D-lactic Acidosis: Successful Suppression of D-lactate-Producing Lactobacillus by Probiotics.
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Yilmaz B
Department of Biomedical Research, Maurice Müller Laboratories, University Clinic of Visceral Surgery and Medicine, Inselspital and.
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Schibli S
University Children's Hospital, Inselspital, University of Bern, Bern, Switzerland.
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Macpherson AJ
Department of Biomedical Research, Maurice Müller Laboratories, University Clinic of Visceral Surgery and Medicine, Inselspital and.
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Sokollik C
University Children's Hospital, Inselspital, University of Bern, Bern, Switzerland christiane.sokollik@insel.ch.
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English
Intestinal microbiota composition in children with short bowel syndrome (SBS) is an important factor influencing the clinical outcome. An increase of D-lactate-producing bacteria can lead to D-lactic acidosis, also referred to as D-lactate encephalopathy, with severe neurologic impairment. Antibiotic treatments for D-lactic acidosis in children with SBS offer often only short-term relief. Here, we present the case of a boy with SBS who developed recurrent episodes of D-lactic acidosis even under continuous cycling antibiotic treatment. Microbiological analyses were used to detect the presence of D-lactate-producing Lactobacillus species in the stool samples. A probiotic cocktail was introduced to alter the intestinal microbiota. During follow-up under treatment with probiotics, the patient remained stable, and there was no additional need for antibiotic therapy for more than a year. Stool composition of the patient was sequenced regularly over that period. His microbiota profile changed completely in species richness, and a clustering of species according to probiotic usage was seen. Importantly, D-lactate-producing Lactobacillus strains disappeared within a few weeks after probiotic introduction and were no longer detected in the subsequent follow-up specimens.
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Open access status
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bronze
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https://folia.unifr.ch/global/documents/140637
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