Programa de Pós-graduação em Ciências da Saúde, Universidade Federal do Maranhão, São Luís, MA, Brazil.
Food Funct. 2018 Oct 17;9(10):5074-5095. doi: 10.1039/c8fo00376a.
Infectious diarrhea is the second most common cause of morbidity and mortality in children under 5 years of age in the underdeveloped areas of the world. Conventional treatment consists of rehydration, which may be coupled with antimicrobial agents in more severe bacterial infections or with antiprotozoal agents. In the last few decades, research on the use of probiotic strains, such as Lactobacillus rhamnosus GG ATCC 53013 (LGG), Lactobacillus reuteri DSM 17938 and Saccharomyces boulardii, has gained much attention to prevent and treat diarrheal diseases. However, they are rarely used in the clinical routine, perhaps because there are still gaps in the knowledge about the effective benefit to the patient in terms of the reduction of the duration of diarrhea and its prevention. Furthermore, only a few probiotic strains are safely indicated for usage in pediatric practice. This review summarizes the current knowledge on the antimicrobial mechanisms of probiotics on distinct enteropathogens and their role in stimulating host defense mechanisms against intestinal infections. In addition, we highlight the potential of probiotics for the treatment and prevention of diarrhea in children. We conclude that the use of probiotics is beneficial for both the treatment and prevention of diarrhea in children and that the identification of other candidate probiotics might represent an important advance to a greater reduction in hospital stays and to prevent infectious diarrhea in a larger portion of this population.
在世界欠发达地区，传染性腹泻是 5 岁以下儿童发病率和死亡率的第二大主要原因。常规治疗包括补液，在更严重的细菌感染中可能与抗菌药物联合使用，或与抗原生动物药物联合使用。在过去几十年中，人们对使用益生菌菌株（如鼠李糖乳杆菌 GG ATCC 53013（LGG）、罗伊氏乳杆菌 DSM 17938 和布拉氏酵母菌）预防和治疗腹泻病的研究引起了广泛关注。然而，它们在临床常规中很少使用，也许是因为在减少腹泻持续时间和预防腹泻方面，对患者有效获益的相关知识仍存在空白。此外，只有少数益生菌菌株被安全地用于儿科实践。本文综述了益生菌对不同肠道病原体的抗菌机制及其在刺激宿主防御机制对抗肠道感染中的作用的最新知识。此外，我们还强调了益生菌在儿童腹泻治疗和预防中的应用潜力。我们的结论是，益生菌的使用对儿童腹泻的治疗和预防都有益，而鉴定其他候选益生菌可能是减少住院时间和预防更大比例人群感染性腹泻的重要进展。
