Lactobacillus plantarum 299v Enhances the Concentrations of Fecal Short-Chain Fatty Acids in Patients with Recurrent Clostridium difficile-Associated Diarrhea
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Our objective was to document how intake of Lactobacillus plantarum 299v affects the concentrations of fecal organic acids during and after metronidazole treatment in 19 patients with recurrent Clostridium difficile-associated diarrhea. Fecal samples were analyzed by gas-liquid chromatography. After intake of metronidazole a significant decrease in total short-chain fatty acids was seen in the placebo group (from 77.1 to 45.5 μmol/g; P=0.028) but not in the Lactobacillus group (79.8–60.4 μmol/g). In addition, a statistically significant difference between treatment groups was noted for butyrate (5.6–1.2 μmol/g in the placebo group vs. 7.6–5.6 μmol/g in the Lactobacillus group; P=0.047). At the end of the study and after cessation of placebo or Lactobacillus, the total short-chain fatty acids rose to the same levels as before antibiotic treatment in the placebo group. Both treatment groups showed a significant decrease in concentrations of succinate at the end of the study in comparison to the time when metronidazole intake was stopped (6.3–1.5 μmol/g in the placebo group versus 9.3–0.9 μmol/g in the Lactobacillus group; P=0.028). The present study of fecal samples from a clinical trial is the first to demonstrate that administration of Lactobacillus plantarum 299v reduces the negative effects of an antibiotic on colonic fermentation. The intake of this probiotic strain may thereby provide an additional benefit for patients with recurrent Clostridium difficile-associated diarrhea.
KeywordsShort-chain fatty acids Recurrent Clostridium difficile-associated diarrhea Lactobacillus plantarum 299v, Probiotic bacteria Colonic microflora Treatment
This study was supported by a grant from the county of Skåne. Probi AB Ltd. (Sweden) provided active preparations of Lactobacillus plantarum 299v and placebo. Anna Berggren is employed at Probi AB. The other authors have no financial interest in the company.
- 8.Surawicz CM, McFarland LV, Greenberg RN, Rubin M, Fekety R, Mulligan ME, Garcia RJ, Brandmarker S, Bowen K, Borjal D, Elmer GW (2000) The search for a better treatment for recurrent Clostridium difficile diasease: use of high-dose vancomycin combined with Saccharomyces boulardii. Clin Infect Dis 31:1012–1017PubMedCrossRefGoogle Scholar
- 19.Scheppach W (1994) Effects of short chain fatty acids on gut morphology and function. Gut 35(Suppl):35S–8SGoogle Scholar
- 20.Mortensen PB, Clausen MR (1996) Short-chain fatty acids in the human colon: relation to gastrointestinal health and disease. Scand J Gastroenterol 216 (Suppl):132S–48SGoogle Scholar
- 21.Johansson ML, Nobaek S, Berggren A, Nyman M, Bjorck I, Ahrne S, Jeppsson B, Molin G (1998) Survival of Lactobacillus plantarum DSM 9843 (299v), and effect on the short-chain fatty acid content of feces after ingestion of a rose-hip drink with fermented oats. Int J Food Microbiol 30:29–38CrossRefGoogle Scholar
- 23.Richardson AJ, Calder AG, Stewart CS (1989) Simultaneous determination of volatile and non-volatile acidic fermentation products of anaerobes by capillary gas-chromatography. Lett Appl Microbiol 9:5–8Google Scholar
- 24.Berggren A (1996) Formation, pattern and physiological effects of short-chain fatty acids. Doctoral thesis. Lund Institute of Technology, Lund University, Lund, SwedenGoogle Scholar