A Pilot Study to Determine the Effectiveness of Probiotic Use in Elderly Patients with Antibiotic-Associated Diarrhea

Long-term care settings have the majority of their patients on multiple antibiotics, and outbreaks of antibiotic-associated diarrhea and Clostridium difficile are common. Probiotics have been used with these patients to reduce these side effects. Probiotics can re-establish the composition of intestinal microflora, enhance immune response, and clear pathogens from the host which may reduce the symptoms of antibiotic-associated diarrhea. Therefore, the goal of this study was to conduct a retrospective study of the effectiveness of using probiotic in elderly patients in a long-term care facility in a Midwestern city who suffered from antibiotic-associated diarrhea. The probiotic, CulturelleTM had been administered once a day to eight males and twelve female patients who were taking antibiotics and stool consistency and number were recorded. Out of the original group, seven of the patients receiving the probiotic appeared to have positive effects while two patients had negative effects on stools. Thirteen patients showed no change in stool consistency and number. It was difficult to determine the effects of the probiotic due to the use by the facility of a bowel movement protocol for preventing constipation and impaction, and the lack of dietary records. Published studies in patients in long-term facilities vary greatly in terms of trial design, type and dose of probiotic and duration of treatment, which may explain why probiotics work for some patients and not for others. Probiotic use is becoming more accepted with antibiotic-associated diarrhea but due to the lack of definitive evidence about efficacy and the safety of probiotic use, more studies need to be conducted. Advisors: Kaye Stanek Krogstrand and Julie Albrecht

Examination of Homalometron elongatum Manter, 1947 and Description of a New Congener from Eucinostomus currani Zahuranec, 1980 in the Pacific Ocean off Costa Rica

Homalometron elongatum is reexamined using heat-killed material that was not subjected to pressure during fixation from Gerres cinereus collected from San Juan Harbor, Puerto Rico, U.S.A. The new material is compared with some paratype specimens and differs by having a much less variable forebody length, and a median rather than submedian genital pore. Tegumental spines reportedly cover the anterior end of the body but we observed tegumental spines covering the entire body surface in both the paratype and new material. Homalometron lesliorum n. sp. is described from Eucinostomus currani from the Pacific coasts of Costa Rica and Nicaragua. The new species has three pairs of oral papillae surrounding the mouth and thus resembles three other congeners: H. elongatum, Homalometron carapevae, and Homalometron papilliferum. Homalometron lesliorum n. sp. is distinguished from the three species by having the anterior extent of the vitelline follicles at or above the base of the ventral sucker, compared with posterior to the ventral sucker at the level of the seminal vesicle (H. elongatum) or further posterior at the posterior margin of the ovary (H. carapevae and H. papilliferum). The four species are further differentiated from one another by sucker width ratio, tegumental spine size and distribution, egg size, host preference, and biogeography. Comparison of nuclear ribosomal DNA (3' end of 18S, internal transcribed spacer [ITS]1, ITS2, and 5' end of 28S) between H. elongatum and H. lesliorum n. sp. revealed one variable base (n = 162) at the 3' end of 18S, 12 variable bases (n = 476) at ITS1, 10 variable bases (n = 310) at ITS2, and 11 variable bases (n = 1,325) at the 5' end fragment of 28S. Nuclear ribosomal DNA from Homalometron pallidum and Homalometron armatum are included for further comparison with H. elongatum and H. lesliorum n. sp.