In this letter, an experimental therapy in four patients with therapy-resistant Clostridioides difficile infection is described. These four patients were treated with Manuka honey via colon lavage. First, the patients received a three-day fidaxomicin treatment. The colon lavage was performed on the third day. During a subsequent ileocolonoscopy, 300 mL 15% Manuka honey was applied via a spray catheter. Patients remained in bed for two hours after the procedure and did not defecate. The patient’s microbiomes were tested before treatment, after the fidaxomicin treatment, and after honey lavage. A decrease in C. difficile load was found in their microbiomes. Additionally, restoration of microbiota diversity after the honey lavage was also noted. The four patients experienced complete cessation of watery stools and remain symptom free. These results indicate the need for more clinical research into this matter.

Recent evidence has shown that gut microbiota dysbiosis is associated with development of gestational diabetes mellitus (GDM). However, the gut microbiota composition of non-obese women with GDM, which accounts for a relatively large percentage of Asian GDM, is unknown. We investigated the characteristics of gut microbiota of Japanese pregnant women with GDM. Fecal samples from Japanese pregnant women with GDM (n=20) and normal glucose tolerance (NGT, n=16) were collected at the time of GDM diagnosis (T1), at 35–37 weeks of gestation (T2), and at 4 weeks postpartum (T3). Gut microbiota composition was characterized from fecal DNA by sequencing of 16S rRNA genes. Serum samples were collected late in the third trimester, and the circulating levels of adiponectin and IL-6 were measured by ELISA. At the genus level, Peptostreptococcaceae Romboutsia was enriched in GDM women at T1 (p=0.008) and T2 (p=0.047). The women with lower serum adiponectin tended to have more Romboutsia. The Shannon index was significantly lower in the GDM women at T3 than in the NGT women (p=0.008), and that of the GDM women decreased significantly from T2 to T3 (p=0.02). No significant difference in bacterial community structure was found in a beta diversity analysis. The non-obese GDM women (body mass index <25.0 kg/m²) showed a lower abundance of Coriobacteriaceae Collinsella at T1 (p=0.03) and higher abundance of Akkermansia at T2 (p=0.04) than the normal control. The non-obese GDM women had the distinctive gut microbiota profiles. Analysis of gut microbiota is potentially useful for risk assessment of GDM in non-obese pregnant women.

This study aimed to evaluate the benefits of oral administration of Lactobacillus acidophilus strain L-55 (LaL-55) to chickens inoculated with a Newcastle disease virus (NDV)-based live-attenuated vaccine by examining the mRNA expression of several genes related to viral infection in the spleen and ileum by quantitative reverse transcription polymerase chain reaction. In the spleen, interferon (IFN)-α was significantly higher in the low- and middle-dose LaL-55 groups at 6 weeks than at 4 weeks. IFN regulatory factor (IRF)-3 and IRF-7 expression was significantly higher in the low-dose LaL-55 group than in the middle- and high-dose LaL-55 groups. In the ileum, melanoma differentiation-associated gene 5 showed a dose-dependent increase at 4 weeks. IFN-γ and IRF-7 showed dose-dependent increases at 6 weeks. These results suggested that LaL-55 boosts the immune response to the NDV vaccine, albeit by different mechanisms in the spleen and ileum.

Lactobacillus delbrueckii subsp. bulgaricus (L. bulgaricus) is widely used as a starter for yogurt and cheese worldwide. Despite the economic importance of this bacterium in the dairy industry, there have been few genetic studies involving knockout or overexpression mutants to identify the functions of L. bulgaricus genes. One of the main reasons for this gap is the low transformation efficiency of available L. bulgaricus chromosome-integrating vectors upon performing conventional electroporation. We previously proposed the conjugal plasmid pAMβ1 as an integration vector for L. bulgaricus, as conjugation could avert the need for a restriction modification system; pAMβ1 does not replicate and integrate into the chromosome of L. bulgaricus. Here, we describe an effective chromosomal manipulation system involving a novel shuttle vector pGMβ1, which could improve the operability of the broad host-range conjugal plasmid pAMβ1. We further developed an enhanced filter-mating method for conjugation. To validate this system, the effectiveness of conversion of the lactate dehydrogenase gene D-ldh of L. bulgaricus to the L-ldh form of Streptococcus thermophilus was examined. As pGMβ1 and pAMβ1 are unable to replicate in L. delbrueckii subsp. delbrueckii, they were chromosomally integrated. However, these plasmids could replicate in L. delbrueckii subsp. indicus and sunkii. This integration system could unearth important gene functions in L. bulgaricus and thus improve its applications in the dairy industry. Moreover, this conjugation system could be used as a stable vector for the transformation of long cluster genes in several species of lactic acid bacteria.