• Fermented fish
• Immunomodulation
• Pangenome
• Probiotic
• Whole genome sequencing

• Probiotics/pharmacology
• Animals
• Mice
• Humans
• HT29 Cells
• India
• Anti-Inflammatory Agents/pharmacology
• Fish Products/microbiology
• RAW 264.7 Cells
• Fishes/microbiology
• Fishes/metabolism
• Fermented Foods/microbiology
• Fermentation
• Lactobacillus plantarum/isolation & purification
• Lactobacillus plantarum/metabolism

• Bama mini-pig
• colonic content
• lipid metabolism
• microbiota composition
• probiotics
• skeletal muscle
• synbiotics

• Animals
• Gastrointestinal Microbiome/drug effects
• Gastrointestinal Microbiome/physiology
• Lipid Metabolism/drug effects
• Lipid Metabolism/physiology
• Female
• Swine
• Synbiotics/administration & dosage
• Probiotics/administration & dosage
• Probiotics/pharmacology
• Pregnancy
• Muscle, Skeletal/metabolism
• Muscle, Skeletal/microbiology
• Muscle, Skeletal/drug effects
• Dietary Supplements
• Colon/microbiology
• Colon/metabolism

• 2023YFD1301305 National Key Research and Development Project
• U20A2056 Key Project of Regional innovation and Development Joint Fund of National Natural Science Foundation of China
• ISA2023203 Open Fund of Key Laboratory of Agro-ecological Processes in Subtropical Region, Chinese Academy of Sciences
• 2022JJ30643 Hunan Natural Science Foundation
• 2019RS3022 Special Funds for Construction of Innovative Provinces in Hunan Province

Patients with “post-COVID” syndrome manifest with a variety of signs and symptoms that continue/develop after acute COVID-19. Among the most common are gastrointestinal (GI) and mental symptoms. The reason for symptom occurrence lies in the SARS-CoV-2 capability of binding to exact receptors, among other angiotensin converting enzyme 2 (ACE2) receptors in gastrointestinal lining and neuropilin-1 (NRP-1) in the nervous system, which leads to loss of gastrointestinal and blood-brain barriers integrity and function. The data are mounting that SARS-CoV-2 can trigger systemic inflammation and lead to disruption of gut-brain axis (GBA) and the development of disorders of gut brain interaction (DGBIs). Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are the most common DGBIs syndromes. On the other hand, emotional disorders have also been demonstrated as DGBIs. Currently, there are no official recommendations or recommended procedures for the use of probiotics in patients with COVID-19. However, it can be assumed that many doctors, pharmacists, and patients will want to use a probiotic in the treatment of this disease. In such cases, strains with documented activity should be used. There is a constant need to plan and conduct new trials on the role of probiotics and verify their clinical efficacy for counteracting the negative consequences of COVID-19 pandemic. Quality control is another important but often neglected aspect in trials utilizing probiotics in various clinical entities. It determines the safety and efficacy of probiotics, which is of utmost importance in patients with post-acute COVID-19 syndrome.

Diabetic foot ulcers (DFU) are a growing concern worldwide as they pose complications in routine clinical practices such as diagnosis and management. Bacterial interactions on the skin surface are vital to the pathophysiology of DFU and may control delayed wound healing. The microbiota from our skin directly regulates cutaneous health and disease by interacting with the numerous cells involved in the wound healing mechanism. Commensal microbiota, in particular, interact with wound-repairing skin cells to enhance barrier regeneration. The observed microbes in DFU include Staphylococcus, Streptococcus, Corynebacterium, Pseudomonas, and several anaerobes. Skin commensal microbes, namely S. epidermidis, can regulate the gamma delta T cells and induce Perforin-2 expression. The increased expression of Perforin-2 by skin cells destroyed S. aureus within the cells, facilitating wound healing. Possible crosstalk between the human commensal microbiome and different cell types involved in cutaneous wound healing promotes the immune response and helps to maintain the barrier function in humans. Wound healing is a highly well-coordinated, complex mechanism; it can be devastating if interrupted. Skin microbiomes are being studied in relation to the gut-skin axis along with their effects on dermatologic conditions. The gut-skin axis illustrates the connection wherein the gut can impact skin health due to its immunological and metabolic properties. The precise mechanism underlying gut-skin microbial interactions is still unidentified, but the immune and endocrine systems are likely to be involved. Next-generation sequencing and the development of bioinformatics pipelines may considerably improve the understanding of the microbiome-skin axis involved in diabetic wound healing in a much more sophisticated way. We endeavor to shed light on the importance of these pathways in the pathomechanisms of the most prevalent inflammatory conditions including the diabetes wound healing, as well as how probiotics may intervene in the gut-skin axis.

• diabetes
• dysbiosis
• microbiota
• probiotics
• wound healing

• Animals
• Diabetes Mellitus/microbiology
• Gastrointestinal Microbiome/physiology
• Humans
• Microbiota/physiology
• Skin/microbiology
• Wound Healing/physiology

• cancer
• gastrointestinal disorders
• pathology
• probiotic
• therapy

• IBS
• guidelines
• irritable bowel syndrome
• probiotics

The probiotic Escherichia coli strain Nissle 1917 (DSM 6601, Mutaflor), generally considered beneficial and safe, has been used for a century to treat various intestinal diseases. However, Nissle 1917 hosts in its genome the pks pathogenicity island that codes for the biosynthesis of the genotoxin colibactin. Colibactin is a potent DNA alkylator, suspected to play a role in colorectal cancer development. We show in this study that Nissle 1917 is functionally capable of producing colibactin and inducing interstrand cross-links in the genomic DNA of epithelial cells exposed to the probiotic. This toxicity was even exacerbated with lower doses of the probiotic, when the exposed cells started to divide again but exhibited aberrant anaphases and increased gene mutation frequency. DNA damage was confirmed in vivo in mouse models of intestinal colonization, demonstrating that Nissle 1917 produces the genotoxin in the gut lumen. Although it is possible that daily treatment of adult humans with their microbiota does not produce the same effects, administration of Nissle 1917 as a probiotic or as a chassis to deliver therapeutics might exert long-term adverse effects and thus should be considered in a risk-versus-benefit evaluation.

IMPORTANCE Nissle 1917 is sold as a probiotic and considered safe even though it has been known since 2006 that it harbors the genes for colibactin synthesis. Colibactin is a potent genotoxin that is now linked to causative mutations found in human colorectal cancer. Many papers concerning the use of this strain in clinical applications ignore or elude this fact or misleadingly suggest that Nissle 1917 does not induce DNA damage. Here, we demonstrate that Nissle 1917 produces colibactin in vitro and in vivo and induces mutagenic DNA damage. This is a serious safety concern that must not be ignored in the interests of patients, the general public, health care professionals, and ethical probiotic manufacturers.

• Escherichia coli
• colibactin
• genotoxin
• probiotic

In a 12-week feeding trial, 32 rabbits (Chinchilla × New Zealand White; 56 days old; 691 ± 1 g body weight) were used to investigate the effect of pro- and prebiotics as growth enhancer on the growth performance, intestinal mucosal development, hematological and serum biochemical responses of rabbits. The dietary Biotronic® prebiotics and Biovet®-YC probiotics were added at 400 mg/kg and 50 mg/kg, respectively. The rabbits were housed individually and randomly assigned to four dietary treatments (n = 8/group; 50:50 bucks to does) including a control diet (diet 1), diet 2 (control + Biotronic® prebiotics), diet 3 (control + Biovet®-YC probiotics) and diet 4 (control + symbiotics [Biotronic® prebiotics and Biovet®-YC probiotics]). Body weight (BW), average daily gain (ADG), dry matter intake (DMI), and feed conversion ratio (FCR) were monitored. Five rabbits per treatment were used for organ assessment and intestinal histomorphology after feeding trial. Blood samples were collected for hematological and serum biochemical analysis. Results showed that supplementation of Biotronic® prebiotics and symbiotics in rabbit diet significantly (P < 0.05) increased final BW and ADG compared to Biovet®-YC probiotic and control diets. Kidney, lung, esophagus, gastro-intestinal tract, small and large intestines were significantly (P < 0.05) influenced by dietary treatments. Ileal mucosal assessment revealed that villus height (VH), villus width, villus density, crypt depth (CD), and VH:CD ratio of rabbits fed Biotronic® prebiotic and symbiotic diets were similar and significantly (P < 0.05) higher than those rabbits fed control and Biovet®-YC probiotic diets. Packed cell volume of rabbits fed symbiotic and control diets was significantly (P < 0.05) higher than those fed Biotronic® prebiotic and Biovet®-YC probiotic diets. This study suggests that Biotronic® prebiotics and its combination with Biovet®-YC probiotics are good alternative growth promoting feed additives in rabbit nutrition. They improved performance, intestinal development and blood profiles and aid feed digestion, nutrient absorption and utilization in rabbits.

• dietary treatment
• growth promoter
• performance
• prebiotics
• probiotics
• rabbits

• PPAR gamma
• enteric bacterial microflora
• experimental colitis
• lipids
• probiotics

Since the 1950s, gradual changes in the gut microbiota of patients with hepatic encephalopathy have been observed. Previous research has indicated potential associations between the gut and brain, and the gut microbiota is becoming a hot topic in research on diseases of the nervous system. However, for the past few decades, studies of hepatic encephalopathy have been restricted to controlling the gut microbiota during macroscopic manipulation, such as probiotic intervention, while its clinical use remains controversial, and the cellular mechanisms underlying this condition are still poorly understood. This thesis seeks to comprehensively understand and explain the role of gut microbiota in hepatic encephalopathy as well as analyze the effects of intervention by regulating the gut microbiota. Evidence is presented that shows that dysbiosis of the gut microbiota is the primary pathological driver of hepatic encephalopathy and impacts pathologic progression via complex regulatory networks. As a result, suggestions were identified for future mechanistic research and improvements in therapeutic strategies for hepatic encephalopathy.

• antibiotics
• fecal microbiota transplantation
• gut microbiota
• gut–liver–brain axis
• hepatic encephalopathy
• probiotic

• gastrointestinal passage
• gut
• probiotics
• resistance
• survivability

• Anti-Bacterial Agents
• Bile Acids and Salts
• Gastrointestinal Tract
• Lactobacillus
• Probiotics

• dental caries
• lactobacilli
• oral health
• probiotics

• Adolescent
• Child
• Dental Caries/prevention & control
• Dental Plaque/epidemiology
• Dental Plaque/prevention & control
• Double-Blind Method
• Feeding Behavior
• Female
• Gingivitis/epidemiology
• Gingivitis/prevention & control
• Health Status
• Humans
• Hydrogen-Ion Concentration
• Limosilactobacillus reuteri
• Male
• Mouth/microbiology
• Oral Health
• Periodontal Index
• Pilot Projects
• Probiotics
• Saliva
• Streptococcus mutans
• Tablets

Antibiotic resistance represents a worldwide recognized issue affecting both human and veterinary medicine, with a particular focus being directed towards monogastric animals destined for human consumption. This scenario is the result of frequent utilization of the antibiotics either for therapeutic purposes (humans and animals) or as growth promoters (farmed animals). Therefore, the search for nutritional alternatives has progressively been the object of significant efforts by the scientific community. So far, probiotics, prebiotics and postbiotics are considered the most promising products, as they are capable of preventing or treating gastrointestinal diseases as well as restoring a eubiosis condition after antibiotic-induced dysbiosis development. This review provides an updated state-of-the-art of these nutritional alternatives in both humans and monogastric animals.

In recent years, the indiscriminate use of antibiotics has been perpetrated across human medicine, animals destined for zootechnical productions and companion animals. Apart from increasing the resistance rate of numerous microorganisms and generating multi-drug resistance (MDR), the nonrational administration of antibiotics causes sudden changes in the structure of the intestinal microbiota such as dysbiotic phenomena that can have a great clinical significance for both humans and animals. The aim of this review is to describe the state-of-the-art of alternative therapies to the use of antibiotics and their effectiveness in humans and monogastric animals (poultry, pigs, fish, rabbits, dogs and cats). In particular, those molecules (probiotics, prebiotics and postbiotics) which have a direct function on the gastrointestinal health are herein critically analysed in the prevention or treatment of gastrointestinal diseases or dysbiosis induced by the consumption of antibiotics.

• antibiotics
• dysbiosis
• human
• intestinal microbiota
• monogastric animals
• pets
• postbiotics
• prebiotics
• probiotics

• children
• diarrhoea
• probiotics

Probiotics have been used in trials to therapeutically modulate the gut microbiome and have shown beneficial effects in cirrhosis. However, their effect on the microbiome of cirrhosis patients is not fully understood yet. Here, we tested the effects of a multispecies probiotic on microbiome composition in compensated cirrhosis. The gut microbiome composition of 58 patients with compensated cirrhosis from a randomized controlled trial who received a daily dose of multispecies probiotics or placebo for six months was analysed by 16S rRNA gene sequencing. Microbiome composition of patients who received probiotics was enriched with probiotic strains and the abundance of Faecalibacterium prausnitzii, Syntrophococcus sucromutans, Bacteroides vulgatus, Alistipes shahii and a Prevotella species was increased in the probiotic group compared to the placebo group. Patients who had microbiome changes in response to probiotic treatment also showed a significant increase in neopterin and a significant decrease in faecal zonulin levels after intervention, which was not observed in placebo-treated patients or patients with unchanged microbiome compositions. In conclusion, multispecies probiotics may enrich the microbiome of compensated cirrhotic patients with probiotic bacteria during a six-month intervention and beneficially change the residential microbiome and gut barrier function.

• 16S
• RNA
• cirrhosis
• gastrointestinal microbiome
• probiotics
• ribosomal

Despite increasing research on the gut-skin axis, there is a lack of comprehensive studies on the improvement of skin health through the regulation of the intestinal condition in humans. In this study, we investigated the benefits of Lactobacillus plantarum HY7714 (HY7714) consumption on skin health through its modulatory effects on the intestine and ensuing immune responses. HY7714 consumption led to differences in bacterial abundances from phylum to genus level, including increases in Actinobacteria followed by Bifidobacterium and a decrease in Proteobacteria. Additionally, HY7714 significantly ameliorated inflammation by reducing matrix metallopeptidases (MMP-2 and MMP-9), zonulin, and calprotectin in plasma, all of which are related to skin and intestinal permeability. Furthermore, RNA-seq analysis revealed its efficacy at restoring the integrity of the gut barrier by regulating gene expression associated with the extracellular matrix and immunity. This was evident by the upregulation of IGFBP5, SERPINE1, EFEMP1, COL6A3, and SEMA3B and downregulation of MT2A, MT1E, MT1X, MT1G, and MT1F between TNF- α and TNF- α plus HY7714 treated Caco-2 cells. These results propose the potential mechanistic role of HY7714 on skin health by the regulation of the gut condition.

• Adult
• Aged
• Biodiversity
• Biomarkers/blood
• Caco-2 Cells
• Female
• Gastrointestinal Microbiome/drug effects
• Gene Ontology
• Humans
• Inflammation/pathology
• Intestines/microbiology
• Lactobacillus plantarum/drug effects
• Lactobacillus plantarum/physiology
• Middle Aged
• Skin/microbiology
• Tumor Necrosis Factor-alpha/pharmacology
• Young Adult

• Metabolic syndrome
• Prediabetes
• Probiotic
• Synbiotic

• Adult
• Aged
• Biomarkers/analysis
• Dietary Supplements
• Double-Blind Method
• Female
• Follow-Up Studies
• Humans
• Male
• Metabolic Syndrome/diagnosis
• Metabolic Syndrome/etiology
• Metabolic Syndrome/prevention & control
• Middle Aged
• Prediabetic State/complications
• Probiotics/therapeutic use
• Prognosis
• Synbiotics/administration & dosage

• chronic idiopathic constipation
• irritable bowel syndrome
• meta-analysis
• microbiota
• probiotics
• recommendations
• systematic review

• Colonization
• Immunoreactivity
• Oral vaccine vector
• Probiotics
• Stability

• UBBC-07
• acute diarrhoea
• children
• stool

• body composition
• dietary intervention
• insulin resistance
• liver
• mouse model
• obesity therapy

• Animals
• Anti-Obesity Agents/administration & dosage
• Anti-Obesity Agents/pharmacology
• Bifidobacterium breve
• Blood Glucose/metabolism
• Body Constitution/physiology
• Body Weight/physiology
• Cholesterol/metabolism
• Diet, Western/adverse effects
• Female
• Gastrointestinal Microbiome/physiology
• Ileum/metabolism
• Lipid Metabolism/physiology
• Male
• Mice, Inbred C57BL
• Obesity/blood
• Obesity/prevention & control
• Phenotype
• Prebiotics/administration & dosage
• Synbiotics/administration & dosage

• Antibiotics
• Bacteria
• Chemicals
• Contamination
• Ethanol

• DSS colitis
• intestinal microbiota
• microRNA
• probiotic
• pyrosequencing

• Dietary fiber
• FMT
• Prebiotics
• Probiotics
• Symbiotics

• Streptococcus mutans
• biofilm
• dental caries
• probiotic Lactobacillus

• Antibiosis
• Bacteriocins/pharmacology
• Biofilms/drug effects
• Biofilms/growth & development
• Catalase/pharmacology
• Culture Media/chemistry
• Humans
• Hydrogen-Ion Concentration
• Interferon-gamma/biosynthesis
• Interleukin-10/biosynthesis
• Lacticaseibacillus casei/drug effects
• Lacticaseibacillus casei/growth & development
• Lacticaseibacillus casei/metabolism
• Lactobacillus plantarum/drug effects
• Lactobacillus plantarum/growth & development
• Lactobacillus plantarum/metabolism
• Limosilactobacillus reuteri/drug effects
• Limosilactobacillus reuteri/growth & development
• Limosilactobacillus reuteri/metabolism
• Ligilactobacillus salivarius/drug effects
• Ligilactobacillus salivarius/growth & development
• Ligilactobacillus salivarius/metabolism
• Leukocytes, Mononuclear/cytology
• Leukocytes, Mononuclear/immunology
• Leukocytes, Mononuclear/microbiology
• Microbial Sensitivity Tests
• Peroxides/pharmacology
• Polysaccharides, Bacterial/antagonists & inhibitors
• Polysaccharides, Bacterial/biosynthesis
• Primary Cell Culture
• Probiotics/pharmacology
• Quorum Sensing/drug effects
• Streptococcus mutans/drug effects
• Streptococcus mutans/genetics
• Streptococcus mutans/growth & development
• Streptococcus mutans/pathogenicity
• Trypsin/pharmacology

• Anti-TNF
• Anti-integrins
• adaptive immunity
• biologic therapies
• inflammatory bowel disease
• inflammatory cytokines
• innate immunity
• molecular targets

• Adaptive Immunity/drug effects
• Anti-Inflammatory Agents/therapeutic use
• Cell Adhesion Molecules/antagonists & inhibitors
• Cell Adhesion Molecules/genetics
• Cell Adhesion Molecules/immunology
• Cytokines/antagonists & inhibitors
• Cytokines/genetics
• Cytokines/immunology
• Gastrointestinal Agents/therapeutic use
• Gastrointestinal Microbiome/immunology
• Gene Expression Regulation
• Humans
• Immunity, Innate/drug effects
• Immunologic Factors/therapeutic use
• Inflammatory Bowel Diseases/drug therapy
• Inflammatory Bowel Diseases/genetics
• Inflammatory Bowel Diseases/immunology
• Inflammatory Bowel Diseases/microbiology
• Integrins/antagonists & inhibitors
• Integrins/genetics
• Integrins/immunology
• Leukocytes/drug effects
• Leukocytes/immunology
• Molecular Targeted Therapy/methods
• Signal Transduction
• Tumor Necrosis Factor-alpha/antagonists & inhibitors
• Tumor Necrosis Factor-alpha/genetics
• Tumor Necrosis Factor-alpha/immunology

Escherichia coli Nissle 1917 (EcN) is a probiotic strain with proven efficacy in inducing and maintaining remission of ulcerative colitis. However, the microbial factors that mediate these beneficial effects are not fully known. Gram-negative bacteria release outer membrane vesicles (OMVs) as a direct pathway for delivering selected bacterial proteins and active compounds to the host. In fact, vesicles released by gut microbiota are emerging as key players in signaling processes in the intestinal mucosa. In the present study, the dextran sodium sulfate (DSS)-induced colitis mouse model was used to investigate the potential of EcN OMVs to ameliorate mucosal injury and inflammation in the gut. The experimental protocol involved pre-treatment with OMVs for 10 days before DSS intake, and a 5-day recovery period. Oral administration of purified EcN OMVs (5 μg/day) significantly reduced DSS-induced weight loss and ameliorated clinical symptoms and histological scores. OMVs treatment counteracted altered expression of cytokines and markers of intestinal barrier function. This study shows for the first time that EcN OMVs can mediate the anti-inflammatory and barrier protection effects previously reported for this probiotic in experimental colitis. Remarkably, translation of probiotics to human healthcare requires knowledge of the molecular mechanisms involved in probiotic–host interactions. Thus, OMVs, as a non-replicative bacterial form, could be explored as a new probiotic-derived therapeutic approach, with even lower risk of adverse events than probiotic administration.

• DSS-experimental colitis
• Escherichia coli Nissle 1917
• immune modulation
• mouse model
• outer membrane vesicles
• probiotic

• Aged
• Aged, 80 and over
• Aging/physiology
• Humans
• Immunity/drug effects
• Middle Aged
• Probiotics/therapeutic use

• diet
• gut
• microbiota
• probiotic
• skin

• Bio-K+
• Clostridium difficile
• Fecal microbiota transplantation
• Lactobacillus
• Lifeway kefir
• Probiotic

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. NAFLD includes a wide spectrum of liver conditions ranging from simple steatosis to nonalcoholic steatohepatitis and advanced hepatic fibrosis. NAFLD has been recognized as a hepatic manifestation of metabolic syndrome linked with insulin resistance. NAFLD should be considered not only a liver specific disease but also an early mediator of systemic diseases. Therefore, NAFLD is usually associated with cardiovascular disease, chronic kidney disease, type 2 diabetes, obesity, and dyslipidemia. NAFLD is highly prevalent in the general population and is associated with increased cardiovascular morbidity and mortality. The underlying mechanisms and pathogenesis of NAFLD with regard to other medical disorders are not yet fully understood. This review focuses on pathogenesis of NAFLD and its relation with other systemic diseases.

• Nonalcoholic fatty liver disease
• Obesity
• Insulin resistance
• Cardiovascular effect
• Multi-systemic disease

• Animals
• Comorbidity
• Diabetes Mellitus, Type 2/epidemiology
• Dyslipidemias/epidemiology
• Humans
• Hypertension/epidemiology
• Insulin Resistance
• Metabolic Syndrome/epidemiology
• Non-alcoholic Fatty Liver Disease/diagnosis
• Non-alcoholic Fatty Liver Disease/epidemiology
• Non-alcoholic Fatty Liver Disease/mortality
• Non-alcoholic Fatty Liver Disease/therapy
• Obesity/epidemiology
• Prognosis
• Renal Insufficiency, Chronic/epidemiology
• Risk Factors
• Sleep Apnea, Obstructive/epidemiology

The healthy intestine represents a remarkable interface where sterile host tissues come in contact with gut microbiota, in a balanced state of homeostasis. The imbalance of gut homeostasis is associated with the onset of many severe pathological conditions, such as inflammatory bowel disease (IBD), a chronic gastrointestinal disorder increasing in incidence and severely influencing affected individuals. Despite the recent development of next generation sequencing and bioinformatics, the current scientific knowledge of specific triggers and diagnostic markers to improve interventional approaches in IBD is still scarce. In this review we present and discuss currently available and emerging therapeutic options in modulating composition and metabolic activity of gut microbiota in patients affected by IBD. Therapeutic approaches at the microbiota level, such as dietary interventions alone or with probiotics, prebiotics and synbiotics, administration of antibiotics, performing fecal microbiota transplantation (FMT) and the use of nematodes, all represent a promising opportunities towards establishing and maintaining of well-being as well as improving underlying IBD symptoms.

• dietary interventions
• fecal microbiota transplantation (FMT)
• gut microbiota
• inflammatory bowel disease (IBD)
• nematodes
• probiotics

• Animals
• Anti-Bacterial Agents/therapeutic use
• Diet
• Fecal Microbiota Transplantation
• Gastrointestinal Microbiome
• Helminths/physiology
• Homeostasis
• Humans
• Inflammatory Bowel Diseases/microbiology
• Inflammatory Bowel Diseases/parasitology
• Inflammatory Bowel Diseases/therapy
• Nutritional Physiological Phenomena
• Prebiotics
• Probiotics/therapeutic use
• Synbiotics

• Erk1/2 MAPK
• activating protein 1
• multidrug resistance 1 promoter
• probiotics
• transcriptional regulation

• cesarean delivery
• dysbiosis
• inflammatory bowel disease
• innate immunity
• microbiota
• obesity
• postnatal development.

• CDI
• Clostridium difficile
• prevention
• probiotic