The nature and role of human milk microbiota in the early colonization and protection of infants from infection is the subject of increasing research. This study investigated the occurrence of Lactobacillus reuteri in milk of nursing mothers living in rural or urban areas in different geografic locations. Breat milk samples were collected from 220 mothers, 6-32 days after delivery, and analysed for the presence of total lactobacilli and L. reuteri. In all, 50% of mothers from rural areas in Japan and Sweden were L. reuteri-positive, whereas mothers from urban areas in South Africa, Israel and Denmark had very low and non-detectable levels. Overall, 15% of mothers had detectable L. reuteri in their milk. There were no significant differences in the prevalence of total Lactobacillus or L. reuteri in women from rural and urban habitats in the participating countries.

Objectives: This is to identify factors affecting the prevalence of Lactobacillus reuteri in maternal faeces and breast milk and infant faeces after oral supplementation with L. reuteri and to assess the influence on microbial ecology, particularly Clostridium difficile and Bifidobacterium colonization. Materials and Methods: In this double-blind trial, 232 mothers with a family history of atopic disease were randomized to a daily intake of either L. reuteri American-type culture collection (ATCC) 55730 (1 x 108 colony forming units (CFU)) or placebo for the last 4 weeks of pregnancy. Their babies then continued with tha same study product daily from birth until 12 months of age. Bacterial counts and prevalence were assessed in maternal breast milk and faeces and infant faeces, using conventional cultivation methods. Results: The prevalence of L. reuteri was higher during the first year of life in the stool samples from infants in the active as compared with the placebo-treated group. The highest prevalence was recorded at 5 to 6 days of age (82% in the treated vs 20% in the placebo group, P < 0.001). Lactobacillus reuteri was isolated from 12% and 2%, respectively, in the colostrum samples (P < 0.05). Breast-feeding seemed to reduce faecal L. reuteri counts, although antibiotics did not influence the levels of L. reuteri. The administration of L. reuteri did not affect bifidobacteria or C. difficile colonization. Conclusion: Lactobacillus reuteri may be detected in breats milk after oral supplementation to the mother and in almost all infants after oral supplementation during the first year of life, as well as occasionally in many untreated infants.

Avsikten med studien var att undersöka om dagligt användande av ett probiotiskt kosttillskott innehållande Lactobacillus reuteri kunde ge positiva effekter på patienter med måttlig eller svår gingivit. I försöket testades placebotuggummi mot 2 olika L. reuteri formuleringar (LR-1 och LR-2) innehållande 100 miljoner laktobaciller per tuggummi. Tuggummi togs 2 gånger per gång, på morgonen och på kvällen efter tandborstning. Studien var dubbelblind, randomiserad och löpte över 2 veckor. Totalt deltog 59 patienter. Två tandytor på varje patient utvaldes och gingival index och plack index mättes för varje yta, både startdagen och efter 2 veckor. För att minimera risken för observatörsberoende bedömning av index utfördes alla bedömningar på en och samma dag av en enda observatör, både vid start och avslut. Tandytorna fotograferades också för att ge ytterligare konsistens i bedömningen. Efter bedömning av index, rengjordes samtliga tandytor och patienterna instruerades av tandhygienist om korrekt tandborstning och behovet av dagligt användande av tandtråd. Salivprover togs både före och efter test behandling för att avgöra skillnader i laktobacillpopulationen över tiden. 20 patienter rendomiserades till LR-1, 21 till LR-2 och 18 till placebo. Gingival index förbättrades signifikant i samtliga grupper över de 14 dagarna. LR-1 formuleringen var dessutom signifikant överlägsen placebo. Plackindex var också signifikant förbättrat över tiden i de båda reuteri-grupperna- LR-1 koloniserades i 65% av patienterna och LR-2 i 95%.

The primary aim of this study was to assess if the probiotic Lactobacillus reuteri could be effective in the treatment of gingivitis and further to evaluate the influence of the probiotic on plaque and the lactobacilli population in the saliva. A randomised, placebo-controlled, double blind study was performed over 2 weeks. Fifty-nine petients with moderate to severe gingivitis were included and given one of two different Lactobacillus reuteri formulations (LR-1 or LR-2) at a dose of 2E+08 CFU per day, or a corresponding placebo. At baseline (day 0) gingival index and plaque index were measured on two surfaces and saliva for lactobacilli determination was collected. The patients were instructed how to brush and floss efficiently and study treatment was started. The patients returned on day 14 for final assessment of gingivitis and plaque and saliva was collected. 20 patients were randomised to LR-1, 21 to LR-2 and 18 to placebo. Gingival index fell significantly in all 3 groups (p<0.0001). LR-1, but not LR-2 improved more than placebo (p<0.0001). Plaque index fell significantly in LR-1 (p<0.05) and in LR-2 (p<0.01) between day 0 and day 14 but there was no significant change in the placebo group. At day 14, 65% of the patients in LR-1 were colonised with Lactobacillus reuteri and 95% in the LR-2 group. Lactobacillus reuteri was efficacious in reducing both gingivitis and plaque in patients with moderate to severe gingivitis.

Avsikten med studien var att undersöka förekomsten av Lactobacillus reuteri i saliv ef- ter användandet av ett probiotiskt kosttillskott innehållande L. reuteri samt fastställa om L. reuteri har effekt på plackindex (PlI) samt på den supra- och subgingivala mikrofloran. Studien var dubbelblind, randomiserad, placebokontrollerad och löpte över 12 veckor. Totalt deltog 23 friska individer randomiserade i test- respektive kontrollgrupp. I försöket testades placebotuggummi mot tuggummi med L. reuteri (ATCC 55730 och ATCC PTA 5289). Tuggummi togs 2 gånger per dag, morgon och kväll efter tandborstning. Startda- gen och efter 12 veckor samlades vilosaliv samt plack supra- och subgingivalt. Dessutom bedömdes plackindex enligt Silness & Löe på 4 indextänder mesialt och distalt. Efter ytterligare 4 veckor gjordes en uppföljning med prov på saliv och bedömning av plack på indextänderna. Mikrobiologisk analys utfördes med hjälp av checkerboard DNA-DNA hybridiseringsteknik samt odling på selektiva medier för bestämning av laktobacill- populationen. Totala laktobacillhalten i saliv ökade signifikant i båda grupperna (p<0,05) med en signifikant ökning av L. reuteri i testgruppen (p=0,008). Efter 16 veckor påträffades ingen L. reuteri i saliv. Kontrollgruppen visade en signifikant ökning av PII efter 12 veckor (p=0,023), medan testgruppen inte visade någon förändring. I båda grupperna regist- rerades en signifikant ökning supra- och subgingivalt av de flesta bakteriearter, men det fanns ingen signifikant skillnad mellan grupperna för undersökta bakterier. Kvoten mellan ”onda/goda” supragingivala bakterier minskade i testgruppen men var inte sig- nifikant. Motsvarande kvot för subgingivala bakterier minskade signifikant i båda grup- perna. Slutsats: Intag av L. reuteri resulterade i förekomst av L. reuteri i saliv men bakterien måste tillföras kontinuerligt. Ingen signifikant förändring i den undersökta supra- och subgingivala mikrofloran kunde påvisas. Den signifikanta ökningen i PlI i kontrollgruppen utan motsvarande förändring i testgruppen kan tyda på en probiotisk effekt av L. reuteri i denna population

Investigate the presence of Lactobacillus reuteri in saliva after supplementation with L. reuteri and the probiotic effect of L. reuteri on plaque index and supra- and subgingival microbiota. Material and Methods: The study included 23 healthy individuals, randomised into test or control subjects. At baseline and after 12 weeks saliva samples, plaque index and supra- and subgingival plaque samples were obtained. The test subjects were given the study product (containing L. reuteri, ATCC 55730 and ATCC PTA 5289) and the control subjects placebo for 12 weeks. Microbiological analyses were done by checkerboard DNA-DNA hybridization technique and selective culturing for lactobacilli determination. Results: A significant increase in total Lactobacillus counts in saliva occurred in both groups (p<0.05) with a significant increase of L. reuteri (p=0.008) in the test group. Ter- mination of intervention resulted in a wash out of L. reuteri. The control group demon- strated a statistically significant increase in PlI after 12 weeks (p=0.023) whilst there was no significant change in the test group. A significant increase was found for most bacterial species in both groups in supra- and subgingival plaque with no significant difference for any of the species between the groups. The ratio between ”bad/good” supragingival bacteria decreased for the test group but this decrease did not reach significance. The corresponding ratio for subgingival bacteria decreased significantly in both groups. Supplementation of L. reuteri resulted in presence of L. reuteri in saliva but L. reuteri was washed out after termination of intervention. No significant effect on supra- or subgingival microbiota was observed. The significant increase in PlI in the control group with no significant change in the test group may, however, indicate a probiotic effect of L. reuteri in this study population.