015Low-moisture foods (LMF) are increasingly implicated in outbreaks of foodborne illness, resulting in a significant public health burden. To inform the development of a... (Review)
Review
Low-moisture foods (LMF) are increasingly implicated in outbreaks of foodborne illness, resulting in a significant public health burden. To inform the development of a new Codex Alimentarius code of hygienic practice for LMF, we applied a rapid knowledge synthesis and transfer approach to review global research on the burden of illness, prevalence, and interventions to control nine selected microbial hazards in eight categories of LMF. Knowledge synthesis methods included an integrated scoping review (search strategy, relevance screening and confirmation, and evidence mapping), systematic review (detailed data extraction), and meta-analysis of prevalence data. Knowledge transfer of the results was achieved through multiple reporting formats, including evidence summary cards. We identified 214 unique outbreaks and 204 prevalence and 126 intervention studies. Cereals and grains (n = 142) and Salmonella (n = 278) were the most commonly investigated LMF and microbial hazard categories, respectively. Salmonella was implicated in the most outbreaks (n = 96, 45%), several of which were large and widespread, resulting in the most hospitalizations (n = 895, 89%) and deaths (n = 14, 74%). Salmonella had a consistently low prevalence across all LMF categories (0 to 3%), but the prevalence of other hazards (e.g., Bacillus cereus) was highly variable. A variety of interventions were investigated in small challenge trials. Key knowledge gaps included underreporting of LMF outbreaks, limited reporting of microbial levels in prevalence studies, and a lack of intervention efficacy research under commercial conditions. Summary cards were a useful knowledge transfer format to inform complementary risk ranking activities. This review builds upon previous work in this area by synthesizing a broad range of evidence using a structured, transparent, and integrated approach to provide timely evidence informed inputs into international guidelines.
Topics: Algorithms; Bacillus; Bacterial Infections; Data Collection; Disease Outbreaks; Food Contamination; Food Microbiology; Foodborne Diseases; Hospitalization; Humans; Prevalence; Proportional Hazards Models; Public Health; Risk; Salmonella; Translational Research, Biomedical
PubMed: 26613924
DOI: 10.4315/0362-028X.JFP-15-146 -
Clinical Infectious Diseases : An... Oct 2022Bacillus anthracis is a high-priority threat agent because of its widespread availability, easy dissemination, and ability to cause substantial morbidity and mortality....
BACKGROUND
Bacillus anthracis is a high-priority threat agent because of its widespread availability, easy dissemination, and ability to cause substantial morbidity and mortality. Although timely and appropriate antimicrobial therapy can reduce morbidity and mortality, the role of adjunctive therapies continues to be explored.
METHODS
We searched 11 databases for articles that report use of anthrax antitoxins in treatment or prevention of systemic anthrax disease published through July 2019. We identified other data sources through reference search and communication with experts. We included English-language studies on antitoxin products with approval by the US Food and Drug Administration (FDA) for anthrax in humans, nonhuman primates, and rabbits. Two researchers independently reviewed studies for inclusion and abstracted relevant data.
RESULTS
We abstracted data from 12 publications and 2 case reports. All 3 FDA-approved anthrax antitoxins demonstrated significant improvement in survival as monotherapy over placebo in rabbits and nonhuman primates. No study found significant improvement in survival with combination antitoxin and antimicrobial therapy compared to antimicrobial monotherapy. Case reports and case series described 25 patients with systemic anthrax disease treated with antitoxins; 17 survived. Animal studies that used antitoxin monotherapy as postexposure prophylaxis (PEP) demonstrated significant improvement in survival over placebo, with greatest improvements coming with early administration.
CONCLUSIONS
Limited human and animal evidence indicates that adjunctive antitoxin treatment may improve survival from systemic anthrax infection. Antitoxins may also provide an alternative therapy to antimicrobials for treatment or PEP during an intentional anthrax incident that could involve a multidrug-resistant B. anthracis strain.
Topics: Animals; Anthrax; Anti-Bacterial Agents; Anti-Infective Agents; Antitoxins; Bacillus anthracis; Humans; Primates; Rabbits
PubMed: 36251559
DOI: 10.1093/cid/ciac532 -
Microbiology (Reading, England) Sep 2020The genus , belonging to the phylum is one of the most important genera and comprises thermophilic bacteria. The genus was erected with the taxonomic reclassification...
The genus , belonging to the phylum is one of the most important genera and comprises thermophilic bacteria. The genus was erected with the taxonomic reclassification of various species. Taxonomic studies of remain in progress. However, there is no comprehensive review of the characteristic features, taxonomic status and study of various applications of this interesting genus. The main aim of this review is to give a comprehensive account of the genus . At present the genus acomprises 25 taxa, 14 validly published (with correct name), nine validly published (with synonyms) and two not validly published species. We describe only validly published species of the genera and . Vegetative cells of species are Gram-strain-positive or -variable, rod-shaped, motile, endospore-forming, aerobic or facultatively anaerobic, obligately thermophilic and chemo-organotrophic. Growth occurs in the pH range 6.08.5 and a temperature of 37-75 °C. The major cellular fatty acids are iso-C15:o, iso-C16:0 and iso-C17:o. The main menaquinone type is MK-7. The G-+C content of the DNA ranges between 48.2 and 58 mol%. The genus is widely distributed in nature, being mostly found in many extreme locations such as hot springs, hydrothermal vents, marine trenches, hay composts, etc. species have been widely exploited in various industrial and biotechnological applications, and thus are promising candidates for further studies in the future.
Topics: Bacillaceae; Biodegradation, Environmental; Biofuels; Biological Evolution; Biotechnology; CRISPR-Cas Systems; Extreme Environments; Geobacillus; Industrial Microbiology; Phylogeny; Temperature
PubMed: 32744496
DOI: 10.1099/mic.0.000945 -
Clinical Infectious Diseases : An... Jun 2016Bacillus anthracis, the causative agent of anthrax, is a potential bioterrorism agent. Anthrax meningitis is a common manifestation of B. anthracis infection, has high... (Review)
Review
BACKGROUND
Bacillus anthracis, the causative agent of anthrax, is a potential bioterrorism agent. Anthrax meningitis is a common manifestation of B. anthracis infection, has high mortality, and requires more aggressive treatment than anthrax without meningitis. Its rapid identification and treatment are essential for successful management of an anthrax mass casualty incident.
METHODS
Three hundred six published reports from 1880 through 2013 met predefined inclusion criteria. We calculated descriptive statistics for abstracted cases and conducted multivariable regression on separate derivation and validation cohorts to identify clinical diagnostic and prognostic factors for anthrax meningitis.
RESULTS
One hundred thirty-two of 363 (36%) cases with systemic anthrax met anthrax meningitis criteria. Severe headache, altered mental status, meningeal signs, and other neurological signs at presentation independently predicted meningitis in the derivation cohort and were tested as a 4-item assessment tool for use during anthrax mass casualty incidents. Presence of any 1 factor on admission had a sensitivity for finding anthrax meningitis of 89% (83%) in the adult (pediatric) validation cohorts. Anthrax meningitis was unlikely in the absence of any of these signs or symptoms (likelihood ratio [LR]- = 0.12 [0.19] for adult [pediatric] cohorts), while presence of 2 or more made meningitis very likely (LR+ = 26.5 [30.0]). Survival of anthrax meningitis was predicted by treatment with a bactericidal agent (P = .005) and use of multiple antimicrobials (P = .01).
CONCLUSIONS
We developed an evidence-based assessment tool for screening patients for meningitis during an anthrax mass casualty incident. Its use could improve both patient outcomes and resource allocation in such an event.
Topics: Adolescent; Adult; Anthrax; Bacillus anthracis; Bioterrorism; Child; Child, Preschool; Cognitive Dysfunction; Female; Headache; Humans; Male; Mass Casualty Incidents; Meningitis, Bacterial; Middle Aged
PubMed: 27025833
DOI: 10.1093/cid/ciw184