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Pediatrics. 2018 Sep;142(3). pii: e20180337. doi: 10.1542/peds.2018-0337. Epub 2018 Aug 8.

D-lactic Acidosis: Successful Suppression of D-lactate-Producing Lactobacillus by Probiotics.

Author information

1
Department of Biomedical Research, Maurice Müller Laboratories, University Clinic of Visceral Surgery and Medicine, Inselspital and.
2
University Children's Hospital, Inselspital, University of Bern, Bern, Switzerland.
3
University Children's Hospital, Inselspital, University of Bern, Bern, Switzerland christiane.sokollik@insel.ch.

Abstract

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.

PMID:
30089656
DOI:
10.1542/peds.2018-0337
[Indexed for MEDLINE]

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