Efficacy and safety of Trang Phuc Linh Plus tablets in patients with irritable bowel syndrome-diarrhea

A double-blind, randomized, phase II clinical trial was conducted within a 14-week follow-up including 2 weeks of the non-drug run-in period, 8 weeks of medication, and 4 weeks of follow-up after discontinuation. The objective of the study was to evaluate the efficacy and safety of Trang Phuc Linh Plus in irritable diarrhea syndrome patients. Group I took Trang Phuc Linh Plus 3 tablets/time x 2 times/day for 8 weeks; Group II took placebo 3 tablets/time x 2 times/day for 8 weeks. Patients will be re-examined, tested, and evaluated over the phone for symptom recurrence and adverse events (AEs). This study showed that the Trang Phuc Linh Plus tablets tended to improve symptoms in patients suffering from irritable bowel syndrome with diarrhea, suggesting its safety and tolerability.

Clostridium perfringens – antibiotic-associated and sporadic diarrhea in children: age, anamnestic and clinical and laboratory features

The article presents the data of the research on the problem of two clinical forms of enteroproducing Clostridium perfringens (C. perfringens) – associated infection in the children who are not connected with food – antibiotic-associated and sporadic forms. Within the period of 2019–2021 a retrospective analysis of the results of complex clinical and laboratory study of children aged from 2 months to 18 years with diarrhea (acute intestinal infection, n = 406 children) was carried out within the framework of the algorithm developed by Pediatric Research and Clinical Center for Infectious Diseases (Russia, Saint Petersburg). The material for the study included stool tests, coprofiltrates and strains of the microorganisms determinating microbiocoenosis of the intestines including enterotoxigenic strains of C. perfringens. The main group included children with diarrhea (n = 38 of 406 children with diarrhea) who at admission presented C. perfringens enterotoxin in coprofiltrates found by immune-enzyme analysis and there were identified the cultures of enterotoxigenic strains of C. perfringens by tests of intestinal contents. The first group included children (n = 30 of 406 children; 7 %) with antibiotic-associated diarrhea (AAD). The second group included children (n = 8 of 406 children; 2 %) with sporadic diarrhea. An overwhelming majority of patients with ААD (n = 20; 92.3 %) of the first 8 (100 %) years of life presented intensity of diarrhea syndrome in direct dependence on colonization activity of enterotoxigenic C perfringens (colony-forming units/g feces) (r = 0.78). The disease proceeded mainly with the syndromes of gastroenteritis, enterocolitis and hemorrhagic colitis. There was noted a reliable high frequency of severe forms of both ААD, and sporadic diarrhea (р < 0.05) caused by enterotoxigenic strains of C perfringens in children of the first year of life. Deep decompensated disorders of large intestine microbiota associated with Klebsiella spp., Staphylococcus aureus and Candida albicans, were characterized by severity and prolonged character of the course (р < 0.05). The received results determine the tactics of differential diagnosis and treatment of AAD and sporadic diarrhea caused by enteroproducing strains of C. perfringens.

Long-term follow-up of a patient with syndromic diarrhea (tricho-hepato-enteral syndrome) with Crohn's-like syndrome

Objective. To describe a long-term follow-up of a patient with a rare genetic disease – syndromic diarrhea, or trichohepatoenteric syndrome.Results. From the first months of life, the child was diagnosed with incurable diarrhea syndrome, which led to the development of malabsorption syndrome, retardation of physical and psychomotor development. Long-term follow-up revealed the progression of malabsorption syndrome, metabolic and endocrine disorders against the background of increasing morphological changes in the intestine. Only a genetic study of the patient and his parents made it possible to formulate the final diagnosis: «Syndromic diarrhea (trichohepatoenteric syndrome, nucleotide variant g.31929071C> T homozygous in the SKIV2L gene) with crown-like syndrome».Conclusion. The combination of incurable chronic diarrhea syndrome with facial dysmorphism, skin and hair abnormalities is important for this diagnosis.

Prevalence of Diarrheagenic E. Coli Among Hospitalized Children in a Clinical Centre

Introduction. Escherichia coli is a common cause of acute diarrhea mainly in young children and, less frequently, in elderly or immunosuppressed patients. Many types of E. coli are part of the normal enteric flora, but can cause urinary tract or nervous system infections. Objective. To study the prevalence of the main types and serogroups of diarrheagenic E. coli among hospitalized children with enteric infections. Material and methods. Over a period of 5 years, 1,160 hospitalized children with acute diarrhea syndrome were studied. Fecal samples underwent culturing, biochemical and phenotypic identification. Results. Among the studied patients, 112/1,160 children (9.7%) had diarrhea caused by E. coli, and only 4 of the isolates were lactose-negative. The most common was diarrhea caused by ETEC – 65/112 (58.0%), followed by EPEC – 38/112 (33.9%), and in third place – EHES 9/112 (8.0%). We did not isolate EIEC types. Depending on the group of E. coli, we observed some differences in the clinical presentation and specifics in the distribution of patients by age. Conclusion. The study shows that this causative agent is common among Bulgarian children with diarrhea. Unfortunately, in Bulgaria the microbiological network is still not able to adequately respond to the challenges of the extended serodiagnosis for detection of diarrheagenic E. coli, which is performed in Western Europe and North America.

Identification of ZDHHC17 as a Potential Drug Target for Swine Acute Diarrhea Syndrome Coronavirus Infection

The recent emergence of deadly zoonotic viral diseases, including Ebola virus and SARS-CoV-2, emphasizes the importance of pandemic preparedness for the animal-sourced viruses with potential risk of animal-to-human spillover. Over the last 2 decades, three significant coronaviruses of bat origin, SARS-CoV, MERS-CoV, and SARS-CoV-2, have caused millions of deaths with significant economy and public health impacts.

The Characteristics of Spike Glycoprotein Gene of Swine Acute Diarrhea Syndrome Coronavirus Strain CH/FJWT/2018 Isolated in China

Swine acute diarrhea syndrome (SADS) is a highly contagious infectious disease characterized by acute vomiting and watery diarrhea in neonatal piglets. The causative agent for SADS is the swine acute diarrhea syndrome coronavirus (SADS-CoV), an alphacoronavirus in the family Coronaviridae. Currently, SADS-CoV was identified only in Guangdong and Fujian provinces of China, not in any other regions or countries in the world. To explore the genetic diversity of SADS-CoV isolates, herein we comparatively analyzed 44 full-length genomes of viruses isolated in Guangdong and Fujian provinces during 2017–2019. The spike glycoprotein gene of SADS-CoV strain CH/FJWT/2018 isolated in Fujian province is distinct from that of other viral isolates in either spike glycoprotein gene-based phylogenetic analysis or whole genome-based gene similarity analysis. Moreover, at least 7 predicted linear B cell epitopes in the spike glycoprotein of CH/FJWT/2018 would be affected by amino acid variations when compared with a representative virus isolated in Guangdong province. The spike glycoprotein of coronaviruses determines viral host range and tissue tropism during virus infection via specific interactions with the cellular receptor and also plays critical roles in eliciting the production of neutralizing antibodies. Since SADS-CoVs have a broad cell tropism, the results in this report further emphasize that the spike glycoprotein gene is a pivotal target in the surveillance of SADS-CoV.

The Broad Range of Coronaviruses Co-existing in Chiropteran: Implications for One Health

Bats are a group of mammals that harbor the most significant number of coronaviruses. The aim of present review article was to analyze the broad spectrum of the coronavirus coexisting in Chiropterans hosts. Bats have certain types of cell receptors that allow them to be the potential hosts of a large number of viruses without the presence of any clinical manifestations, and to be a source of contagion infections for other animals and human species. Emphasis can be placed on five coronaviruses, such as Porcine Epidemic Diarrhea Disease, Severe Acute Diarrhea Syndrome, Middle East Respiratory Syndrome, Severe Acute Respiratory Syndrome, and Severe Acute Respiratory Syndrome 2, which have had significant impacts causing epidemic outbreaks in different parts of the world, and generating implications for both human and animal health. In conclusion, recent research indicated the importance of bats as potential hosts of multiple coroaviruses leading to some zoonotic diseases.