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Возможные меры по снижению рисков развития антибиотикоассоциированных диарей у детей
Возможные меры по снижению рисков развития антибиотикоассоциированных диарей у детей
Бабаян М.Л. Возможные меры по снижению рисков развития антибиотикоассоциированных диарей у детей. Педиатрия (Прил. к журн. Consilium Medicum). 2017; 1: 58–62.
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Аннотация
В настоящее время известно, что ключевую роль в поддержании здоровья человека играет кишечная микрофлора. При некоторых заболеваниях уже выявлены характерные нарушения состава микробиома, которые, в свою очередь, могут способствовать обострению и ухудшению течения основного заболевания. Сегодня достаточно актуальной проблемой являются антибиотикоассоциированные диареи (ААД) у детей. Нередко развитие ААД связано с расстройством функционирования микрофлоры кишечника. Развитие ААД в более поздние сроки, по-видимому, обусловлено колонизацией кишечника условно-патогенными штаммами бактерий. Для предотвращения развития дисбиотических изменений при антибактериальной терапии необходимо наряду с антибиотиками назначать пробиотики. Штамм Bifidobacterium animalis subsp. lactis (BB-12) – один из наиболее изученных штаммов бифидобактерий. Результаты многочисленных исследований, доказавших клиническую эффективность и безопасность штамма Bifidobacterium animalis subsp. lactis (BB-12), послужили основанием широкого его использования во всем мире в качестве компонента продуктов питания, лекарственных препаратов и пищевых добавок.
Ключевые слова: кишечная микрофлора, дисбиотические нарушения, антибиотики, антибиотикоассоциированная диарея, пробиотики, Bifidobacterium animalis subsp. lactis (BB-12), Линекс® Форте, Линекс для детей® капли.
Key words: intestinal microflora, dysbiotic disorders, antibiotics, antibiotic-associated diarrhea, probiotics, Bifidobacterium animalis subsp. Lactis (BB-12), Linex® Forte, Linex for children® drops.
Ключевые слова: кишечная микрофлора, дисбиотические нарушения, антибиотики, антибиотикоассоциированная диарея, пробиотики, Bifidobacterium animalis subsp. lactis (BB-12), Линекс® Форте, Линекс для детей® капли.
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Key words: intestinal microflora, dysbiotic disorders, antibiotics, antibiotic-associated diarrhea, probiotics, Bifidobacterium animalis subsp. Lactis (BB-12), Linex® Forte, Linex for children® drops.
Полный текст
Список литературы
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2. Suau A, Bonnet R, Sutren M et al. Direct analysis of genes encoding 16S rRNA from complex communities reveals many novel molecular species within the human gut. Appl Environ Microbiol 1999; 65 (11): 4799–807.
3. Egert M, de Graaf AA, Smidt H et al. Beyond diversity: functional microbiomics of the human colon. Trends Microbiol 2006; 14: 86–91.
4. Qin J, Li R, Raes J et al. A human gut microbial gene catalogue established by metagenomic sequencing. MetaHIT Consortium. Nature 2010; 464 (7285): 59–65.
5. Huse SM, Ye Y, Zhou Y, Fodor A. A core human microbiome as viewed through 16 s rRNA sequence clusters. PLoS One 2012; 7: e34242.
6. Arumugam M, Raes J, Pelletier E et al. Enterotypes of the human gut microbiome. Nature 2011; 473 (7346): 174–80.
7. Bulatova E.M., Bogdanova N.M. Kishechnaia mikroflora – odin iz faktorov formirovaniia zdorov'ia cheloveka. Meditsinskii sovet. 2013; 1: 30–3. [in Russian]
8. Roberfroid M, Gibson GR, Hoyles L et al. Prebiotic effects: metabolic and health benefits. Br J Nutr 2010; 104: S1–S63.
9. Sellitto M, Bai G, Serena G et al. Proof of concept of microbiome-metabolome analysis and delayed gluten exposure on celiac disease autoimmunity in genetically at-risk infants. PloS One 2012; 7: e33387.
10. Schwiertz A, Jacobi M, Frick J-S et al. Microbiota in pediatric inflammatory bowel disease. J Pediatr 2010; 157: 240–4.e1.
11. Swidsinski A, Dorffel Y, Loening-Baucke V et al. Acute appendicitis is characterized by local invasion with Fusobacterium nucleatum/necrophorum. Gut 2011; 60: 34–40.
12. Hviid A, Svanstrom H, Frisch M. Antibiotic use and inflammatory bowel diseases in childhood. Gut 2011; 60: 49–54.
13. Saulnier DM, Riehle K, Mistretta T-A et al. Gastrointestinal microbiome signatures of pediatric patients with irritable bowel syndrome. Gastroenterology 2011; 141: 1782–91.
14. Jeffery IB, O’Toole PW, Ohman L et al. An irritable bowel syndrome subtype defined by species-specific alterations in faecal microbiota. Gut 2012; 61: 997–1006.
15. Ly NP, Litonjua A, Gold DR, Celedon JC. Gut microbiota, probiotics, and vitamin D: interrelated exposures influencing allergy, asthma, and obesity? J Allergy Clin Immunol 2011; 127: 1087–94.
16. Abrahamsson TR, Jakobsson HE, Andersson AF et al. Low diversity of the gut microbiota in infants with atopic eczema. J Allergy Clin Immunol 2012; 129: 434–40.
17. Bisgaard H, Li N, Bonnelykke K et al. Reduced diversity of the intestinal microbiota during infancy is associated with increased risk of allergic disease at school age. J Allergy Clin Immunol 2011; 128: 646–52.
18. Grigor'eva G.A., Meshalkina N.Iu. Smekta v lechenii zabolevanii kishechnika. RMZh. 2005; 13 (7): 464–6. [in Russian]
19. Zaplatnikov A.L., Zakharova I.N., Korovina N.A. Clostridium difficile-infektsiia u detei. RMZh. 2004; 12 (5): 373–7. [in Russian]
20. Nizhevich A.A., Khasanov R.Sh., Nurtdinova R.A. i dr. Antibiotik-assotsiirovannyi disbakterioz kishechnika u detei. Det. gastroenterologiia. 2005; 2: 3–6. [in Russian]
21. Shenderov B.A. Meditsinskaia mikrobnaia etiologiia i funktsional'noe pitanie. M.: Grant, 1998. T. 1; s. 286. T. 2; s. 412. [in Russian]
22. Shcherbakov P.L., Tsvetkov P.M., Nechaeva L.V. Profilaktika diarei sviazannoi s priemom antibiotikov u detei. Vopr. sovrem. pediatrii. 2004; 3 (2). [in Russian]
23. Uchaikin V.F. Rukovodstvo po infektsionnym zabolevaniiam u detei. M.: Geotar-Media, 1998; s. 492–4. [in Russian]
24. Hogenauer C, Hammer HF, Krejs GJ, Reisinger EC. Mechanisms and managment of antibiotic-associated diarrhea. Clin Infect Dis 1998; 27: 702–10.
25. Torres JF, Cedillo R, Sanchez J et al. Prevalence of Clostridium difficile and its cytotoxin in infants in Mexico. J Clin Microbiol 1984; 20 (2): 274–5.
26. Probiotics and prebiotics. Practice Guideline World Gastroenterology Organization, 2011. http://www.worldgastroenterology.org
27. Guidelines for the Evaluation of Probiotics in Food. Joint FAO/WHO (Food and Agriculture Organization/World Health Organisation) Working Group. London, Ontario, Canada, 2002.
28. Probiotics and prebiotics. Practice Guideline World Gastroenterology Organization, 2011. http://www.worldgastroenterology.org.
29. Guidelines for the Evaluation of Probiotics in Food. Joint FAO/WHO (Food and Agriculture Organization/World Health Organisation) Working Group. London, Ontario, Canada, 2002.
30. Garrigues C, Johansen E, Pedersen MB. Complete genome sequence of Bifidobacterium animalis subsp. lactis BB-12, a widely consumed probiotic strain. J Bacteriol 2010; 192 (9): 2467–8.
31. Zakharova I.N., Dmitrieva Iu.A. Shtamm-spetsificheskie svoistva Bifidobacterium animalis subsp. lactis BB-12. Effektivnaia farmakoterapiia. Pediatriia. 2013; 2. [in Russian]
32. Matsumoto M, Ohishi H, Benno Y. H+-ATPase activity in Bifidobacterium with special reference to acid tolerance. Int J Food Microbiol 2004; 93(1): 109–13.
33. Garrigues C, Stuer-Lauridsen B, Johansen E. Characterisation of Bifidobacterium animalissubsp. lactis BB-12 and other probiotic bacteria using genomics, transcriptomics and proteomics. Aust J Dairy Technol 2005; 60: 84–92.
34. Langhendries JP, Detry J, Van Hees J et al. Effect of a fermented infant formula containing viable bifidobacteria on the fecal flora composition and pH of healthy full-term infants. J Pediatr Gastroenterol Nutr 1995; 21 (2): 177–81.
35. Kailasapathy K, Chin J. Survival and therapeutic potential of probiotic organisms with reference to Lactobacillus acidophilus and Bifidobacterium spp. Immunol Cell Biol 2000; 78 (1): 80–8.
36. Martinez FA, Dominguez JM, Converti A, Oliveira RP. Production of bacteriocin-like inhibitory substance by Bifidobacterium lactis in skim milk supplemented with additives. J Dairy Res 2015; 82 (3): 350–5.
37. Holscher HD, Czerkies LA, Cekola P et al. Bifidobacterium lactis Bb12 enhances intestinal antibody response in formula-fed infants: a randomized, double-blind, controlled trial. JPEN J Parenter Enteral Nutr 2012; 36 (Suppl. 1): 106S–117S.
38. Chouraqui JP, Van Egroo LD, Fichot MC. Acidified milk formula supplemented with bifidobacterium lactis: impact on infant diarrhea in residential care settings. J Pediatr Gastroenterol Nutr 2004; 38 (3): 288–92.
39. Bhalla A. Randomized placebo-controlled, double blind, multicentric trial on efficacy and safety of providac techsules (Lactobacillus Acidophilus LA-5 and Bifidobacterium BB-12) for prevention of antibiotic-associated diarrhea in Indian patients [in: Abstracts: 40th Annual Meeting of the American college of clinical pharmacology; September 11–13, 2011; Chicago, IL]. J Clin Pharmacol 2011; 51 (9): 1327.
40. Chatterjee S, Kar P, Das T et al. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated diarrhoea. J Assoc Physicians India 2013; 61 (10): 708–12.
2. Suau A, Bonnet R, Sutren M et al. Direct analysis of genes encoding 16S rRNA from complex communities reveals many novel molecular species within the human gut. Appl Environ Microbiol 1999; 65 (11): 4799–807.
3. Egert M, de Graaf AA, Smidt H et al. Beyond diversity: functional microbiomics of the human colon. Trends Microbiol 2006; 14: 86–91.
4. Qin J, Li R, Raes J et al. A human gut microbial gene catalogue established by metagenomic sequencing. MetaHIT Consortium. Nature 2010; 464 (7285): 59–65.
5. Huse SM, Ye Y, Zhou Y, Fodor A. A core human microbiome as viewed through 16 s rRNA sequence clusters. PLoS One 2012; 7: e34242.
6. Arumugam M, Raes J, Pelletier E et al. Enterotypes of the human gut microbiome. Nature 2011; 473 (7346): 174–80.
7. Булатова Е.М., Богданова Н.М. Кишечная микрофлора – один из факторов формирования здоровья человека. Медицинский совет. 2013; 1: 30–3. / Bulatova E.M., Bogdanova N.M. Kishechnaia mikroflora – odin iz faktorov formirovaniia zdorov'ia cheloveka. Meditsinskii sovet. 2013; 1: 30–3. [in Russian]
8. Roberfroid M, Gibson GR, Hoyles L et al. Prebiotic effects: metabolic and health benefits. Br J Nutr 2010; 104: S1–S63.
9. Sellitto M, Bai G, Serena G et al. Proof of concept of microbiome-metabolome analysis and delayed gluten exposure on celiac disease autoimmunity in genetically at-risk infants. PloS One 2012; 7: e33387.
10. Schwiertz A, Jacobi M, Frick J-S et al. Microbiota in pediatric inflammatory bowel disease. J Pediatr 2010; 157: 240–4.e1.
11. Swidsinski A, Dorffel Y, Loening-Baucke V et al. Acute appendicitis is characterized by local invasion with Fusobacterium nucleatum/necrophorum. Gut 2011; 60: 34–40.
12. Hviid A, Svanstrom H, Frisch M. Antibiotic use and inflammatory bowel diseases in childhood. Gut 2011; 60: 49–54.
13. Saulnier DM, Riehle K, Mistretta T-A et al. Gastrointestinal microbiome signatures of pediatric patients with irritable bowel syndrome. Gastroenterology 2011; 141: 1782–91.
14. Jeffery IB, O’Toole PW, Ohman L et al. An irritable bowel syndrome subtype defined by species-specific alterations in faecal microbiota. Gut 2012; 61: 997–1006.
15. Ly NP, Litonjua A, Gold DR, Celedon JC. Gut microbiota, probiotics, and vitamin D: interrelated exposures influencing allergy, asthma, and obesity? J Allergy Clin Immunol 2011; 127: 1087–94.
16. Abrahamsson TR, Jakobsson HE, Andersson AF et al. Low diversity of the gut microbiota in infants with atopic eczema. J Allergy Clin Immunol 2012; 129: 434–40.
17. Bisgaard H, Li N, Bonnelykke K et al. Reduced diversity of the intestinal microbiota during infancy is associated with increased risk of allergic disease at school age. J Allergy Clin Immunol 2011; 128: 646–52.
18. Григорьева Г.А., Мешалкина Н.Ю. Смекта в лечении заболеваний кишечника. РМЖ. 2005; 13 (7): 464–6. / Grigor'eva G.A., Meshalkina N.Iu. Smekta v lechenii zabolevanii kishechnika. RMZh. 2005; 13 (7): 464–6. [in Russian]
19. Заплатников А.Л., Захарова И.Н., Коровина Н.А. Clostridium difficile-инфекция у детей. РМЖ. 2004; 12 (5): 373–7. / Zaplatnikov A.L., Zakharova I.N., Korovina N.A. Clostridium difficile-infektsiia u detei. RMZh. 2004; 12 (5): 373–7. [in Russian]
20. Нижевич А.А., Хасанов Р.Ш., Нуртдинова Р.А. и др. Антибиотик-ассоциированный дисбактериоз кишечника у детей. Дет. гастроэнтерология. 2005; 2: 3–6. / Nizhevich A.A., Khasanov R.Sh., Nurtdinova R.A. i dr. Antibiotik-assotsiirovannyi disbakterioz kishechnika u detei. Det. gastroenterologiia. 2005; 2: 3–6. [in Russian]
21. Шендеров Б.А. Медицинская микробная этиология и функциональное питание. М.: Грант, 1998. Т. 1; с. 286. Т. 2; с. 412. / Shenderov B.A. Meditsinskaia mikrobnaia etiologiia i funktsional'noe pitanie. M.: Grant, 1998. T. 1; s. 286. T. 2; s. 412. [in Russian]
22. Щербаков П.Л., Цветков П.М., Нечаева Л.В. Профилактика диареи связанной с приемом антибиотиков у детей. Вопр. соврем. педиатрии. 2004; 3 (2). / Shcherbakov P.L., Tsvetkov P.M., Nechaeva L.V. Profilaktika diarei sviazannoi s priemom antibiotikov u detei. Vopr. sovrem. pediatrii. 2004; 3 (2). [in Russian]
23. Учайкин В.Ф. Руководство по инфекционным заболеваниям у детей. М.: Гэотар-Медиа, 1998; с. 492–4. / Uchaikin V.F. Rukovodstvo po infektsionnym zabolevaniiam u detei. M.: Geotar-Media, 1998; s. 492–4. [in Russian]
24. Hogenauer C, Hammer HF, Krejs GJ, Reisinger EC. Mechanisms and managment of antibiotic-associated diarrhea. Clin Infect Dis 1998; 27: 702–10.
25. Torres JF, Cedillo R, Sanchez J et al. Prevalence of Clostridium difficile and its cytotoxin in infants in Mexico. J Clin Microbiol 1984; 20 (2): 274–5.
26. Probiotics and prebiotics. Practice Guideline World Gastroenterology Organization, 2011. http://www.worldgastroenterology.org
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33. Garrigues C, Stuer-Lauridsen B, Johansen E. Characterisation of Bifidobacterium animalissubsp. lactis BB-12 and other probiotic bacteria using genomics, transcriptomics and proteomics. Aust J Dairy Technol 2005; 60: 84–92.
34. Langhendries JP, Detry J, Van Hees J et al. Effect of a fermented infant formula containing viable bifidobacteria on the fecal flora composition and pH of healthy full-term infants. J Pediatr Gastroenterol Nutr 1995; 21 (2): 177–81.
35. Kailasapathy K, Chin J. Survival and therapeutic potential of probiotic organisms with reference to Lactobacillus acidophilus and Bifidobacterium spp. Immunol Cell Biol 2000; 78 (1): 80–8.
36. Martinez FA, Dominguez JM, Converti A, Oliveira RP. Production of bacteriocin-like inhibitory substance by Bifidobacterium lactis in skim milk supplemented with additives. J Dairy Res 2015; 82 (3): 350–5.
37. Holscher HD, Czerkies LA, Cekola P et al. Bifidobacterium lactis Bb12 enhances intestinal antibody response in formula-fed infants: a randomized, double-blind, controlled trial. JPEN J Parenter Enteral Nutr 2012; 36 (Suppl. 1): 106S–117S.
38. Chouraqui JP, Van Egroo LD, Fichot MC. Acidified milk formula supplemented with bifidobacterium lactis: impact on infant diarrhea in residential care settings. J Pediatr Gastroenterol Nutr 2004; 38 (3): 288–92.
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41. Chatterjee S, Kar P, Das T et al. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated diarrhoea. J Assoc Physicians India 2013; 61 (10): 708–12.
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27. Guidelines for the Evaluation of Probiotics in Food. Joint FAO/WHO (Food and Agriculture Organization/World Health Organisation) Working Group. London, Ontario, Canada, 2002.
28. Probiotics and prebiotics. Practice Guideline World Gastroenterology Organization, 2011. http://www.worldgastroenterology.org.
29. Guidelines for the Evaluation of Probiotics in Food. Joint FAO/WHO (Food and Agriculture Organization/World Health Organisation) Working Group. London, Ontario, Canada, 2002.
30. Garrigues C, Johansen E, Pedersen MB. Complete genome sequence of Bifidobacterium animalis subsp. lactis BB-12, a widely consumed probiotic strain. J Bacteriol 2010; 192 (9): 2467–8.
31. Zakharova I.N., Dmitrieva Iu.A. Shtamm-spetsificheskie svoistva Bifidobacterium animalis subsp. lactis BB-12. Effektivnaia farmakoterapiia. Pediatriia. 2013; 2. [in Russian]
32. Matsumoto M, Ohishi H, Benno Y. H+-ATPase activity in Bifidobacterium with special reference to acid tolerance. Int J Food Microbiol 2004; 93(1): 109–13.
33. Garrigues C, Stuer-Lauridsen B, Johansen E. Characterisation of Bifidobacterium animalissubsp. lactis BB-12 and other probiotic bacteria using genomics, transcriptomics and proteomics. Aust J Dairy Technol 2005; 60: 84–92.
34. Langhendries JP, Detry J, Van Hees J et al. Effect of a fermented infant formula containing viable bifidobacteria on the fecal flora composition and pH of healthy full-term infants. J Pediatr Gastroenterol Nutr 1995; 21 (2): 177–81.
35. Kailasapathy K, Chin J. Survival and therapeutic potential of probiotic organisms with reference to Lactobacillus acidophilus and Bifidobacterium spp. Immunol Cell Biol 2000; 78 (1): 80–8.
36. Martinez FA, Dominguez JM, Converti A, Oliveira RP. Production of bacteriocin-like inhibitory substance by Bifidobacterium lactis in skim milk supplemented with additives. J Dairy Res 2015; 82 (3): 350–5.
37. Holscher HD, Czerkies LA, Cekola P et al. Bifidobacterium lactis Bb12 enhances intestinal antibody response in formula-fed infants: a randomized, double-blind, controlled trial. JPEN J Parenter Enteral Nutr 2012; 36 (Suppl. 1): 106S–117S.
38. Chouraqui JP, Van Egroo LD, Fichot MC. Acidified milk formula supplemented with bifidobacterium lactis: impact on infant diarrhea in residential care settings. J Pediatr Gastroenterol Nutr 2004; 38 (3): 288–92.
39. Bhalla A. Randomized placebo-controlled, double blind, multicentric trial on efficacy and safety of providac techsules (Lactobacillus Acidophilus LA-5 and Bifidobacterium BB-12) for prevention of antibiotic-associated diarrhea in Indian patients [in: Abstracts: 40th Annual Meeting of the American college of clinical pharmacology; September 11–13, 2011; Chicago, IL]. J Clin Pharmacol 2011; 51 (9): 1327.
40. Chatterjee S, Kar P, Das T et al. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated diarrhoea. J Assoc Physicians India 2013; 61 (10): 708–12.
Авторы
М.Л.Бабаян*
ОСП «Научно-исследовательский клинический институт педиатрии им. акад. Ю.Е.Вельтищева»
ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 125412, Россия, Москва, ул. Талдомская, д. 2
*margarita.babayan@gmail.com
N.I.Pirogov Pediatrics Medical University of the Ministry of Health of the Russian Federation. 125412, Russian Federation, Moscow, ul. Taldomskaia, d. 2
*margarita.babayan@gmail.com
ОСП «Научно-исследовательский клинический институт педиатрии им. акад. Ю.Е.Вельтищева»
ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 125412, Россия, Москва, ул. Талдомская, д. 2
*margarita.babayan@gmail.com
________________________________________________
N.I.Pirogov Pediatrics Medical University of the Ministry of Health of the Russian Federation. 125412, Russian Federation, Moscow, ul. Taldomskaia, d. 2
*margarita.babayan@gmail.com
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