Therapeutic interventions for gut dysbiosis and related disorders in the elderly: Antibiotics, probiotics or faecal microbiota transplantation?

Beneficial Microbes

Volumn 8, Issue 2, 2017, Pages 179-192

  Vemuri, R C ^a   Gundamaraju, R ^a   Shinde, T ^a   Eri, R ^a  

^a UNIVERSITY OF TASMANIA   (Australia)

Author keywords

Age specific; Antibiotic resistance; Feacal microbiota; Gut microbiota; Synbiotics

Indexed keywords

ANTIBIOTIC AGENT; PREBIOTIC AGENT; PROBIOTIC AGENT; SYNBIOTIC AGENT; ANTIINFECTIVE AGENT;

AGING; ANTIBIOTIC ASSOCIATED DIARRHEA; ANTIBIOTIC RESISTANCE; ARTICLE; DIARRHEA; DIET SUPPLEMENTATION; DRUG MECHANISM; DYSBIOSIS; FECAL MICROBIOTA TRANSPLANTATION; FECES MICROFLORA; GASTROINTESTINAL DISEASE; GERIATRIC PATIENT; HOSPITAL INFECTION; HUMAN; IMMUNE SYSTEM; IMMUNITY; INTESTINE EPITHELIUM CELL; INTESTINE MUCOSA; METABOLISM; NONHUMAN; PEPTOCLOSTRIDIUM DIFFICILE; PHYSIOLOGY; AGED; CHEMICALLY INDUCED; CROSS INFECTION; DIETARY SUPPLEMENT; DRUG EFFECTS; GASTROENTERITIS; INTESTINE FLORA; MICROBIOLOGY; PSEUDOMEMBRANOUS COLITIS;

AGED; AGING; ANTI-BACTERIAL AGENTS; CLOSTRIDIUM DIFFICILE; CROSS INFECTION; DIETARY SUPPLEMENTS; DYSBIOSIS; ENTEROCOLITIS, PSEUDOMEMBRANOUS; FECAL MICROBIOTA TRANSPLANTATION; GASTROENTERITIS; GASTROINTESTINAL MICROBIOME; HUMANS; PREBIOTICS; PROBIOTICS;

EID: 85018355861     PISSN: 18762883     EISSN: 18762891     Source Type: Journal    
DOI: 10.3920/BM2016.0115     Document Type: Article

References (95)

1. Agrawal, M., Aroniadis, O.C., Brandt, L.J., Kelly, C., Freeman, S., Surawicz, C., Broussard, E., Stollman, N., Giovanelli, A., Smith, B., Yen, E., Trivedi, A., Hubble, L., Kao, D., Borody, T., Finlayson, S., Ray, A. and Smith, R., 2016. The long-term efficacy and safety of fecal microbiota transplant for recurrent, severe, and complicated Clostridium difficile infection in 146 elderly individuals. Journal of Clinical Gastroenterology 50: 403-407
2. Ahmed, M., Prasad, J., Gill, H., Stevenson, L. and Gopal, P., 2007. Impact of consumption of different levels of Bifidobacterium lactis HN019 on the intestinal microflora of elderly human subjects. Journal of Nutrition Health and Aging 11: 26-31
3. Akatsu, H., Nagafuchi, S., Kurihara, R., Okuda, K., Kanesaka, T., Ogawa, N., Kanematsu, T., Takasugi, S., Yamaji, T., Takami, M., Yamamoto, T., Ohara, H. and Maruyama, M., 2015. Enhanced vaccination effect against influenza by prebiotics in elderly patients receiving enteral nutrition. Geriatrics and Gerontology International 16: 205-213
4. Allen, S., Wareham, K., Wang, D., Bradley, C., Sewell, B., Hutchings, H. and Gravenor, M., 2013. PWE-008 placide: probiotics in the prevention of antibiotic associated diarrhoea (AAD) and Clostridium difficile associated diarrhoea (CDD) in elderly patients admitted to hospital-results of a large multi-centre RCT in the UK. Gut 62: A133
5. Amati, L., Marzulli, G., Martulli, M., Pugliese, V., Caruso, C., Candore, G. and Jirillo, E., 2010. Administration of a synbiotic to free-living elderly and evaluation of serum cytokines. A pilot study. Current Pharmaceutical Design 16: 854-858
6. Andrews, P., Borody, T.J., Shortis, N.P. and Thompson, S., 1995. Bacteriotherapy for chronic constipation-long term follow-up. Gastroenterology 108: A563
7. Angelberger, S., Reinisch, W., Makristathis, A., Lichtenberger, C., Dejaco, C., Papay, P., Novacek, G., Trauner, M., Loy, A. and Berry, D., 2013. Temporal bacterial community dynamics vary among ulcerative colitis patients after fecal microbiota transplantation. American Journal of Gastroenterology 108: 1620-1630
8. Aroniadis, O.C. and Brandt, L.J., 2013. Fecal microbiota transplantation: past, present and future. Current Opinion in Gastroenterology 29: 79-84
9. Aroniadis, O.C., Brandt, L.J., Greenberg, A., Borody, T., Kelly, C.R., Mellow, M., Surawicz, C., Cagle, L., Neshatian, L., Stollman, N., Giovanelli, A., Ray, A. and Smith, R., 2016. Long-term followup study of fecal microbiota transplantation for severe and/or complicated Clostridium difficile infection: a multicenter experience. Journal of Clinical Gastroenterology 50: 398-402
10. Bakken, J.S., 2009. Fecal bacteriotherapy for recurrent Clostridium difficile infection. Anaerobe 15: 285-289
11. Bartosch, S., Fite, A., Macfarlane, G.T. and McMurdo, M.E., 2004. Characterization of bacterial communities in feces from healthy elderly volunteers and hospitalized elderly patients by using realtime PCR and effects of antibiotic treatment on the fecal microbiota. Applied and Environmental Microbiology 70: 3575-3581
12. Bergonzelli, G.E., Blum, S., Brüssow, H. and Corthésy-Theulaz, I., 2005. Probiotics as a treatment strategy for gastrointestinal diseases? Digestion 72: 57-68
13. Biagi, E., Nylund, L., Candela, M., Ostan, R., Bucci, L., Pini, E., Nikkïla, J., Monti, D., Satokari, R., Franceschi, C., Brigidi, P. and De Vos, W., 2010. Through ageing, and beyond: gut microbiota and inflammatory status in seniors and centenarians. PloS ONE 5: e10667
14. Bilinski, J., Grzesiowski, P., Muszynski, J., Wróblewska, M., Madry, K., Robak, K., Dzieciatkowski, T., Wiktor-Jedrzejczak, W. and Basak, G.W., 2016. Fecal microbiota transplantation inhibits multidrugresistant gut pathogens: preliminary report performed in an immunocompromised host. Archivum Immunologiae et Therapiae Experimentalis 64: 255-258
15. Boll, E.V.J., Ekström, L.M., Courtin, C.M., Delcour, J.A., Nilsson, A.C., Björck, I.M. and östman, E.M., 2015. Effects of wheat bran extract rich in arabinoxylan oligosaccharides and resistant starch on overnight glucose tolerance and markers of gut fermentation in healthy young adults. European Journal of Nutrition 55: 1661-1670
16. Borody, T.J., George, L., Andrews, P.J., Brandl, S., Noonan, S., Cole, P., Hyland, L., Morgan, A., Maysey, J. and Moore-Jones, D., 1989. Bowel flora alteration: a potential cure of inflammatory bowel disease and irritable bowel syndrome? Medical Journal of Australia 150: 604
17. Borody, T.J., Warren, E.F., Leis, S.M., Surace, R., Ashman, O. and Siarakas, S., 2004. Bacteriotherapy using fecal flora: toying with human motions. Journal of Clinical Gastroenterology 38: 475-483
18. Bouhnik, Y., Achour, L., Paineau, D., Riottot, M., Attar, A. and Bornet, F., 2007. Four-week short chain fructo-oligosaccharides ingestion leads to increasing fecal bifidobacteria and cholesterol excretion in healthy elderly volunteers. Nutrition Journal 6: 1
19. Brandt, L.J., Aroniadis, O.C., Mellow, M., Kanatzar, A., Kelly, C., Park, T., Stollman, N., Rohlke, F. and Surawicz, C., 2012. Long-term follow-up of colonoscopic fecal microbiota transplant for recurrent Clostridium difficile infection. American Journal of Gastroenterology 107: 1079-1087
20. Chang, J.Y., Antonopoulos, D.A., Kalra, A., Tonelli, A., Khalife, W.T., Schmidt, T.M. and Young, V.B., 2008. Decreased diversity of the fecal microbiome in recurrent Clostridium difficile-associated diarrhea. Journal of Infectious Diseases 197: 435-438
21. Charpentier, C., Salleron, J., Savoye, G., Fumery, M., Merle, V., Laberenne, J.-E., Vasseur, F., Dupas, J.L., Cortot, A., Dauchet, L., Peyrin-Biroulet, L., Lerebours, E., Colombel, J.F. and Gower-Rousseau, C., 2013. Natural history of elderly-onset inflammatory bowel disease: a population-based cohort study. Gut 63: 423-432
22. Chassard, C., Dapoingy, M., Scott, K.P., Crouzet, L., Del'homme, C., Marquet, P., Martin, J.C., Pickering, G., Ardid, D., Eschalier, A., Dubray, C., Flint, H.J. and Bernalier-Donadille, A., 2012. Functional dysbiosis within the gut microbiota of patients with constipatedirritable bowel syndrome. Alimentary Pharmacolpgy and Therapy 35: 828-838
23. Chung, Y.C., Hsu, C.K., Ko, C.Y. and Chan, Y.C., 2007. Dietary intake of xylooligosaccharides improves the intestinal microbiota, fecal moisture, and pH value in the elderly. Nutrition Research 27: 756-761
24. Chutka, D.S., Evans, J.M., Fleming, K.C. and Mikkelson, K.G., 1995. Drug prescribing for elderly patients. Mayo Clinic Proceedings 70: 685-693
25. Claesson, M.J., Jeffery, I.B., Conde, S., Power, S.E., O'Connor, E.M., Cusack, S. and Fitzgerald, G.F., 2012. Gut microbiota composition correlates with diet and health in the elderly. Nature 488: 178-184
26. Cui, B., Feng, Q., Wang, H., Wang, M., Peng, Z., Li, P. and Ji, G., 2015. Fecal microbiota transplantation through mid-gut for refractory Crohn's disease: safety, feasibility, and efficacy trial results. Journal of Gastroenterology and Hepatology 30: 51-58
27. Cusack, S. and O'toole, P.W., 2012. Challenges and implications for biomedical research and intervention studies in older populations: insights from the ELDERMET study. Gerontology 59: 114-121
28. Damman, C., Brittnacher, M., Hayden, H., Radey, M., Hager, K., Miller, S. and Zisman, T.L., 2014. Su1403 single colonoscopically administered fecal microbiota transplant for ulcerative colitis-a pilot study to determine therapeutic benefit and graft stability. Gastroenterology 146: S460
29. Deng, F., Wang, Y., Zhang, Y. and Shen, Z., 2015. Characterization of the genetic environment of the ribosomal RNA methylase gene erm(B) in Campylobacter jejuni. Journal of Antimicrobial Chemotherapy 70: 613-615
30. Dethlefsen, L., Huse, S., Sogin, M.L. and Relman, D.A., 2008. The pervasive effects of an antibiotic on the human gut microbiota, as revealed by deep 16S rRNA sequencing. PLoS Biology 6: e280
31. Dong, D., Zhang, L., Chen, X., Jiang, C., Yu, B., Wang, X. and Peng, Y., 2013. Antimicrobial susceptibility and resistance mechanisms of clinical Clostridium difficile from a Chinese tertiary hospital. International Journal of Antimicrobial Agents 41: 80-84
32. Dunne, C., Murphy, L., Flynn, S., O'Mahony, L., O'Halloran, S., Feeney, M., Morrissey, D., Thornton, G., Fitzgerald, G., Daly, C., Kiely, B., Quigley, E.M., O'Sullivan, G.C., Shanahan, F. and Collins, J.K., 1999. Probiotics: from myth to reality. Demonstration of functionality in animal models of disease and in human clinical trials. Antonie van Leeuwenhoek 76: 279-292
33. Eiseman, B., Silen, W., Bascom, G.S. and Kauvar, A.J., 1958. Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis. Surgery 44: 854-859
34. Fang, H., Elina, T., Heikki, A. and Seppo, S., 2006. Modulation of humoral immune response through probiotic intake. FEMS Immunology and Medical Microbiology 29: 47-52
35. Frank, D.N., St Amand, A.L., Feldman, R.A., Boedeker, E.C., Harpaz, N. and Pace, N.R., 2007. Molecular-phylogenetic characterization of microbial community imbalances in human inflammatory bowel diseases. Proceedings of the National Academy of Sciences of the USA 104: 13780-13785
36. Gibson, G.R., Probert, H.M., Van Loo, J., Rastall, R.A. and Roberfroid, M.B., 2004. Dietary modulation of the human colonic microbiota: updating the concept of prebiotics. Nutrition Research Reviews 17: 259-275
37. Gopal, P.K., Prasad, J. and Gill, H.S., 2003. Effects of the consumption of Bifidobacterium lactis HN019 (DR10 TM) and galactooligosaccharides on the microflora of the gastrointestinal tract in human subjects. Nutrition Research 23: 1313-1328
38. Granata, M., Brandi, G., Borsari, A., Gasbarri, R. and Gioia, D.D., 2013. Synbiotic yogurt consumption by healthy adults and the elderly: the fate of bifidobacteria and LGG probiotic strain. International Journal of Food Sciences and Nutrition 64: 162-168
39. Hamilton, M.J., Weingarden, A.R., Sadowsky, M.J. and Khoruts, A., 2012. Standardized frozen preparation for transplantation of fecal microbiota for recurrent Clostridium difficile infection. American Journal of Gastroenterology 107: 761-767
40. Higgins, J.A. and Brown, I.L., 2013. Resistant starch: a promising dietary agent for the prevention/treatment of inflammatory bowel disease and bowel cancer. Current Opinion in Gastroenterology 29: 190-194
41. Hill, C., Guarner, F., Reid, G., Gibson, G.R., Merenstein, D.J., Pot, B. and Calder, P.C., 2014. Expert consensus document: the international scientific association for probiotics and prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology and Hepatology 11: 506-514
42. Holvoet, T., Boelens, J., Joossens, M., Raes, J., De Vos, M. and De Looze, D., 2015. Fecal microbiota transplantation in irritable bowel syndrome with bloating: results from a prospective pilot study. Gastroenterology 148: S963
43. Hopkins, M.J. and Macfarlane, G.T., 2002. Changes in predominant bacterial populations in human faeces with age and with Clostridium difficile infection. Journal of Medical Microbiology 51: 448-454. Imahori, K., 1992. How I understand aging. Nutrition Reviews 50: 351-352
44. Imahori, K., 1992. How I understand aging. Nutrition Reviews 50: 351-352
45. Jernberg, C., Löfmark, S., Edlund, C. and Jansson, J.K., 2007. Longterm ecological impacts of antibiotic administration on the human intestinal microbiota. ISME Journal 1: 56-66
46. Jernberg, C., Löfmark, S., Edlund. and Jansson, J.K., 2010. Long-term impacts of antibiotic exposure on the human intestinal microbiota. Microbiology 156: 3216-3223
47. Katz, J.A., 2006. Probiotics for the prevention of antibiotic-associated diarrhea and Clostridium difficile diarrhea. Journal of Clinical Gastroenterology 40: 249-255
48. Khoruts, A. and Weingarden, A.R., 2014. Emergence of fecal microbiota transplantation as an approach to repair disrupted microbial gut ecology. Immunology Letters 162: 77-81
49. Khoruts, A., Dicksved, J., Jansson, J.K. and Sadowsky, M.J., 2010. Changes in the composition of the human fecal microbiome after bacteriotherapy for recurrent Clostridium difficile associated diarrhea. Journal of Clinical Gastroenterology 44: 354-360
50. Kleessen, B., Sykura, B., Zunft, H.-J. and Blaut, M., 1997. Effects of inulin and lactose on fecal microflora, microbial activity, and bowel habit in elderly constipated persons. American Journal of Clinical Nutrition 65: 1397-1402
51. Lahtinen, S.J., Tammela, L., Korpela, J., Parhiala, R., Ahokoski, H., Mykkänen, H. and Salminen, S.J., 2009. Probiotics modulate the Bifidobacterium microbiota of elderly nursing home residents. Age (Disorders) 31: 59-66
52. Lakshminarayanan, B., Stanton, C., O'Toole, P.W. and Ross, R.P., 2014. Compositional dynamics of the human intestinal microbiota with aging: implications for health. Journal of Nutrition, Health and Aging 18: 773-786
53. Likotrafiti, E., Tuohy, K.M., Gibson, G.R. and Rastall, R.A., 2014. An in vitro study of the effect of probiotics, prebiotics and synbiotics on the elderly faecal microbiota. Anaerobe 27: 50-55
54. Likotrafiti, E., Tuohy, K.M., Gibson, G.R. and Rastall, R.A., 2016. Antimicrobial activity of selected synbiotics targeted for the elderly against pathogenic Escherichia coli strains. International Journal of Food Sciences and Nutrition 67: 1-9
55. Lobley, G.E., Holtrop, G., Bremner, D.M., Calder, A.G., Milne, E. and Johnstone, A.M., 2013. Impact of short term consumption of diets high in either non-starch polysaccharides or resistant starch in comparison with moderate weight loss on indices of insulin sensitivity in subjects with metabolic syndrome. Nutrients 5: 2144-2172
56. Louie, T.J., Miller, M.A., Derrick, C.W., Lentnek, A., Bernard, L., High, K.P., Shue, Y.-K. and Gorbach, S.L., 2013. Effect of age on treatment outcomes in Clostridium difficile infection. Journal of the American Geriatrics Society 61: 222-230
57. Louie, T.J., Cannon, K., Byrne, B., Emery, J., Ward, L., Eyben, M. and Krulicki, W., 2012. Fidaxomicin preserves the intestinal microbiome during and after treatment of Clostridium difficile infection (CDI) and reduces both toxin reexpression and recurrence of CDI. Clinical Infectious Diseases 55: S132-S142
58. Mäkivuokko, H., Tiihonen, K., Tynkkynen, S., Paulin, L. and Rautonen, N., 2010. The effect of age and non-steroidal anti-inflammatory drugs on human intestinal microbiota composition. British Journal of Nutrition 103: 227
59. Mathur, H., O'Connor, P.M., Hill, C., Cotter, P.D. and Ross, R.P., 2013. Analysis of anti-Clostridium difficile activity of thuricin CD, vancomycin, metronidazole, ramoplanin, and actagardine, both singly and in paired combinations. Antimicrobial Agents and Chemotherapy 57: 2882-2886
60. McGuckin, M.A., Eri, R., Simms, L.A., Florin, T.H. and Radford-Smith, G., 2009. Intestinal barrier dysfunction in inflammatory bowel diseases. Inflammatory Bowel Diseases 15: 100-113
61. Moore, T., Rodriguez, A. and Bakken, J.S., 2014. Fecal microbiota transplantation: a practical update for the infectious disease specialist. Clinical Infectious Diseases 58: 541-545
62. Moroti, C., Magri, L.F.S., De Rezende Costa, M., Cavallini, D.C. and Sivieri, K., 2012. Effect of the consumption of a new symbiotic shake on glycemia and cholesterol levels in elderly people with type 2 diabetes mellitus. Lipids in Health and Disease 11: 29
63. Nagata, S., Asahara, T., Wang, C., Suyama, Y., Chonan, O., Takano, K. and Yamashiro, Y., 2015. The effectiveness of Lactobacillus beverages in controlling infections among the residents of an aged care facility: a randomized placebo-controlled double-blind trial. Annals of Nutrition and Metabolism 68: 51-59
64. Neto, J.V., De Melo, C.M. and Ribeiro, S.M.L., 2013. Effects of threemonth intake of synbiotic on inflammation and body composition in the elderly: a pilot study. Nutrients 5: 1276-1286
65. Nord, C.E. and Edlund, C., 1991. Ecological effects of antimicrobial agents on the human intestinal microflora. Microbial Ecology in Health and Disease 4: 193-207
66. O'Sullivan, O., Coakley, M., Lakshminarayanan, B., Conde, S., Claesson, M.J., Cusack, S., Fitzgerald, A.P., O'Toole, P.W., Stanton, C., Ross, R.P., ELDERMET Consortium, 2013. Alterations in intestinal microbiota of elderly Irish subjects post-antibiotic therapy. Journal of Antimicrobial Agents and Chemotherapy 68: 214-221
67. O'Donoghue, C., Solomon, K., Fenelon, L., Fitzpatrick, F. and Kyne, L., 2016. Effect of proton pump inhibitors and antibiotics on the gut microbiome of hospitalized older persons. Journal of Infection 72: 498-500
68. Orimo, H., Ito, H., Suzuki, T., Araki, A., Hosoi, T. and Sawabe, M., 2006. Reviewing the definition of 'elderly'. Geriatrics and Gerontology International 6: 149-158
69. Ouwehand, A.C., Salminen, S. and Isolauri, E., 2002. Probiotics: an overview of beneficial effects. Antonie van Leeuwenhoek 82: 279-289
70. Pamer, E.G. 2014. Fecal microbiota transplantation: effectiveness, complexities, and lingering concerns. Mucosal Immunology 7: 210-214
71. Pellino, G., Sciaudone, G., Candilio, G., Camerlingo, A., Marcellinaro, R., De Fatico, S. and Selvaggi, F., 2013. Early postoperative administration of probiotics versus placebo in elderly patients undergoing elective colorectal surgery: a double-blind randomized controlled trial. BMC Surgery 13: 1
72. Pérez-Cobas, A.E., Gosalbes, M.J., Friedrichs, A., Knecht, H., Artacho, A., Eismann, K. and Neulinger, S.C., 2013. Gut microbiota disturbance during antibiotic therapy: a multi-omic approach. Gut 62: 1591-1601
73. Pitkala, K.H., Strandberg, T.E., Finne-Soveri, U.H., Ouwehand, A.C., Poussa, T. and Salminen, S., 2007. Fermented cereal with specific bifidobacteria normalizes bowel movements in elderly nursing home residents. a randomized, controlled trial. Journal of Nutrition Health and Aging 11: 305-311
74. Rampelli, S., Candela, M., Severgnini, M., Biagi, E., Turroni, S., Roselli, M., Carnevali, P., Donini, L. and Brigidi P., 2013. A probioticscontaining biscuit modulates the intestinal microbiota in the elderly. Journal of Nutrition Health and Aging 17: 166-172
75. Rea, M.C., Alemayehu, D., Casey, P.G., O'Connor, P.M., Lawlor, P.G., Walsh, M., Shanahan, F., Kiely, B., Ross, R.P. and Hill, C., 2014. Bioavailability of the anti-clostridial bacteriocin thuricin CD in gastrointestinal tract. Microbiology 160: 439-445
76. Rea, M.C., O'Sullivan, O., Shanahan, F., O'Toole, P.W., Stanton, C., Ross, R.P. and Hill, C., 2012. Clostridium difficile carriage in elderly subjects and associated changes in the intestinal microbiota. Journal of Clinical Microbiology 50: 867-875
77. Rodríguez-Julbe, M.C., Ramírez-Ronda, C.H., Arroyo, E., Maldonado, G., Saavedra, S., Meléndez, B., González, G. and Figueroa, J., 2010. Antibiotics in older adults. Puerto Rico Health Sciences Journal 23: 25-33
78. Rossen, N.G., Fuentes, S., Van der Spek, M.J., Tijssen, J.G., Hartman, J.H., Duflou, A., Löwenberg, M., Van den Brink, G.R., Mathus-Vliegen, E.M., De Vos, W.M. and Zoetendal, E.G., 2015. Findings from a randomized controlled trial of fecal transplantation for patients with ulcerative colitis. Gastroenterology 149: 110-118
79. Sachs, R.E. and Edelstein, C.A., 2015. Ensuring the safe and effective FDA regulation of fecal microbiota transplantation. Journal of Law and the Biosciences, lsv032: 1-20
80. Salazar, N., Dewulf, E.M., Neyrinck, A.M., Bindels, L.B., Cani, P.D., Mahillon, J. and Delzenne, N.M., 2015. Inulin-type fructans modulate intestinal Bifidobacterium species populations and decrease fecal short-chain fatty acids in obese women. Clinical Nutrition 34: 501-507
81. Sears, P., Ichikawa, Y., Ruiz, N. and Gorbach, S., 2013. Advances in the treatment of Clostridium difficile with fidaxomicin: a narrow spectrum antibiotic. Annals of the New York Academy of Sciences 1291: 33-41
82. Sekirov, I., Russell, S.L., Antunes, C.M. and Finlay, B.B., 2010. Gut microbiomes in health and disease. Physiology Reviews 90: 859-904. Singh, S. and Bajorek, B., 2014. Defining 'elderly' in clinical practice guidelines for pharmacotherapy. Pharmacy Practice 12: 489
83. Singh, S. and Bajorek, B., 2014. Defining 'elderly' in clinical practice guidelines for pharmacotherapy. Pharmacy Practice 12: 489
84. Sjölund, M., Wreiber, K., Andersson, D.I., Blaser, M.J. and Engstrand, L., 2003. Long-term persistence of resistant enterococcus species after antibiotics to eradicate helicobacter pylori. Annals of Internal Medicine 139: 483-487
85. Stewardson, A.J., Gaïa, N., Francois, P., Malhotra-Kumar, S., Delemont, C., De Tejada, B.M. and Groups, W.S., 2015. Collateral damage from oral ciprofloxacin versus nitrofurantoin in outpatients with urinary tract infections: a culture-free analysis of gut microbiota. Clinical Microbiology and Infection 21: 344-e1
86. Swidsinski, A., Ladhoff, A., Pernthaler, A., Swidsinski, S., Loening-Baucke, V., Ortner, M., Weber, J., Hoffmann, U., Schreiber, S., Dietel, M. and Lochs, H., 2002. Mucosal flora in inflammatory bowel disease. Gastroenterology 122: 44-54
87. Van den Nieuwboer, M., Klomp-Hogeterp, A., Verdoorn, S., Metsemakers-Brameijer, L., Vriend, T.M., Claassen, E. and Larsen, O.F.A., 2015. Improving the bowel habits of elderly residents in a nursing home using probiotic fermented milk. Beneficial Microbes 6: 397-403
88. Vrieze, A., Van Nood, E., Holleman, F., Salojärvi, J., Kootte, R.S., Bartelsman, J.F., Dallinga-Thie, G.M., Ackermans, M.T., Serlie, M.J., Oozeer, R., Derrien, M., Druesne, A., Van Hylckama Vlieg, J.E., Bloks, V.W., Groen, A.K., Heilig, H.G., Zoetendal, E.G., Stroes, E.S., De Vos, W.M., Hoekstra, J.B. and Nieuwdorp, M., 2012. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome. Gastroenterology 143: 913-916
89. Vulevic, J., Juric, A., Walton, G.E., Claus, S.P., Tzortzis, G., Toward, R.E. and Gibson, G.R., 2015. Influence of galacto-oligosaccharide mixture (B-GOS) on gut microbiota, immune parameters and metabonomics in elderly persons. British Journal of Nutrition 114: 586-595
90. Wallace, R.J., Dukart, G., Brown-Elliott, B.A., Griffith, D.E., Scerpella, E.G. and Marshall, B., 2014. Clinical experience in 52 patients with tigecycline-containing regimens for salvage treatment of Mycobacterium abscessus and Mycobacterium chelonae infections. Journal of Antimicrobial Chemotherapy 69: 1945-1953
91. Weingarden, A., González, A., Vázquez-Baeza, Y., Weiss, S., Humphry, G., Berg-Lyons, D., Knights, D., Unno, T., Bobr, A., Kang, J., Khoruts, A., Knight, R. and Sadowsky, M.J., 2015. Dynamic changes in shortand long-term bacterial composition following fecal microbiota transplantation for recurrent Clostridium difficile infection. Microbiome 3: 10
92. Woodmansey, E.J., McMurdo, M.E.T., MacFarlane, G.T. and MacFarlane, S., 2004. Comparison of compositions and metabolic activities of fecal microbiotas in young adults and in antibiotictreated and non-antibiotic-treated elderly subjects. Applied and Environmental Microbiology 70: 6113-6122
93. World Health Organization (WHO), 2016. Health statistics and information system. WHO, Geneva, Switzerland. Available at: http://tinyurl.com/q8l8ovm
94. Youngster, I., Sauk, J., Pindar, C., Wilson, R.G., Kaplan, J.L., Smith, M.B., Alm, E.J., Gevers, D., Russell, G.H. and Hohmann, E.L., 2014. Fecal microbiota transplant for relapsing Clostridium difficile infection using a frozen inoculum from unrelated donors: a randomized, open-label, controlled pilot study. Clinical Infectious Diseases 58: 1515-1522
95. Zhang, F., Luo, W., Shi, Y., Fan, Z. and Ji, G., 2012. Should we standardize the 1,700-year-old fecal microbiota transplantation and quest. American Journal of Gastroenterology 107: 1755-1755