Novel Dietary Approach with Probiotics, Prebiotics, and Synbiotics to Mitigate Antimicrobial Resistance and Subsequent Out Marketplace of Antimicrobial Agents: A Review

Figures & data

Table 1 Current Evidence Revealing in vitro Antimicrobial Activity of Probiotics

Probiotics with in vitro Antimicrobial Activity	Tested Pathogenic Microorganisms	Reported Result	In vitro Testing Method Employed	Ref
Lactobacillus Strains (L. acidophilus PBS066, L. fermentum PBS073, L. plantarum PBS067, L. rhamnosus PBS070, L. reuteri PBS072,) and Bifidobacterium Strains (B. animalis subsp. Lactis PBS075, B. longum subsp. longum PBS108)	G+: S. aureus ATCC 6538, E. faecalis ATCC 29212, G‐: E. coli ATCC 25922, P. aeruginosa ATCC 9027, fng: C. albicans ATCC 10231	Cell culture supernatants of the examined strains showed inhibition of the growth of the pathogen at different extents, especially for P. aeruginosa and E. coli	Agar well diffusion assay/paper disc assay	[24]
L. salivarius JM41, JK21V, JM31, JS2A, JM14, JK22, JM2A1 and JM32, L. plantarum PZ01, P. acidilactici JM241 and JH231, P. pentosaceus JS233, E. faecium JS11	G+: S. aureus ATCC 29213, G‐: E. coli K88, 25922 and 1569, S. enteritidis ATCC 13076, S. typhimurium ATCC 14082	Probiotic strains exert immunomodulation activity and efficiently inhibit adhesion and invasion of Salmonella to Caco-2 cells	Agar well diffusion assay/paper disc assay	[12]
L. plantarum FH185	G+: S. aureus, G‐: S. typhimurium	Have a variable extent of growth Inhibition effect on S. Typhimurium and S. aureus	Co‐culturing assay	[25]
P. pentosaceus KID7	G+: (S. aureus KCCM11335, S. aureus KCCM40510 (Methicillin-resistant), S. epidermidis KCTC 1917, L. monocytogenes KACC10764, B. cereus KACC11240) G‐: S. Typhi KCTC2514, S. choleraesuis KCTC2932, S. gallinarum KCTC2931, S. boydii KACC10792, Y. enterocolitica KACC15320, E. coli O138KCTC2615, O1KCTC2441, P. aeruginosa KCCM 11802,	The concentrated culture filtrate of the tested probiotic showed a broad-spectrum antimicrobial activity against both gram-positive and gram-negative pathogenic bacteria	Agar well diffusion or paper disc assay	[26]
L. fermentum 907, B. longum 1011	G‐: E. coli O157:H7, E. coli O86	The supernatant of both tested probiotics significantly inhibits the growth rates of both strains of E. coli	Co‐culturing assay	[27]
L. paraplantarum FT259	G+: L. monocytogenes IAL 633, L. innocua ATCC 3309	L. paraplantarum FT259 produces bacteriocins that inhibit the growth of Listeria monocytogenes, Listeria innocua, and several lactic acid bacteria	Spot‐on lawn/agar spot assay	[15]
Lactobacillus MSMC64‐1	G+: MRSA DMST 20651, 20654, G‐: S. typhi DMST 5784, V. parahaemolyticus DMST 5665, S. dysenteriae DMST 15111	Lactobacillus strain MSMC64-1 produced reuterin that has potent antimicrobial activity against seven pathogenic indicator strains with very strong inhibitory activities against S. typhi DMST 5784 and MRSA DMST 20651.	Agar well diffusion or paper disc assay	[28]
Lb: L13, L18, S30, S49, L. plantarum L14, L. fermentum L32, L. pentosus L45	V. cholera strain 0139 MTCC 3906, Salmonella enterica Typhimurium MTCC 733, Listeria monocytogenes MTCC 657, Escherichia coli MTCC 119, Shigella flexneri MTCC 1457, V. parahaemolyticus MTCC 451, and Staphylococcus aureus MTCC 96.	The culture supernatant (CS) of all seven isolates of Lactobacillus spp. used in the study inhibited the biofilm formation of V. cholerae by more than 90%.	Agar well diffusion assay	[29]
L. helveticus KLDS 1.8701	G+ (S. aureus ATCC 25923, L. monocytogenes ATCC 19115), and G-: (E. coli O157:H7 ATCC 43889, S. typhimurium ATCC 14028)	Cell-free supernatants of KLDS1.8701 exhibited a higher inhibition of food-borne pathogens	Co-culturing assay	[30]
L. plantarum (P6)	S. aureus ATCC 25923, E. coli ATCC 25921, B. cereus, P. aeruginosa, V. cholerae, L. ivanovii ATCC 19119 and S. enterica	Neutralized free-cell supernatant from the culture of the Lb. plantarum (P6) inhibited the growth of all pathogenic indicators	Spot-on lawn/agar spot assay	[31]
L. viridescens NRRL B‐1951	G+: L. monocytogenes CWD 1002, CWD 1198	Lactobacillus viridescens NRRL B-1951 could produce an inhibitory compound with a proteinaceous nature that is active against L. monocytogenes CWD 1002 and CWD 1198	Agar well diffusion or paper disc assay	[16]
L. acidophilus La‐5,: B. longum ATCC 15707	G+: S. aureus, L. monocytogenes; G-: E. coli O157:H7	Probiotics in yoghurt inhibit the growth of S. aureus, E. coli O157:H7, and L. monocytogenes in vitro	Spot-on lawn/agar spot assay	[32]
L. acidophilus P106, L. plantarum P164	Prs: Giardia lamblia	L. acidophilus bacteriocin showed in vitro activity against G. lamblia trophozoites	Co-culturing assay	[33]
L. plantarum C014	G-: A. hydrophila TISTR 1321	The bacterial strain isolated from the intestines of hybrid catfish exhibited an in vitro inhibitory effect, Aeromonas hydrophila TISTR 1321	Co-culturing assay	[34]
FloraMax^®-B11 containing LAB 18, LAB 48	G‐: S. enterica serovar enteritidis, E. coli O157:H7, C. jejuni	Both strains showed in vitro antibacterial activity against S. enterica serovar enteritidis, E. coli (O157:H7), and C. jejun	Spot-on lawn/agar spot assay	[35]
L. plantarum WCFS1, L. plantarum NA7	G+: L. monocytogenes CIP 81.3 ILSI NA 39, G-: E. coli O157:H7 ATCC 43888, S. enterica ser enteritidis CIP 81.3	Supernatants from different Lactobacillus could produce food pathogen inhibitory molecules and inhibit TNF-α production	Agar well diffusion or paper disc assay	[36]
L. casei	G+: L. monocytogenes, G-: E. coli C17, S. enterica ser Typhimurium	Twenty Lactobacillus strains were able to inhibit the enteropathogenic bacterium Yersinia enterocolitica, and two strains inhibit Y. enterocolitica, S. serovar Typhimurium, and L. monocytogenes. All acts by decreasing the Ph	Agar well diffusion or paper disc assay	[37]
E. faecium CV1, LPP29, W. cibaria P71, L. lactis subsp. cremoris SMF110, Lc. mesenteroides subsp. cremoris SMM69, P. pentosaceus SMM73, TPP3	G‐: T. maritimum NCIMB2154, LL01.8.3.8, V. splendidus CECT528, DMC‐1	Cell-free culture supernatants from all LAB but Lb. curvatus BCS35 inhibited the growth of T. maritimum NCIM2154 and V. splendidus CECT528.	Spot-on lawn/agar spot assay	[38]
13 strains of Lactobacilli (CM1, CM2, FS2, FM13, FM14, FM22, MF5, PM8, PS2, SP13, PS11, SF6, FS10)	S. aureus ATCC 6538, L. monocytogenes DSM 12464, E. faecalis, E. coli ATCC 25922	All strains were effective against both S. aureus and E. coli, and variable activity versus L. monocytogenes and E. faecalis strains	Agar well diffusion or paper disc assay	[39]
S. cerevisiae JCM7255	G+: S. agalactiae	Agar spot anti-streptococcal activity showed inhibition of 20 out of 30 strains of S. agalactiae.	Spot-on lawn/agar spot assay	[40]
L. reuteri, B. subtilis MA139	G‐: E. coli K88	Lactobacillus reuteri alone as well as in combination with B. subtilis MA139 spores exerted strong inhibition against E. coli K88 under static conditions	Co-culturing assay	[41]
L. acidophilus JN188382, L. fermentum JN188383, L. fermentum JN188384, L. buchneri JN188385, L. buchneri JN188386, L. buchneri JN188387, L. casei JN188388, L. casei JN188389, L. casei JN188390	G+: E. faecium ATCC 51558, S. epidermidis ATCC 12228, P. acnes ATCC 6919, L. monocytogenes, S. aureus S244; G-: E. coli ATCC 29181, K. pneumoniae K36, E. cloacae, S. sonnei ATCC 25931, H. pylori ATCC 43579, V. parahaemolyticus, fng: C. albicans ATCC 44831	Nine of the Lactobacillus strains exhibited good antimicrobial activities and a good ability to attach to intestinal epithelial cells with no resistance to the tested antibiotics	Spot-on lawn/agar spot assay	[42]
L. paracasei CNCM I_4034, L. Bifidobacterium breve CNCM I-4035 and L. rhamnosus CNCM I-4036	G-: E. coli ETEC CECT 501, S. Typhimurium CECT	Supernatants obtained from L. paracasei CNCM I-4034, B. breve CNCM I-4035 and L. rhamnosus CNCM I-4036 inhibit the growth of enterotoxigenic and enteropathogenic (EPEC) bacteria	Co-culturing assay	[43]
L. casei LC‐01, L. acidophilus LA‐5, L. paracasei	Fng: A. niger PTCC 5012, A. flavus PTCC 5004, A. parasiticus PTCC 5286, P. chrysogenum PTCC 5035	Both liquid culture and supernatant of probiotic bacteria strains have the ability to prevent the growth of pathogenic and mycotoxigenic fungi as antifungal agents, L. case being with the highest activity	Agar well diffusion or paper disc assay	[44]
L. casei PTCC 1608, L. rhamnosus PTCC 1637	G‐: P. aeruginosa PTCC 1430	Cell-free supernatant (CFS) of probiotics could curtail the growth of P. aeruginosa. synergistic interactions were observed in the combination of CFS and aminoglycoside antibiotics	Agar well diffusion or paper disc assay	[45]
L. mesenteroides subsp. mesenteroides SD1, SD23, SF2, SF3	G+: S. aureus ATCC 25923, FRI 184, L. monocytogenes ATCC 19115, G‐: E. coli ATCC43895, S. enterica ATCC 14028	The supernatant of the isolated showed inhibition to three enteropathogenic strains: E. coli ATCC43895 (EC), S. enterica ATCC 14028 (ST), and L. monocytogenes ATCC 19115 (LM) as well as two enterotoxigenic strains: S. aureus [ATCC 25923 (SA) and FRI 184 (SAI)]	Agar well diffusion or paper disc assay	[46]
B. pumilus B16, B. mojavensis J7	G‐: V. parahaemolyticus	Twenty-four among 249 isolates displayed direct antimicrobial activity to V. parahaemolyticus with spot inoculation	Spot-on lawn/agar spot assay	[47]
L. plantarum S2	G+: S. aureus CMCC2607, G‐: E. coli CMCC44825, S. Typhimurium CMCC50115, S. flexneri CMCC51061	L. plantarum S2 combined with xylooligosaccharides have enhanced antimicrobial activity against gastrointestinal pathogens	Agar well diffusion or paper disc assay	[48]
L. rhamnosus GR‐1, L. reuteri RC‐14	Fng: C. glabrata	Probiotic Lact. rhamnosus GR-1 and Lact. reuteri RC-14 strains exhibited potent antagonistic activities against all of the tested C. glabrata strains causing cessation of growth and eventual cell death of C. glabrata	Co-culturing assay	[49]
L. plantarum CK06, CK19, B01, B07, K09, K10, K21, LM11, ZS07, ZS11 and ZS15	G+: S. aureus SSV25, S. epidermidis SSV30, S. lentus CCM 3472, E. faecalis V583, L. monocytogenes CCM 4699, G-: A. calcoaceticus CCM 4503; S. paucimobilis CCM 3293; S. enterica subsp. enterica TA100 CCM 3812	When tested against indicator strains, the Lactobacillus isolates demonstrated different inhibitory activities with a zone of inhibition ranging from 1mm to 5mm by the production of organic acids,	Spot-on lawn/agar spot assay	[50]
L. helveticus PJ4, L. plantarum PJ7	G+: S. aureus MTCC737, G‐: E. coli MTCC443, S. Typhimurium MTCC733, S. flexneri MTCC1457, P. aeruginosa MTCC1688	L. helveticus PJ4 and L. plantarum PJ7 exhibited strong antibacterial activities against the pathogens tested as assessed in neutral pH culture supernatants	Agar well diffusion or paper disc assay	[51]
B. subtilis JQ302302, B. aerophilus JQ312663	G‐: A. hydrophila ATCC 49140, MTCC 1739, Aeromonas sp. JX136697, JX136698, A. enteropelogenes JX136699, P. rettgeri JX 136696	Isolates demonstrated significant antibacterial activity against the fish pathogens A. hydrophila ATCC 49140, A. hydrophila MTCC 1739, A. enteropelogenes JX136699, and P. rettgeri JX136696.	Agar well diffusion or paper disc assay	[52]
L. rhamnosus 204, L. rhamnosus 45B, L. plantarum N221-1, L. rhamnosus N145-1A, L. rhamnosus QF60-2	G‐: H. pylori	L. johnsonii NCC533 found to be the most efficient probiotic strain with anti-H. pylori activity compared with L. rhamnosus GG and L. plantarum 299v	Agar well diffusion or paper disc assay	[53]
B. amyloliquefaciens KATMIRA1933	Vir: Herpes simplex virus types 1 and 2	At high concentrations, subtilosin produced by B. amyloliquefaciens, has a virucidal effect against HSV-1. Subtilosin non-virucidal concentrations can inhibit wild-type HSV-1 and acyclovir-resistant mutants in a dose-dependent manner	Agar well diffusion or paper disc assay	[54]
B. subtilis DCU, B. pumilus BP, B. cereus HL7	G‐: V. parahaemolyticus	Of the 135 isolated strains three Bacillus strains (BP, DCU, HL7) showed strong inhibition against the pathogen, causing a clear zone of about 15–20 mm in the agar spot assay	Spot-on lawn/agar spot assay	[55]
B. amyloliqufaciens	G+: C. difficile	After incubation with B. amyloliquefaciens supernatant growth inhibition were observed against all C. difficile ribotypes.	Agar well diffusion or paper disc assay	[56]
L. fermentum M059, L. fermentum F‐6, W. cibaria 4213	G+: S. aureus ATCC 6538, B. cereus NCIM 245, B. subtilis ATCC 6633, G‐: E. coli ATCC 25922, S. typhi 25, P. aeruginosa ATCC 27853	The selected strains exhibited varied inhibitory effects against each indicator bacterium and inhibited both Gram-positive and Gram-negative pathogens	Agar well diffusion or paper disc assay	[57]
L. acidophilus L‐1, L. bulgaricus 6, L. plantarum 24‐4B, L. fermentum 1, L. brevis, B. animalis subsp. lactis L‐3	G+: S. aureus, B. cereus G‐: E. coli	Ten strains of Lactobacillus and Bifidobacterium showed promising antimicrobial activity against two pathogens or in both model systems (broth and milk)	Agar well diffusion or paper disc assay	[58]
L. casei	G‐: S. flexneri, S. sonnei	L. casei strongly inhibits the development of MDR Shigella pathogenic strains	Agar well diffusion or paper disc assay	[59]
L. brevis DT24	G‐: E. coli MTCC 729	Expression of E. coli colicin E2 (ColE2) into Lactobacillus showed increased expression of colicin E2 at the extracellular level to inhibit the infectious disease that occurred by uropathogenic E. coli. Antimicrobial properties of transformed L. brevis DT24-ColE2 showed a higher zone of inhibition (56 mm) compared to Wild Type L. brevis DT24 (23 mm)	Agar well diffusion or paper disc assay	[60]
B. amyloliquefaciens FPTB16	E. tarda, A. hydrophila, V. harveyi, V. parahaemolyticus	Dietary supplementation of 109 CFU/g B. amyloliquefaciens significantly improves health status and resistance of catla against bacterial challenge	Agar well diffusion or paper disc assay	[61]
L. plantarum DK211, DK303; L. paracasei DK215, L. sakei DK301	S. aureus KCTC 3881, E. faecalis KCTC 2011, B. cereus KCTC 3624	DK211, DK215, DK301, and DK303 had effective inhibitory activity against all pathogens tested except E. coli. This suggests a potential probiotic	Agar well diffusion or paper disc assay	[62]
L. plantarum, L. salivarius, L. johnsonii, L. ingluviei, L. agilis, L. kitasatonis, L. mucosae, and L. oris	S. aureus ATCC 6538S, C. perfringens ATCC 13124, E. coli ATCC 8734, S. enteritidis ATCC 13311, R. anatipestifer ATCC 11845, P. multocida ATCC 43137	The selected Lactobacillus strains show strong inhibition against the growth of pathogenic bacteria due to lactic acid production and can potentially restore the balance of intestinal microflora in geese and could offer an alternative to antibiotic therapy	Agar well diffusion or paper disc assay	[63]
L. salivarius K35, K43	G+: S. mutans ATCC 25175	K35 and K43L. Salivarius strains, significantly inhibited S. mutans biofilm formation and possessed a stronger bactericidal activity against S. mutans on Spot assay	Agar well diffusion or paper disc assay	[64]
L. mesenteroides MTCC 5442, B. subtilis	G‐: V. cholerae	L. mesenteroides or B. subtilis, is able to produce an inhibitory effect on the growth of V. cholerae and had a synergistic effect when used in combination	Agar well diffusion or disc assay	[65]
L. acidophilus P106, L. plantarum P164	Prs: Giardia lamblia	L. acidophilus bacteriocin showed in vitro activity against G. lamblia trophozoites	Agar well diffusion or paper disc assay	[33]
L. acidophilus ATCC3456, L. casei ATCC 39392, L. rhamnosus ATCC 7469	S. aureus ATCC 25923, E. coli ATCC 25922	All three Lactobacillus strains have inhibitory effects for E. coli, Cell-free supernatant of L. casei being the most effective probiotic	Microplate technique	[66]
L. reuteri (DSM17938), L. acidophilus (DSM), B. coagulans (DSM1), L. plantarum 299v (DSM9843), and B. bifidum (DSM20456)	P. aeruginosa	Combination of probiotic strains with antibiotics have enhanced inhibitory effect. Lactobacillus plantarum 299v had the highest effect.	Disk diffusion method.	[67]
L. acidophilus EMCC 1324, L. helveticus EMCC 1654, L. plantarum EMCC 1027, L. rhamnosus EMCC 1105 B. longum EMCC 1547 B. bifidum EMCC 1334	E. coli	All probiotic isolates exhibit strong antibacterial activity against all E. coli isolates and eradicated biofilms formed by multidrug-resistant E. coli.	Agar diffusion method	[68]
L. paracasei ABRIINW. F58	S. aureus, P. aeruginosa	Both MDR E. coli isolates and (9–12 mm), Pseudomonas aeruginosa isolates (7–10 mm) were sensitive to bacteriocins produced by L. paracasei ABRIINW. F58	Disc diffusion method	[69]
L. acidophilus and S. cerevisiae	S. typhimurium	Increased concentration of probiotic filtrate could increase the inhibition zone due to the increased concentration of inhibitory compounds especially the bacteriocins	Agar well diffusion method	[70]
Curd lactobacilli (L. animalis, L. gasseri, L. acidophilus, L. rhamnosus)	E. coli, K. pneumoniae	Curd of lactobacilli alone or in combination with antibiotics had excellent antibacterial activities against E. coli and K. pneumoniae clinical isolates infection	Agar-overlay method	[71]
L. reuteri DSM 17938	S. aureus, S. pyogenes, Cutibacterium acnes, P. aeruginosa.	The probiotic decreased the inflammatory process and presented antimicrobial action against S. aureus, S. pyogenes, Cutibacterium acnes, and P. aeruginosa.	Agar well diffusion/paper disc method	[72]
B. longum ATCC 15707, L. brevis ATCC 367, L. delbrueckii ATCC 9649, L. fermentum ATCC 23271, L. paracasei ATCC 335, L. plantarum ATCC 8014, and L. rhamnosus ATCC 9595	C. butyricum ATCC 860, C. difficile ATCC 9689, C. perfringens ATCC 12924	L. plantarum strain ATCC 8014 has probiotic potential, with antimicrobial activity against C. butyricum ATCC 860, C. difficile ATCC 9689, and C. perfringens ATCC 12924	Agar spot test	[73]

Abbreviations: G+, Gram-positive; G−, Gram-negative; fng, fungi; prs, parasite; Vir, Virus.

Table 2 Current Evidence Revealing in vivo Antimicrobial Activity of Probiotics

Probiotics with Efficient in vivo Antimicrobial Activity	Tested Pathogenic Microorganisms	Finding	In vivo Testing Method Employed	Ref
L. paracasei	Galleria mellonella	L. paracasei was able to modulate the immune system of G. mellonella and protect against candidiasis.	Clinical trial	[74]
L. rhamnosus, L. acidophilus, and B. bifidum	Candida spp.	Decrease in Candida spp. in individuals who used the probiotic formulation.	Randomized double-blind study	[75]
L. salivarius NK02	Aggregatibacter actinomycetemcomitans	The results suggest that the mouthwash containing probiotics were healthy for daily use as an alternative to maintaining dental and periodontal health.	Randomized double-blind study	[76]
L. casei	Cryptosporidium parvum	Oral administration of the probiotic L. casei associated with albendazole reduced Giardia infection,	Murine model.	[77]
B. animalis subsp. lactis DN-173010	Periodontopathogens (P. gingivalis, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans)	B. animalis showed a positive effect against the accumulation of bacterial plaque and gingival inflammatory parameters.	Randomized controlled trial	[78]
L. reuteri CL9, K16, K67 and S33	G‐: E. coli O149: K88 JG280	Isolates showed ≥50%protection from cell and worm death caused by enterotoxin expressed in E. coli. CL9promoted host defensive responses,	Porcine	[79]
L. casei B–7280, B. longum VK1, B. bifidumVK2	G+: S. aureus8325–4	The number of colonies of Staph. aureus 8325–4 decreased significantly in infected mice that received probiotics compared to the mice that did not receive	Mice	[80]
Lb. FloraMax-B11 (L. salivarius, L. Pediococcus parvulus)	S. enteritidis	Administration of this probiotic significantly reduced S. enteritidis intestinal colonization in chickens	Broiler chickens	[81]
Pseudoalteromonas sp.	G‐: V. harveryi ATCC 14126	Significant reduction in accumulated mortality of larvae in aquaculture system when supplemented with culture supernatant	Crustacean’s larva	[82]
L. salivarius JM32, L. plantarum PZ01, P. acidilactici JH231	G‐: S. enteritidis ATCC 13076	Lb strains reduced the number of Salmonella in intestinal content, spleen, and liver,	Broiler chicks	[12]
B. amyloliqufaciens	G+: C. difficile	An increase in C. difficile toxin A and B levels and a significant weight loss were seen in untreated and S. boulardii treated mic than in B. amyloliquefaciens treated mice	Mice	[56]
L. acidophilus CH1	Prs: Enterocytozoon bieneusi	Anti-microsporidial effects of L. acidophilus CH1-derived bacteriocin in immunosuppressed mice were significantly potent.	Mice	[83]
Lb: L. plantarum LA5 and L. paracasei LA7	G‐: S. typhi	LA5 or LA7 eradicate S. Typhi induced typhoid infection from infected mice due to antimicrobial, anti-inflammatory, and immunomodulatory activities	Mice	[84]
L. plantarum LR/14	Ins: Drosophila melanogaster	At a concentration of 15 mg/mL, antimicrobial peptides from L. plantarum resulted in the deformity in cellular architecture, DNA fragmentation, premature apoptosis, and death of insects	Drosophila melanogaster fly	[85]
L. plantarum C014	G‐: A. hydrophila TISTR 1321	Feeding the fish with the L. plantarum C014 supplemented diet for 45 days before challenging them with A. hydrophila at the dose of LD50 enhances innate immune response, and reduces the mortality rate of the fish from 50% (in the control group) to 0% (in treated group)	Hybrid Catfish	[34]
L. acidophilus and S. cerevisiae	S. typhimurium	Oral administration of both probiotic isolates could decrease the counts of S. typhimurium in liver and spleen	Mice	[71]
L. casei, L. acidophilus, L. rhamnosus, L. bulgaricus, B. breve, B. longum	K. pneumoniae	Administration of Lactocare can reduce ICU and a hospital stays of patients	Randomized clinical trial	[86]
L. plantarum MTCC 1407, L. acidophilus MTCC 10307	Enteroaggregative E. coli and E. coli ATCC 25922	Probiotic strains can serve as a therapeutic agent against multi-drug-resistant E. coli.	Mice	[87]
L. casei (Shirota Strain)	K. pneumoniae	Oral administration of probiotic L. casei Shirota strain reduces the risk of Ventilator-associated pneumonia (VAP) in patients	Randomized, open-label controlled trial	[88]
L. acidophilus, Pediococcus	G‐: S. enteritidis 13A	Probiotic treatment with L. acidophilus and Pediococcus significantly reduced Salmonella colonization in chicks	Birds	[89]
LactoLevure^® (containing L. plantarum, L. acidophilus, S. boulardii and B. lactis)	P. aeruginosa and E. coli	Pretreatment with these probiotics products could increase the survival rate and levels of cytokine eg, TNF and IL-10 of mice under infection conditions with MDR P. aeruginosa, E. coli.	Mice	[90]

Abbreviations: G+, Gram-positive; G−, Gram-negative; Prs, parasite; Ins, insect; MDR, multidrug-resistant.

Table 3 Current Evidence Revealing Antimicrobial Activity of Selected Prebiotics

Prebiotics with Reported Antimicrobial Activity	Target Pathogenic Microorganisms	Reported Results	Testing Method Employed	Ref
Combination of GOS and FOS	Rotavirus	Increased levels of SCFAs, decreased incidence of stools, improved stool consistency, a significant reduction in viral shredding, improved immune system, reduced effects of rotavirus-induced gastroenteritis	Suckling rat rotavirus infection model	[108]
GOS	Bifidobacterium	Increased Bifidobacterium, improving the immune system of the host due to the interaction of immune cells and host epithelium with colonic microbiota, reducing the risk of infections	Double-blind, controlled trial, formula-fed infants	[109]
MOS and FOS	E. coli, C. perfringens	Decreased in the population of pathogens	Broiler chickens	[110]
FOS and MOS	C. perfringens, E. coli	Decreased populations of C. perfringens and E. coli	Broiler chickens	[111]
Raffinose	P. aeruginosa	Inhibition P. aeruginosa biofilm formation	In vitro agar plates	[112]
Lactosucrose	Influenza A virus	Provide enhanced innate immune responses and aid in suppressing influenza A virus infection which increased the overall survival rate of tested mice	Mice	[113]
Casein, fiber-rich soybean meal	Eubacteria, Lactobacillus spp., Bifidobacterium spp., Clostridium Cluster IV, Clostridium Cluster XIVa,	Enhanced fecal counts of tested beneficial bacterial groups which could out-compete and potentially prevent invasion with pathogenic microbes	Pigs	[114]
Whey peptide extract from Cynara cardunculus	L. acidophilus and Bifidobacterium	The proliferation and growth of tested probiotic bacteria were greatly enhanced and aided in shifting toward the beneficial microbiota profile	Rats	[115]
Raffinose	S. mutans	Inhibit oral bacterial adhesion and biofilm formation and keep oral health by preventing bacterial-induced dental caries	In vitro culturing method	[116]
Raffinose	P. aeruginosa, S. aureus	It effectively reduces the biofilm formation of tested pathogens in a dose-dependent manner	In vitro co-culturing	[117]

Abbreviations: FOS, Fructooligosaccharide; GOS, Galactooligosaccharide; MOS, Mannan-oligosaccharide.

Table 4 Current Evidence Revealing in vivo or ex vivo Antimicrobial Activity of Synbiotics

Synbiotics	Target Infectious Diseases/Microorganisms	Reported Results	Study Undertaken	Ref
L. fermentum CECT5716 with GOS	Gastrointestinal and respiratory infection	Synbiotic administration has marked inhibition on rotavirus and prevented community-acquired gastrointestinal infections in infants	Randomized controlled study	[132]
L. acidophilus, L. rhamnosus, B. bifidum, B. longum, E. faecium, with FOS	Acute diarrhea	Duration of diarrhea and hospitalization was significantly shorter in children receiving the synbiotic group	Randomized controlled study	[133]
S. thermophilus, L. rhamnosus, L. acidophilus, B. lactis, B. infantis with FOS	Acute diarrhea of likely infectious origin	Synbiotics could shorten the duration of diarrhea and reduce the number of additional medications (antipyretics, antiemetics, antibiotics) used	Randomized, controlled clinical trial	[134]
Non-digestible oligosaccharides (GOS, FOS, XOS, IMOS, and lactulose) with B. breve 46, B. lactis 8:8, B. longum 6:18, B. breve CCUG 24611, B. lactis JCM 10602, B. pseudocatenulatum JCM 1200	Clostridium difficile	In the presence of such prebiotics, Bifidobacterium, breve 46 and Bifidobacterium lactis 8:8 inhibited the growth and toxin production in four different strains of Clostridium difficile.	Agar plate assays	[135]
B. lactis B94 with inulin	Rotavirus, Adenovirus, Entamoeba histolytica, Salmonella, Shigella, Campylobacter, Clostridium difficile, Cryptosporidium, and parasites	Synbiotic treatment decreased the duration of diarrhea	Randomized controlled study	[136]
Garlic and basil as natural prebiotics with Pediococcus acidilactici	E. coli, Salmonella, E. faecalis and S. aureus.	The presence of prebiotics augments the antimicrobial activity of probiotic strains against tested pathogens.	Agar plate assays	[137]
L. acidophilus and FOS	P. aeruginosa, E. coli, S. aureus and B cereus	Enhanced activity of the probiotic bacteria (L. acidophilus) and inhibited the pathogenic bacteria, where E. coli was more susceptible to inhibition, followed by S. aureus, P. aeruginosa, and B. cereus, respectively.	Agar plate assays	[138]
L. rhamnosus and P. acidilactici in combination with inulin-type fructans	Candida albicans.	The synbiotic combinations inhibit the growth and biofilm formation of Candida albicans and could be used as an alternative to antifungal drugs in candidiasis therapy.	Microtiter plates	[139]
L. rhamnosus with inulin or FOS	Vancomycin susceptible Enterococcus faecalis (VSEF) and clinical vancomycin-resistant Enterococcus faecium (VREF)	Synbiotic showed an inhibition effect on VREF growth, Lactobacillus rhamnosus with inulin being the most effective	Agar well diffusion method	[140]
P. pentosaceus 5–33:3, L. mesenteroides 32–77:1, L. paracasei ssp. paracasei 19; and L. plantarum 2362; and inulin, oat bran, pectin, and resistant starch	Critically ill, mechanically ventilated, multiple trauma patients	Symbiotic treatment in critically ill, mechanically ventilated, multiple trauma patients improve the patient’s response by reducing infection and sepsis rates and	Randomized Controlled Trial	[141]
L. plantarum ATCC-202195 plus FOS	Sepsis in infants	The synbiotic combination reduced culture-positive and culture-negative sepsis and lower respiratory tract infections.	Randomized, controlled trial	[142]
L. acidophilus 10, L. rhamnosus HS 111, L. casei 10, B. bifidum plus FOS	Surgical infections and complication prevention	Synbiotic administration significantly decreases the incidence of postoperative infection and also shortens the duration of antibiotic therapy	Randomized, Clinical Trial	[143]
B. breve strain Yakult, L. casei strain Shirota plus GOS	Postoperative infections	Synbiotics reduce the number of harmful bacteria, and post-operative infection complications, and enhanced beneficial bacteria and organic acids	Randomized, controlled trial	[144]
S. faecalis T-110, C. butyricum TO- A, Bacillus mesentericus TO- A, L. sporogenes	Postoperative infectious complications	Synbiotics significantly reduce septic complications, hospital stay, and antibiotic requirements in patients undergoing pancreatic surgery for chronic pancreatitis.	Randomized Control Trial	[145]

Abbreviations: FOS, fructooligosaccharides; GOS, galactooligosaccharides; IMOS, isomaltooligosaccharides; XOS, xylooligosaccharides.

Presti I, D’Orazio G, Labra M, et al. Evaluation of the probiotic properties of new Lactobacillus and Bifidobacterium strains and their in vitro effect. Appl Microbiol Biotechnol. 2015;99(13):5613–5626. doi:10.1007/s00253-015-6482-8

 PubMed Web of Science ®Google Scholar

Feng J, Wang L, Zhou L, Yang X, Zhao X. Using in vitro immunomodulatory properties of lactic acid bacteria for selection of probiotics against salmonella infection in broiler chicks. PLoS One. 2016;11(1):e0147630. doi:10.1371/journal.pone.0147630

 PubMed Web of Science ®Google Scholar

Park SY, Lim SD. Probiotic characteristics of lactobacillus plantarum FH185 isolated from human feces. Korean J Food Sci Anim Resour. 2015;35(5):615–621. doi:10.5851/kosfa.2015.35.5.615

 PubMedGoogle Scholar

Damodharan K, Lee YS, Palaniyandi SA, Yang SH, Suh JW. Preliminary probiotic and technological characterization of Pediococcus pentosaceus strain KID7 and in vivo assessment of its cholesterol-lowering activity. Front Microbiol. 2015;6:768. doi:10.3389/fmicb.2015.00768

 PubMed Web of Science ®Google Scholar

Likotrafiti E, Tuohy KM, Gibson GR, Rastall RA. Development of antimicrobial synbiotics using potentially-probiotic faecal isolates of Lactobacillus fermentum and Bifidobacterium longum. Anaerobe. 2013;20:5–13. doi:10.1016/j.anaerobe.2013.01.002

 PubMed Web of Science ®Google Scholar

Tulini FL, Winkelströter LK, De Martinis EC. Identification and evaluation of the probiotic potential of Lactobacillus paraplantarum FT259, a bacteriocinogenic strain isolated from Brazilian semi-hard artisanal cheese. Anaerobe. 2013;22:57–63. doi:10.1016/j.anaerobe.2013.06.006

 PubMed Web of Science ®Google Scholar

Chimchang J, Theparee T, Ladda B, Tanasupawat S, Wongsatayanon BT, Taweechotipatr M. Antimicrobial properties of a potential probiotic lactobacillus from Thai newborn feces. J Med Assoc Thai. 2015;98(Suppl 9):S116–S122.

 PubMedGoogle Scholar

Kaur S, Sharma P, Kalia N, Singh J, Kaur S. Anti-biofilm properties of the fecal probiotic lactobacilli against Vibrio spp. Front Cell Infect Microbiol. 2018;8:120. doi:10.3389/fcimb.2018.00120

 PubMed Web of Science ®Google Scholar

Bian X, Evivie SE, Muhammad Z, et al. In vitro assessment of the antimicrobial potentials of Lactobacillus helveticus strains isolated from traditional cheese in Sinkiang China against food-borne pathogens. Food Funct. 2016;7(2):789–797. doi:10.1039/c5fo01041a

 PubMed Web of Science ®Google Scholar

Anas M, Ahmed K, Mebrouk K. Study of the antimicrobial and probiotic effect of Lactobacillus Plantarum isolated from raw goat’s milk from the region of Western Algeria. World Appl Sci J. 2014;32(7):1304–1310.

 Google Scholar

Ünlü G, Nielsen B, Ionita C. Production of antilisterial bacteriocins from lactic acid bacteria in dairy-based media: a comparative study. Probiotics Antimicrob Proteins. 2015;7(4):259–274. doi:10.1007/s12602-015-9200-z

 PubMed Web of Science ®Google Scholar

El‐Kholy AM, El‐Shinawy SH, Meshref AMS, Korny AM. Screening of antagonistic activity of probiotic bacteria against some food‐borne pathogens. J Appl Environ Microbiol. 2014;2(2):53–60.

 Google Scholar

Amer EI, Mossallam SF, Mahrous H. Therapeutic enhancement of newly derived bacteriocins against Giardia lamblia. Exp Parasitol. 2014;146:52–63. doi:10.1016/j.exppara.2014.09.005

 PubMed Web of Science ®Google Scholar

Butprom S, Phumkhachorn P, Rattanachaikunsopon P. Effect of Lactobacillus plantarum C014 on innate immune response and disease resistance against Aeromonas hydrophila in hybrid catfish. Sci World J. 2013;2013:392523. doi:10.1155/2013/392523

 Google Scholar

Menconi A, Kallapura G, Latorre JD, et al. Identification and characterization of lactic Acid bacteria in a commercial probiotic culture. Biosci Microbiota Food Health. 2014;33(1):25–30. doi:10.12938/bmfh.33.25

 PubMedGoogle Scholar

Aoudia N, Rieu A, Briandet R, et al. Biofilms of Lactobacillus plantarum and Lactobacillus fermentum: effect on stress responses, antagonistic effects on pathogen growth and immunomodulatory properties. Food Microbiol. 2016;53(Pt A):51–59. doi:10.1016/j.fm.2015.04.009

 PubMedGoogle Scholar

Bujalance C, Jiménez-Valera M, Moreno E, Ruiz-López MD, Lasserrot A, Ruiz-Bravo A. Lack of correlation between in vitro antibiosis and in vivo protection against enteropathogenic bacteria by probiotic lactobacilli. Res Microbiol. 2014;165(1):14–20. doi:10.1016/j.resmic.2013.10.006

 PubMed Web of Science ®Google Scholar

Muñoz-Atienza E, Araújo C, Magadán S, et al. In vitro and in vivo evaluation of lactic acid bacteria of aquatic origin as probiotics for turbot (Scophthalmus maximus L). farming. Fish Shellfish Immunol. 2014;41(2):570–580. doi:10.1016/j.fsi.2014.10.007

 PubMed Web of Science ®Google Scholar

Caggia C, De Angelis M, Pitino I, Pino A, Randazzo CL. Probiotic features of Lactobacillus strains isolated from Ragusano and Pecorino Siciliano cheeses. Food Microbiol. 2015;50:109–117. doi:10.1016/j.fm.2015.03.010

 PubMed Web of Science ®Google Scholar

Pinpimai K, Rodkhum C, Chansue N, Katagiri T, Maita M, Pirarat N. The study on the candidate probiotic properties of encapsulated yeast, Saccharomyces cerevisiae JCM 7255, in Nile Tilapia (Oreochromis niloticus). Res Vet Sci. 2015;102:103–111. doi:10.1016/j.rvsc.2015.07.021

 PubMed Web of Science ®Google Scholar

Yang JJ, Niu CC, Guo XH. Mixed culture models for predicting intestinal microbial interactions between Escherichia coli and Lactobacillus in the presence of probiotic Bacillus subtilis. Benef Microbes. 2015;6(6):871–877. doi:10.3920/BM2015.0033

 PubMed Web of Science ®Google Scholar

Shokryazdan P, Sieo CC, Kalavathy R, et al. Probiotic potential of Lactobacillus strains with antimicrobial activity against some human pathogenic strains. Biomed Res Int. 2014;2014:927268. doi:10.1155/2014/927268

 PubMed Web of Science ®Google Scholar

Muñoz-Quezada S, Bermudez-Brito M, Chenoll E, et al. Competitive inhibition of three novel bacteria isolated from faeces of breast milk-fed infants against selected enteropathogens. Br J Nutr. 2013;109(Suppl 2):S63–S69. doi:10.1017/S0007114512005600

 PubMedGoogle Scholar

Abbaszadeh S, Tavakoli R, Sharifzadeh A, Shokri H. Lactic acid bacteria as functional probiotic isolates for inhibiting the growth of Aspergillus flavus, A. parasiticus, A. Niger and Penicillium chrysogenum. J Mycol Med. 2015;25(4):263–267. doi:10.1016/j.mycmed.2015.10.011

 PubMed Web of Science ®Google Scholar

Aminnezhad S, Kermanshahi RK, Ranjbar R. Evaluation of synergistic interactions between cell-free supernatant of lactobacillus strains and amikacin and gentamicin against Pseudomonas aeruginosa. Jundishapur J Microbiol. 2015;8(4):e16592. doi:10.5812/jjm.8(4)2015.16592

 PubMed Web of Science ®Google Scholar

Diana CR, Humberto HS, Jorge YF. Probiotic properties of leuconostoc mesenteroides Isolated from Aguamiel of Agave salmiana. Probiotics Antimicrob Proteins. 2015;7(2):107–117. doi:10.1007/s12602-015-9187-5

 PubMed Web of Science ®Google Scholar

Liu XF, Li Y, Li JR, et al. Isolation and characterisation of Bacillus spp. antagonistic to Vibrio parahaemolyticus for use as probiotics in aquaculture. World J Microbiol Biotechnol. 2015;31(5):795–803. doi:10.1007/s11274-015-1833-2

 PubMed Web of Science ®Google Scholar

Yu X, Yin J, Li L, et al. Prebiotic potential of xylooligosaccharides derived from corn cobs and their in vitro antioxidant activity when combined with lactobacillus. J Microbiol Biotechnol. 2015;25(7):1084–1092. doi:10.4014/jmb.1501.01022

 PubMed Web of Science ®Google Scholar

Chew SY, Cheah YK, Seow HF, Sandai D, Than LT. Probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 exhibit strong antifungal effects against vulvovaginal candidiasis-causing Candida glabrata isolates. J Appl Microbiol. 2015;118(5):1180–1190. doi:10.1111/jam.12772

 PubMed Web of Science ®Google Scholar

Belicová A, Mikulášová M, Dušinský R. Probiotic potential and safety properties of Lactobacillus plantarum from Slovak Bryndza cheese. Biomed Res Int. 2013;2013:760298. doi:10.1155/2013/760298

 PubMed Web of Science ®Google Scholar

Jena PK, Trivedi D, Thakore K, Chaudhary H, Giri SS, Seshadri S. Isolation and characterization of probiotic properties of Lactobacilli isolated from rat fecal microbiota. Microbiol Immunol. 2013;57(6):407–416. doi:10.1111/1348-0421.12054

 PubMed Web of Science ®Google Scholar

Thankappan B, Ramesh D, Ramkumar S, Natarajaseenivasan K, Anbarasu K. Characterization of Bacillus spp. from the gastrointestinal tract of Labeo rohita--towards to identify novel probiotics against fish pathogens. Appl Biochem Biotechnol. 2015;175(1):340–353. doi:10.1007/s12010-014-1270-y

 PubMed Web of Science ®Google Scholar

Gotteland M, Cires MJ, Carvallo C, et al. Probiotic screening and safety evaluation of Lactobacillus strains from plants, artisanal goat cheese, human stools, and breast milk. J Med Food. 2014;17(4):487–495. doi:10.1089/jmf.2013.0030

 PubMed Web of Science ®Google Scholar

Torres NI, Noll KS, Xu S, et al. Safety, formulation, and in vitro antiviral activity of the antimicrobial peptide subtilosin against herpes simplex virus type 1. Probiotics Antimicrob Proteins. 2013;5(1):26–35. doi:10.1007/s12602-012-9123-x

 PubMedGoogle Scholar

Wu HJ, Sun LB, Li CB, et al. Enhancement of the immune response and protection against Vibrio parahaemolyticus by indigenous probiotic Bacillus strains in mud crab (Scylla paramamosain). Fish Shellfish Immunol. 2014;41(2):156–162. doi:10.1016/j.fsi.2014.08.027

 PubMed Web of Science ®Google Scholar

Geeraerts S, Ducatelle R, Haesebrouck F, Van Immerseel F. Bacillus amyloliquefaciens as prophylactic treatment for Clostridium difficile-associated disease in a mouse model. J Gastroenterol Hepatol. 2015;30(8):1275–1280. doi:10.1111/jgh.12957

 PubMed Web of Science ®Google Scholar

Gomathi S, Sasikumar P, Anbazhagan K, et al. Screening of indigenous oxalate degrading lactic acid bacteria from human faeces and South Indian fermented foods: assessment of probiotic potential. ScientificWorldJournal. 2014;2014:648059. doi:10.1155/2014/648059

 PubMedGoogle Scholar

Georgieva R, Yocheva L, Tserovska L, et al. Antimicrobial activity and antibiotic susceptibility of Lactobacillus and Bifidobacterium spp. intended for use as starter and probiotic cultures. Biotechnol Biotechnol Equip. 2015;29(1):84–91. doi:10.1080/13102818.2014.987450

 PubMed Web of Science ®Google Scholar

Mirnejad R, Vahdati AR, Rashidiani J, Erfani M, Piranfar V. The antimicrobial effect of lactobacillus casei culture supernatant against multiple drug resistant clinical isolates of Shigella sonnei and Shigella flexneri in vitro. Iran Red Crescent Med J. 2013;15(2):122–126. doi:10.5812/ircmj.7454

 PubMed Web of Science ®Google Scholar

Trivedi D, Jena PK, Seshadri S. Colicin E2 expression in Lactobacillus brevis DT24, A vaginal probiotic isolate, against uropathogenic Escherichia coli. ISRN Urol. 2014;2014:869610. doi:10.1155/2014/869610

 PubMedGoogle Scholar

Das A, Nakhro K, Chowdhury S, Kamilya D. Effects of potential probiotic Bacillus amyloliquefaciens [corrected] FPTB16 on systemic and cutaneous mucosal immune responses and disease resistance of catla (Catla catla). Fish Shellfish Immunol. 2013;35(5):1547–1553. doi:10.1016/j.fsi.2013.08.022

 PubMed Web of Science ®Google Scholar

Baick SC, Kim CH. Assessment of characteristics and functional properties of lactobacillus species isolated from kimchi for dairy use. Korean J Food Sci Anim Resour. 2015;35(3):339–349. doi:10.5851/kosfa.2015.35.3.339

 PubMedGoogle Scholar

Dec M, Puchalski A, Urban-Chmiel R, Wernicki A. Screening of Lactobacillus strains of domestic goose origin against bacterial poultry pathogens for use as probiotics. Poult Sci. 2014;93(10):2464–2472. doi:10.3382/ps.2014-04025

 PubMed Web of Science ®Google Scholar

Wu CC, Lin CT, Wu CY, Peng WS, Lee MJ, Tsai YC. Inhibitory effect of Lactobacillus salivarius on Streptococcus mutans biofilm formation. Mol Oral Microbiol. 2015;30(1):16–26. doi:10.1111/omi.12063

 PubMed Web of Science ®Google Scholar

VidyaLaxme B, Rovetto A, Grau R, Agrawal R. Synergistic effects of probiotic Leuconostoc mesenteroides and Bacillus subtilis in malted ragi (Eleucine corocana) food for antagonistic activity against V. cholerae and other beneficial properties. J Food Sci Technol. 2014;51(11):3072–3082. doi:10.1007/s13197-012-0834-5

 PubMed Web of Science ®Google Scholar

Naderi A, Kasra-Kermanshahi R, Gharavi S, Imani Fooladi AA, Abdollahpour Alitappeh M, Saffarian P. Study of antagonistic effects of Lactobacillus strains as probiotics on multi drug resistant (MDR) bacteria isolated from urinary tract infections (UTIs). Iran J Basic Med Sci. 2014;17(3):201–208.

 PubMed Web of Science ®Google Scholar

Moghadam SS, Khodaii Z, Zadeh SF, Ghooshchian M, Aghmiyuni ZF, Shabestari TM. Synergistic or antagonistic effects of probiotics and antibiotics-alone or in combination-on antimicrobial-resistant Pseudomonas aeruginosa isolated from burn wounds. Arch Clin Infect Dis. 2018;13(3):e63121.

 Web of Science ®Google Scholar

Abdelhamid AG, Esaam A, Hazaa MM. Cell free preparations of probiotics exerted antibacterial and antibiofilm activities against multidrug resistant E. coli. Saudi Pharm J. 2018;26(5):603–607. doi:10.1016/j.jsps.2018.03.004

 PubMed Web of Science ®Google Scholar

Gomaa EZ. Synergistic antibacterial efficiency of Bacteriocin and silver nanoparticles produced by probiotic Lactobacillus paracasei against multidrug-resistant bacteria. Int J Pept Res Ther. 2019;1(25):1113–1125. doi:10.1007/s10989-018-9759-9

 Google Scholar

Ibraheem SK, Alshaibani AB, Ad’hiah AH. Protective effect of Lactobacillus acidophilus and Saccharomyces cerevisiae against multi-drug resistant Salmonella enterica serovar typhimurium in vitro and in vivo. World J Pharm Res. 2014;28(3):193–203.

 Google Scholar

Halder D, Mandal S. Antibacterial potentiality of commercially available probiotic lactobacilli and curd lactobacilli strains, alone and in combination, against human pathogenic bacteria. Transl Biomed. 2016;7(2):1–7. doi:10.21767/2172-0479.100061

 Google Scholar

Khmaladze I, É B, Fabre S, Gillbro JM. Lactobacillus reuteri DSM 17938-A comparative study on the effect of probiotics and lysates on human skin. Exp Dermatol. 2019;28(7):822–828. doi:10.1111/exd.13950

 PubMed Web of Science ®Google Scholar

Monteiro CRAV, Do Carmo MS, Melo BO, et al. In Vitro antimicrobial activity and probiotic potential of Bifidobacterium and Lactobacillus against species of Clostridium. Nutrients. 2019;11(2):448. doi:10.3390/nu11020448

 PubMed Web of Science ®Google Scholar

Rossoni RD, Fuchs BB, de Barros PP, et al. Lactobacillus paracasei modulates the immune system of Galleria mellonella and protects against Candida albicans infection. PLoS One. 2017;12(3):e0173332. doi:10.1371/journal.pone.0173332

 PubMed Web of Science ®Google Scholar

Ishikawa KH, Mayer MP, Miyazima TY, et al. A multispecies probiotic reduces oral Candida colonization in denture wearers. J Prosthodont. 2015;24(3):194–199. doi:10.1111/jopr.12198

 PubMedGoogle Scholar

Sajedinejad N, Paknejad M, Houshmand B, et al. Lactobacillus salivarius NK02: a potent probiotic for clinical application in mouthwash. Probiotics Antimicrob Proteins. 2018;10(3):485–495. doi:10.1007/s12602-017-9296-4

 PubMed Web of Science ®Google Scholar

Helmy YA, Krücken J, Nöckler K, von Samson-Himmelstjerna G, Zessin KH. Comparison between two commercially available serological tests and polymerase chain reaction in the diagnosis of Cryptosporidium in animals and diarrhoeic children. Parasitol Res. 2014;113(1):211–216. doi:10.1007/s00436-013-3645-3

 PubMed Web of Science ®Google Scholar

Kuru BE, Laleman I, Yalnızoğlu T, Kuru L, Teughels W. The influence of a bifidobacterium animalis probiotic on gingival health: a randomized controlled clinical trial. J Periodontol. 2017;88(11):1115–1123. doi:10.1902/jop.2017.170213

 PubMed Web of Science ®Google Scholar

Zhou M, Zhu J, Yu H, et al. Investigation into in vitro and in vivo models using intestinal epithelial IPEC-J2 cells and Caenorhabditis elegans for selecting probiotic candidates to control porcine enterotoxigenic Escherichia coli. J Appl Microbiol. 2014;117(1):217–226. doi:10.1111/jam.12505

 PubMed Web of Science ®Google Scholar

Lazarenko L, Babenko L, Sichel LS, et al. Antagonistic action of lactobacilli and bifidobacteria in relation to Staphylococcus aureus and their influence on the immune response in cases of intravaginal Staphylococcosis in mice. Probiotics Antimicrob Proteins. 2012;4(2):78–89. doi:10.1007/s12602-012-9093-z

 PubMed Web of Science ®Google Scholar

Prado-Rebolledo OF, Delgado-Machuca JJ, Macedo-Barragan RJ, et al. Evaluation of a selected lactic acid bacteria-based probiotic on Salmonella enterica serovar Enteritidis colonization and intestinal permeability in broiler chickens. Avian Pathol. 2017;46(1):90–94. doi:10.1080/03079457.2016.1222808

 PubMed Web of Science ®Google Scholar

Morya VK, Choi W, Kim EK. Isolation and characterization of Pseudoalteromonas sp. from fermented Korean food, as an antagonist to Vibrio harveyi. Appl Microbiol Biotechnol. 2014;98(3):1389–1395. doi:10.1007/s00253-013-4937-3

 PubMed Web of Science ®Google Scholar

Mossallam SF, Amer EI, Diab RG. Potentiated anti-microsporidial activity of Lactobacillus acidophilus CH1 bacteriocin using gold nanoparticles. Exp Parasitol. 2014;144:14–21. doi:10.1016/j.exppara.2014.06.002

 PubMed Web of Science ®Google Scholar

Mazaya B, Hamzawy MA, Khalil MA, Tawkol WM, Sabit H. Immunomodulatory and antimicrobial efficacy of Lactobacilli against enteropathogenic infection of Salmonella typhi: in-vitro and in-vivo study. Int J Immunopathol Pharmacol. 2015;28(4):469–478. doi:10.1177/0394632015592099

 PubMed Web of Science ®Google Scholar

Gupta R, Sarkar S, Srivastava S. In vivo toxicity assessment of antimicrobial peptides (AMPs LR14) derived from Lactobacillus plantarum strain LR/14 in Drosophila melanogaster. Probiotics Antimicrob Proteins. 2014;6(1):59–67. doi:10.1007/s12602-013-9154-y

 PubMed Web of Science ®Google Scholar

Mahmoodpoor A, Hamishehkar H, Asghari R, Abri R, Shadvar K, Sanaie S. Effect of a probiotic preparation on ventilator-associated pneumonia in critically ill patients admitted to the intensive care unit: a prospective double-blind randomized controlled trial. Nutr Clin Pract. 2019;34(1):156–162. doi:10.1002/ncp.10191

 PubMed Web of Science ®Google Scholar

Kumar M, Dhaka P, Vijay D, et al. Antimicrobial effects of Lactobacillus plantarum and Lactobacillus acidophilus against multidrug-resistant enteroaggregative Escherichia coli. Int J Antimicrob Agents. 2016;48(3):265–270. doi:10.1016/j.ijantimicag.2016.05.014

 PubMed Web of Science ®Google Scholar

Rongrungruang Y, Krajangwittaya D, Pholtawornkulchai K, Tiengrim S, Thamlikitkul V. Randomized controlled study of probiotics containing Lactobacillus casei (Shirota strain) for prevention of ventilator-associated pneumonia. J Med Assoc Thai. 2015;98(3):253–259.

 PubMedGoogle Scholar

Gonzalez-Gil F, Diaz-Sanchez S, Pendleton S, et al. Yerba mate enhances probiotic bacteria growth in vitro but as a feed additive does not reduce Salmonella Enteritidis colonization in vivo. Poult Sci. 2014;93(2):434–440. doi:10.3382/ps.2013-03339

 PubMed Web of Science ®Google Scholar

Machairas N, Pistiki A, Droggiti DI, et al. Pre-treatment with probiotics prolongs survival after experimental infection by multidrug-resistant Pseudomonas aeruginosa in rodents: an effect on sepsis-induced immunosuppression. Int J Antimicrob Agents. 2015;45(4):376–384. doi:10.1016/j.ijantimicag.2014.11.013

 PubMed Web of Science ®Google Scholar

Rigo-Adrover M, Saldaña-Ruíz S, van Limpt K, et al. A combination of scGOS/lcFOS with Bifidobacterium breve M-16V protects suckling rats from rotavirus gastroenteritis. Eur J Nutr. 2017;56(4):1657–1670. doi:10.1007/s00394-016-1213-1

 PubMed Web of Science ®Google Scholar

Nomayo A, Schwiertz A, Rossi R, et al. Infant formula with cow’s milk fat and prebiotics affects intestinal flora, but not the incidence of infections during infancy in a double-blind randomized controlled trial. Mol Cell Pediatr. 2020;7(1):6. doi:10.1186/s40348-020-00098-1

 PubMedGoogle Scholar

Janardhana V, Broadway MM, Bruce MP, et al. Prebiotics modulate immune responses in the gut-associated lymphoid tissue of chickens. J Nutr. 2009;139(7):1404–1409. doi:10.3945/jn.109.105007 PMID: 19474157.

 PubMed Web of Science ®Google Scholar

Kim GB, Seo YM, Kim CH, Paik IK. Effect of dietary prebiotic supplementation on the performance, intestinal microflora, and immune response of broilers. Poult Sci. 2011;90(1):75–82. doi:10.3382/ps.2010-00732 PMID: 21177446.

 PubMed Web of Science ®Google Scholar

Kim HS, Cha E, Kim Y, et al. Raffinose, a plant galactoside, inhibits Pseudomonas aeruginosa biofilm formation via binding to LecA and decreasing cellular cyclic diguanylate levels. Sci Rep. 2016;6:25318. doi:10.1038/srep25318

 PubMed Web of Science ®Google Scholar

Kishino E, Takemura N, Masaki H, Ito T, Nakazawa M. Dietary lactosucrose suppresses influenza A (H1N1) virus infection in mice. Biosci Microbiota Food Health. 2015;34(4):67–76. doi:10.12938/bmfh.2015-005

 PubMedGoogle Scholar

Rist VT, Weiss E, Sauer N, Mosenthin R, Eklund M. Effect of dietary protein supply originating from soybean meal or casein on the intestinal microbiota of piglets. Anaerobe. 2014;25:72–79. doi:10.1016/j.anaerobe.2013.10.003

 PubMed Web of Science ®Google Scholar

Yu YJ, Amorim M, Marques C, Calhau C, Pintado M. Effects of whey peptide extract on the growth of probiotics and gut microbiota. J Funct Foods. 2016;1(21):507–516. doi:10.1016/j.jff.2015.10.035

 Google Scholar

Ham SY, Kim HS, Cha E, Lim T, Byun Y, Park HD. Raffinose inhibits Streptococcus mutans biofilm formation by targeting glucosyltransferase. Microbiol Spectr. 2022;10(3):e0207621. doi:10.1128/spectrum.02076-21

 PubMed Web of Science ®Google Scholar

Kim HS, Jang Y, Ham SY, et al. Effect of broad-spectrum biofilm inhibitor raffinose, a plant galactoside, on the inhibition of co-culture biofilm on the microfiltration membrane. J Hazard Mater. 2021;402:123501. doi:10.1016/j.jhazmat.2020.123501

 PubMed Web of Science ®Google Scholar

Maldonado J, Cañabate F, Sempere L, et al. Human milk probiotic Lactobacillus fermentum CECT5716 reduces the incidence of gastrointestinal and upper respiratory tract infections in infants. J Pediatr Gastroenterol Nutr. 2012;54(1):55–61. doi:10.1097/MPG.0b013e3182333f18

 PubMed Web of Science ®Google Scholar

Dinleyici EC, Dalgic N, Guven S, et al. The effect of a multispecies synbiotic mixture on the duration of diarrhea and length of hospital stay in children with acute diarrhea in Turkey: single blinded randomized study. Eur J Pediatr. 2013;172(4):459–464. doi:10.1007/s00431-012-1903-5

 PubMed Web of Science ®Google Scholar

Vandenplas Y, De Hert SG. PROBIOTICAL-Study Group. Randomised clinical trial: the synbiotic food supplement Probiotical vs placebo for acute gastroenteritis in children. Aliment Pharmacol Ther. 2011;34(8):862–867. doi:10.1111/j.1365-2036.2011.04835.x

 PubMed Web of Science ®Google Scholar

Kondepudi KK, Ambalam P, Nilsson I, Wadström T, Ljungh A. Prebiotic-non-digestible oligosaccharides preference of probiotic bifidobacteria and antimicrobial activity against Clostridium difficile. Anaerobe. 2012;18(5):489–497. doi:10.1016/j.anaerobe.2012.08.005

 PubMed Web of Science ®Google Scholar

Işlek A, Sayar E, Yılmaz A, Bö B, Mutlu D, Artan R. The role of Bifidobacterium lactis B94 plus inulin in the treatment of acute infectious diarrhea in children. Turk J Gastroenterol. 2014;25(6):628–633. doi:10.5152/tjg.2014.14022

 PubMed Web of Science ®Google Scholar

Koruri SS, Chowdhury R, Bhattacharya P. Potentiation of functional and antimicrobial activities through synergistic growth of probiotic Pediococcus acidilactici with natural prebiotics (garlic, basil). Microbes Spotlight. 2016;28:219–224.

 Google Scholar

Ibrahem AA, Al-Shawi SG, Al-Temimi WKA. The antagonistic activity of the synbiotic containing Lactobacillus acidophilus and pineapple residue FOS against pathogenic bacteria. Braz J Biol. 2022;84:e258277. doi:10.1590/1519-6984.258277

 PubMedGoogle Scholar

García-Gamboa R, Domínguez-Simi M, Gradilla-Hernández MS, et al. Anticandidal and antibiofilm effect of synbiotics including probiotics and inulin-type fructans. Antibiotics. 2022;11(8):1135. doi:10.3390/antibiotics11081135

 Google Scholar

Erginkaya Z, Konuray G, Harmanci M, Kesen G, Nagihan ME. Antibacterial effects of microencapsulated probiotic and synbiotics. Çukurova Tarim ve Gida Bilimleri Dergisi. 2019;34(1):27–36.

 Google Scholar

Kotzampassi K, Giamarellos-Bourboulis EJ, Voudouris A, Kazamias P, Eleftheriadis E. Benefits of a synbiotic formula (Synbiotic 2000Forte) in critically Ill trauma patients: early results of a randomized controlled trial. World J Surg. 2006;30(10):1848–1855. doi:10.1007/s00268-005-0653-1

 PubMed Web of Science ®Google Scholar

Panigrahi P, Parida S, Nanda NC, et al. A randomized synbiotic trial to prevent sepsis among infants in rural India. Nature. 2017;548(7668):407–412. doi:10.1038/nature23480

 PubMed Web of Science ®Google Scholar

Sommacal HM, Bersch VP, Vitola SP, Osvaldt AB. Perioperative synbiotics decrease postoperative complications in periampullary neoplasms: a randomized, double-blind clinical trial. Nutr Cancer. 2015;67(3):457–462. doi:10.1080/01635581.2015.1004734 PMID: 25803626.

 PubMed Web of Science ®Google Scholar

Kanazawa H, Nagino M, Kamiya S, et al. Synbiotics reduce postoperative infectious complications: a randomized controlled trial in biliary cancer patients undergoing hepatectomy. Langenbecks Arch Surg. 2005;390(2):104–113. doi:10.1007/s00423-004-0536-1

 PubMed Web of Science ®Google Scholar

Rammohan A, Sathyanesan J, Rajendran K, et al. Synbiotics in surgery for chronic pancreatitis: are they truly effective? A single-blind prospective randomized control trial. Ann Surg. 2015;262(1):31–37. doi:10.1097/SLA.0000000000001077

 PubMed Web of Science ®Google Scholar