{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:01:32Z","timestamp":1793052092762,"version":"4.5.0"},"reference-count":13,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9,1]]},"abstract":"<jats:p>Intestinal microbiota composition in children with short bowel syndrome (SBS) is an important factor influencing the clinical outcome. An increase of D-lactate\u2013producing bacteria can lead to D-lactic acidosis, also referred to as D-lactate encephalopathy, with severe neurologic impairment. Antibiotic treatments for D-lactic acidosis in children with SBS offer often only short-term relief. Here, we present the case of a boy with SBS who developed recurrent episodes of D-lactic acidosis even under continuous cycling antibiotic treatment. Microbiological analyses were used to detect the presence of D-lactate\u2013producing Lactobacillus species in the stool samples. A probiotic cocktail was introduced to alter the intestinal microbiota. During follow-up under treatment with probiotics, the patient remained stable, and there was no additional need for antibiotic therapy for more than a year. Stool composition of the patient was sequenced regularly over that period. His microbiota profile changed completely in species richness, and a clustering of species according to probiotic usage was seen. Importantly, D-lactate\u2013producing Lactobacillus strains disappeared within a few weeks after probiotic introduction and were no longer detected in the subsequent follow-up specimens.<\/jats:p>","DOI":"10.1542\/peds.2018-0337","type":"journal-article","created":{"date-parts":[[2018,8,8]],"date-time":"2018-08-08T07:25:14Z","timestamp":1533713114000},"source":"Crossref","is-referenced-by-count":40,"title":["D-lactic Acidosis: Successful Suppression of D-lactate\u2013Producing <i>Lactobacillus<\/i> by Probiotics"],"prefix":"10.1542","volume":"142","author":[{"given":"Bahtiyar","family":"Yilmaz","sequence":"first","affiliation":[{"name":"Department of Biomedical Research, Maurice M\u00fcller Laboratories, University Clinic of Visceral Surgery and Medicine, Inselspital and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Schibli","sequence":"additional","affiliation":[{"name":"University Children\u2019s Hospital, Inselspital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Macpherson","sequence":"additional","affiliation":[{"name":"Department of Biomedical Research, Maurice M\u00fcller Laboratories, University Clinic of Visceral Surgery and Medicine, Inselspital and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Sokollik","sequence":"additional","affiliation":[{"name":"University Children\u2019s Hospital, Inselspital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2018,9,1]]},"reference":[{"issue":"5","key":"2021120916425857400_B1","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1006\/mpat.1996.0122","article-title":"Role of bacteria in the pathogenesis of short bowel syndrome-associated D-lactic acidemia.","volume":"22","author":"Bongaerts","year":"1997","journal-title":"Microb Pathog"},{"issue":"4","key":"2021120916425857400_B2","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.jpedsurg.2003.12.026","article-title":"D-lactic acidosis in short-bowel syndrome managed with antibiotics and probiotics.","volume":"39","author":"Uchida","year":"2004","journal-title":"J Pediatr Surg"},{"issue":"8","key":"2021120916425857400_B3","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.braindev.2009.09.024","article-title":"A case of D-lactic acid encephalopathy associated with use of probiotics.","volume":"32","author":"Munakata","year":"2010","journal-title":"Brain Dev"},{"issue":"1","key":"2021120916425857400_B4","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.mimet.2012.07.008","article-title":"Microbial 16S rRNA Ion Tag and community metagenome sequencing using the Ion Torrent (PGM) Platform.","volume":"91","author":"Whiteley","year":"2012","journal-title":"J Microbiol Methods"},{"issue":"5","key":"2021120916425857400_B5","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1038\/nmeth.f.303","article-title":"QIIME allows analysis of high-throughput community sequencing data.","volume":"7","author":"Caporaso","year":"2010","journal-title":"Nat Methods"},{"issue":"4","key":"2021120916425857400_B6","doi-asserted-by":"crossref","first-page":"e61217","DOI":"10.1371\/journal.pone.0061217","article-title":"Phyloseq: an R package for reproducible interactive analysis and graphics of microbiome census data.","volume":"8","author":"McMurdie","year":"2013","journal-title":"PLoS One"},{"issue":"5728","key":"2021120916425857400_B7","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1126\/science.1110591","article-title":"Diversity of the human intestinal microbial flora.","volume":"308","author":"Eckburg","year":"2005","journal-title":"Science"},{"issue":"4","key":"2021120916425857400_B8","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1111\/j.1365-2672.2006.02955.x","article-title":"Examination of Lactobacillus plantarum lactate metabolism side effects in relation to the modulation of aeration parameters.","volume":"101","author":"Quatravaux","year":"2006","journal-title":"J Appl Microbiol"},{"issue":"7","key":"2021120916425857400_B9","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1177\/0148607116658762","article-title":"Severe gut microbiota dysbiosis is associated with poor growth in patients with short bowel syndrome.","volume":"41","author":"Piper","year":"2017","journal-title":"JPEN J Parenter Enteral Nutr"},{"key":"2021120916425857400_B10","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s40168-015-0084-7","article-title":"Intestinal dysbiosis in children with short bowel syndrome is associated with impaired outcome.","volume":"3","author":"Engstrand Lilja","year":"2015","journal-title":"Microbiome"},{"issue":"4","key":"2021120916425857400_B11","first-page":"CD005496","article-title":"Probiotics for prevention of necrotizing enterocolitis in preterm infants.","author":"AlFaleh","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"issue":"4","key":"2021120916425857400_B12","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1097\/MPG.0000000000000320","article-title":"Use of probiotics for management of acute gastroenteritis: a position paper by the ESPGHAN Working Group for Probiotics and Prebiotics.","volume":"58","author":"Szajewska","year":"2014","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"3","key":"2021120916425857400_B13","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1097\/MPG.0000000000001081","article-title":"Probiotics for the prevention of antibiotic-associated diarrhea in children.","volume":"62","author":"Szajewska","year":"2016","journal-title":"J Pediatr Gastroenterol Nutr"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2018-0337\/1065116\/peds_20180337.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2018-0337\/1065116\/peds_20180337.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T04:47:07Z","timestamp":1639111627000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/142\/3\/e20180337\/38632\/D-lactic-Acidosis-Successful-Suppression-of-D"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,1]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2018,9,1]]},"published-print":{"date-parts":[[2018,9,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2018-0337","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,1]]},"article-number":"e20180337"}}