GI360 stool profile / Doctor's Data

Acinetobacter junii is rarely a cause of disease in humans. A. junii has mainly been associated with bacteremia in preterm infants and pediatric oncologic patients.

Acinetobacter junii is one of more than 50 different species belonging to the genus Acinetobacter, most of which are nonpathogenic environmental organisms. They may cause opportunistic infections only in people with compromised immune status or with an indwelling device (such as urinary catheters, vascular access devices, endotracheal tubes, tracheostomies, enteral feeding tubes and wound drains), or both.

Acinetobacter species are ubiquitous and can be isolated from many sources including soil, water, sewage, and food. Acinetobacter species can colonize skin, wounds, the oral mucosa, and respiratory and gastrointestinal tracts.

Actinobacteria is one of the largest bacterial phyla, comprised of Gram-positive bacteria.

Actinomycetales are considered low abundance colonizers of the gastrointestinal tract with primary residence on the skin.

Adenoviruses are non-enveloped DNA viruses.

Adenovirus is a cause of acute gastroenteritis in infants, young children, the elderly and immuno-compromised patients. The Adenovirus serotypes most frequently associated with gastroenteritis are Adenovirus 40 and 41.

Adenovirus gastroenteritis generally causes watery diarrhea lasting one to two weeks.

Akkermansia muciniphila may represent 3–5% of the microbial composition in the healthy human intestinal tract, and have a crucial role in the regulation of the gut barrier and other homeostatic and metabolic functions.

- Alistipes does not contribute significantly to short chain fatty acid production.

- A diet rich in animal protein and fat increases the abundance of Alistipes.

- High abundance of Alistipes was identified as a possible predictor of successful weight loss.

- Alistipes may positively correlate with depression.

Alistipes does not contribute significantly to short chain fatty acid production. A diet rich in animal protein and fat increases the abundance of Alistipes. High abundance of Alistipes was identified as a possible predictor of successful weight loss. Increased abundance of Alistipes has been correlated with a greater frequency of pain in pediatric irritable bowel syndrome patients.

The phylum Firmicutes constitutes the most diverse and abundant group of gastrointestinal microbiota which are grouped into four classes, Bacilli, Clostridia, Erysipelotrichi, and Negativicutes. They make up approximately 39% of the gut microbiota, on average, in healthy adults, but can comprise as much as 80% of the community.

Imbalanced bacteria are usually neither pathogenic nor beneficial to the host GI tract. Imbalances can occur when there are insufficient levels of beneficial bacteria and increased levels of commensal bacteria. Certain commensal bacteria are reported as dysbiotic at higher levels.

Species in the genus Bacteroides carry out broad metabolic functions, including degradation of complex plant polysaccharides, proteolytic activities, de-conjugation of bile acids, mucosal barrier integrity, short chain fatty acid production, fatty acid storage and glucose metabolism.

Bacteroides spp. are maintained at a higher abundance in breastfed individuals into adulthood.

Bacteroides fragilis plays an important role in the prevention of intestinal inflammation. An energy-restricted diet has been shown to increase B. fragilis in overweight adolescents. An increase in B. stercoris has been associated with higher risk of colon cancer. Decreased levels of Bacteroides spp. have been reported in association with multiple sclerosis, rheumatoid arthritis and Parkinson’s disease.

Bacteroides pectinophilus contributes to breakdown of dietary pectins which are prebiotics. Pectins are complex, plantderived carbohydrates that are indigestible by human enzymes, but can be easily degraded by certain commensal bacteria in the gut.

Species in the genus Bacteroides carry out broad metabolic functions, including degradation of complex plant polysaccharides, proteolytic activities, de-conjugation of bile acids, mucosal barrier integrity, short chain fatty acid production, fatty acid storage and glucose metabolism. 

The predominant genera in the human colonic microbiota are Bacteroides and Prevotella, which belong to the major phyla Bacteroidetes.

Species in the genus Bacteroides carry out broad metabolic functions, including degradation of complex plant polysaccharides, proteolytic activities, de-conjugation of bile acids, mucosal barrier integrity, short chain fatty acid production, fatty acid storage and glucose metabolism. Bacteroides spp. are maintained at a higher abundance in breastfed individuals into adulthood.

Bacteroides zoogleoformans is part of the Bacteroides genus. Species in the genus Bacteroides carry out broad metabolic functions, including:

- degradation of complex plant polysaccharides,

- proteolytic activities (=the breakdown of proteins into smaller polypeptides or amino acids),

- de-conjugation of bile acids,

- mucosal barrier integrity,

- short chain fatty acid production,

- fatty acid storage and glucose metabolism.

Bacteroides spp. are maintained at a higher abundance in breastfed individuals into adulthood. Bacteroides fragilis plays an important role in the prevention of intestinal inflammation. An energy-restricted diet has been shown to increase B. fragilis in overweight adolescents. An increase in B. stercoris has been associated with higher risk of colon cancer. Decreased levels of Bacteroides spp. have been reported in association with multiple sclerosis, rheumatoid arthritis and Parkinson’s disease.

Considered amongst the most beneficial commensal bacteria in the human gut, Bifidobacterium spp. are able to degrade monosaccharides, galacto-, manno-, and fructo-oligosaccharides, as well as some complex carbohydrates. Many of the non-digestible oligosaccharides, found as natural components in mother’s milk, select for colonization of these species which dominate the infant gut shortly after birth.

Bifidobacteria may provide health benefits directly through interactions with the host, and indirectly through interactions with other microorganisms. Bifidobacterium spp. take part in production and adsorption of vitamins, such as vitamins K and B12, biotin, folate, thiamine, riboflavin, and pyridoxine.

Most Campylobacter infections in industrialized countries are caused by C. jejuni, C. coli, and C. lari with an estimated 1.5 million cases of foodborne illness due to Campylobacter per year in the US. Campylobacter spp. are responsible for approximately 15% of hospitalizations resulting from foodborne infections.

Generally, campylobacteriosis presents as one to three days of fever, vomiting, and headaches followed by three to seven days of watery or bloody diarrhea and may include abdominal pain, cramping, nausea, headache, and/ or muscle pain within 2-5 days of infection.

Contaminated water, pets, food, unpasteurized milk and undercooked poultry, are sources of infection. Use of antibiotics is controversial but may benefit children whom have had symptoms for less than 7 days, and immunocompromised individuals.

Simple sugars are absorbed in the small intestine and should not be appreciably present in the colon because they are a primary energy source for pathogenic or dysbiotic bacteria and yeast.

Consumption of a Western diet has been shown to increase Catenibacterium mitsuokai in the human gut microbiota.

Catenibacterium mitsuokai ferments glucose, mannose, galactose, fructose, sucrose, maltose, cellobiose, lactose and salicin in the production of lactic acid, acetic acid as well as iso-butyric acid.

The presence of Catenibacterium mitsuokai has been positively associated with obesity-related insulin resistance.

Citrobacter spp., a gram-negative bacterium and member of the Enterobacteriaceae family, is considered dysbiotic at 3+ or greater. Citrobacter freundii complex (including C. freundii, C. braakii, C. gullenii, C. murliniae, rodentium, C. wermanii, C. youngae, C. koseri and C. farmeri) can cause diarrheal disease.

Citrobacter spp., a gram-negative bacterium and member of the Enterobacteriaceae family, is considered dysbiotic at 3+ or greater.

Citrobacter freundii complex (including C. freundii, C. braakii, C. gullenii, C. murliniae, rodentium, C. wermanii, C. youngae, C. koseri and C. farmeri, can cause diarrheal disease.

Symptoms are the result of an E. coli-like heat-stable enterotoxin and hydrogen sulfide.

Citrobacter freundii complex has been implicated as a cause of gastrointestinal infection and inflammation, acute dysentery, and dyspepsia.

Markers in this class are important producers of short-chain fatty acids, and have many well-documented roles in promoting a healthy intestinal barrier, immune balance, and protection against pathogens.

C. difficile may cause diarrhea following the production of two toxins, enterotoxin A and cytotoxin B.

C. difficile is the most common cause of nosocomial infectious diarrhea in developed countries and is the major cause of antibiotic-associated pseudo-membranous colitis. C. difficile infection (CDI) symptoms vary from asymptomatic carriage (30% of young children) to mild/moderate watery diarrhea with fever and malaise to pseudomembranous colitis with bloody diarrhea, severe abdominal pain and fever. CDI occurs almost exclusively after broad-spectrum antibiotic use. No treatment is necessary for asymptomatic carriers. Anti-motility agents are contraindicated. CDI can be treated with vancomycin 125 mg given 4 times daily for 10 days, administered orally, and fidaxomicin 200 mg given twice daily for 10 days, as first-line options for both non-severe and severe initial CDI. Patients with fulminant CDI should receive vancomycin 500 mg 4 times per day in combination with IV metronidazole. In second or subsequent recurrences, patients can be treated with oral vancomycin, fidaxomicin, or a fecal transplant. Co-administration of Saccharomyces boulardii and Lactobacillus rhamnosus during antibiotic therapy may reduce the risk of infection relapse. Oral rehydration therapy is recommended to prevent dehydration.

Appropriate digestion and metabolism of complex dietary carbohydrates from plants drives healthy diversity in the gut microbiota. Clostridium methylpentosum ferments the naturally occurring sugar L-rhamnose that is released by microbial breakdown of plant-derived pectin.

Coprobacillus cateniformis ferment glucose and other common sugars primarily to acetic and lactic acid, and to a lesser extent butyrate and valerate.

The Cryptosporidium parasite causes disease in humans through ingestion of infectious oocysts in contaminated water or food, and by direct contact with fecal material from individuals or animals actively shedding oocysts. Two species of Cryptosporidium cause disease in humans, Cryptosporidium hominis and Cryptosporidium parvum. C. hominis is more prevalent in the US, South America, Australia, and Africa, while C. parvum accounts for most cases in Europe. Along with Giardia, Cryptosporidium is the most common parasitic cause of diarrheal illness in the US and other developed nations.

Dialister invisus is generally considered an endodontic pathogen (Endo is the Greek word for inside and odont is Greek for tooth). Dialister invisus is often associated with periodontitis, caries, halitosis, and endodontic infections. 

Dialister invisus (D. invisus) is capable of generating both acetate and propionate, and the abundance of this bacterium is reduced in patients with CD.

Dialister invisus is generally considered an endodontic pathogen (Endo is the Greek word for inside and odont is Greek for tooth). Dialister invisus is often associated with periodontitis, caries, halitosis, and endodontic infections. 

Dialister invisus (D. invisus) is capable of generating both acetate and propionate, and the abundance of this bacterium is reduced in patients with CD.

Dorea is a genus within the Lachnospiraceae family that is in the Firmicutes phylum. Dorea species are known to produce hydrogen and carbon dioxide as end-products of glucose fermentation and may be associated with bloating.

Elastase is a pancreatic enzyme that digests and degrades a number of proteins. A finding of low elastase in a formed stool specimen is an indicator of pancreatic exocrine insufficiency. Moderate pancreatic insufficiency is defined at 100-200 μg/mL, and severe pancreatic insufficiency as <100 μg/mL. Fecal elastase can be artefactually low due to fluid dilution effects in a loose/watery stool sample. Check the
reported consistency of the stool specimen.

Fecal elastase measured by a sensitive immunoassay is a specific marker for pancreatic function and maintains a high diagnostic accuracy among patients with small intestinal diseases. This elastase marker allows for the diagnosis or exclusion of pancreatic exocrine insufficiency and degree of severity, which can be caused by chronic pancreatitis, cystic fibrosis, pancreatic tumor, cholelithiasis or diabetes mellitus.

Entamoeba histolytica is a protozoan parasite that infects an estimated 34 to 50 million people per year worldwide, and kills 100,000 individuals annually. The disease caused by E. histolytica, amebiasis, is common in tropical areas with poor sanitary conditions but is also endemic in the US with the prevalence of E. histolytica infection estimated to be 4%. The most common clinical manifestation of infection with E. histolytica is amoebic diarrhea without dysentery; however, more severe cases can result in amoebic dysentery, which is diarrhea with mucous and visible or microscopic blood, severe abdominal pain, fever, and elevated fecal lysozyme. Occasional asymptomatic carriage is possible.

Enterobacter cloacae complex is part of the Enterobacteriaceae family. E cloacae complex is a group of six closely related species with similar resistance patterns:

E. cloacae, E. asburiae, E. hormaechei, E. kobei, E. ludwigii, and E. nimipressuralis.

Enterobacteriaceae is a large family of bacteria within the Proteobacteria phyla. Enterobacteriaceae is inclusive of normal commensal species, harmless opportunists, and many of the more familiar pathogens, such as Salmonella, Escherichia coli, Klebsiella, Shigella and Proteus.

Other potential disease-causing bacteria in this family include Enterobacter and Citrobacter species.

Overall, Enterobacteriaceae were found at higher levels in patients with NAFLD and PD. Diets rich in in complex carbohydrates are associated with lower levels of Enterobacteriaceae, in comparison to diets rich in fat and/or protein.

ETEC is a major cause of traveler’s diarrhea in adults in industrialized countries and a leading cause of infant diarrhea in developing countries. ETEC is estimated to cause 200 million episodes of diarrhea and approximately 380,000 deaths in children in the developing world and travelers to those areas. In the US, ETEC is estimated to cause approximately 17,800 foodborne illnesses annually. Enterotoxins produced by ETEC strains include heat-labile LT toxin and heat-stable ST toxin. ETEC illnesses are usually associated with acute watery diarrhea and sometimes nausea, headache, vomiting, or fever.

E. coli O157 is a member of the pathogenic enterohemorrhagic E. coli strains (also known as verocytotoxin producing or Shiga-toxin producing E. coli (STEC)), and is an uncommon but serious cause of gastroenteritis. Infection with E. coli O157 often causes hemorrhagic colitis which involves severe abdominal cramps with watery non-hemorrhagic diarrhea which can become grossly bloody after two or three days. 

Eubacterium hallii and Eubacterium rectale are both part of the Lachnospiraceae family that is in the Firmicutes phylum.

Faecalibacterium prausnitzii is one of the most abundant butyrate producing bacteria in a healthy gastrointestinal tract.

Gram-negative Bacteroidetes and grampositive Firmicutes are bacterial phyla that dominate the entire human digestive tract, including the mouth, nose, throat, and colon.2 An abnormal result in one or both of these phylum suggest imbalanced normal microbes in the GI tract. Further, high Firmicutes and low Bacteroidetes (resulting in a high F/B ratio) suggest microbial imbalance which may be related to increased caloric extraction from food, fat deposition and lipogenesis, impaired insulin sensitivity, and increased inflammation.

G. duodenalis, a single celled protozoa, is the most frequent cause of non-bacterial diarrhea in the United States. The Centers for Disease Control and Prevention (CDC) estimates as many as 2.5 million cases of Giardia infection occur annually in the U.S. Symptomatic individuals may experience diarrhea, abdominal cramps, dehydration, malabsorption, loss of appetite, anemia, and weight loss 1-2 weeks following the ingestion of cysts. Typically symptoms will last 1-2 weeks and infections are self-limiting. Most individuals will be completely asymptomatic. Prevalence of giardiasis in adults has been estimated to be 4-7%. Higher prevalence rates have been reported in children.

Klebsiella spp. are gram-negative bacilli belonging to the Enterobacteriaceae family and closely related to the genera Enterobacter and Serratia. Klebsiella spp. are considered dysbiotic in the amount of 3 - 4 +. Klebsiella spp. are widely distributed in nature and in the gastrointestinal tract of humans. In humans, they may colonize the skin, oral cavity, pharynx, or gastrointestinal tract. Regarded as normal flora in many parts of the colon, intestinal tract and biliary tract, the gut is the main reservoir of opportunistic strains.

This bacteria has the potential to cause intestinal, lung, urinary tract, and wound infections, but overgrowth of Klebsiella spp. is commonly asymptomatic.

Klebsiella spp. are gram-negative bacilli belonging to the Enterobacteriaceae family and closely related to the genera Enterobacter and Serratia. Klebsiella spp. are widely distributed in nature and in the gastrointestinal tract of humans. In humans, they may colonize the skin, oral cavity, pharynx, or gastrointestinal tract.

The Lachnospiraceae family is a diverse group of butyric acid producers, which have been associated with beneficial microbial and epithelial cell growth. Consumption of a Mediterranean diet decreased levels of species belonging to Lachnospiraceae.

Lachnospiraceae are known to increase with intake of cruciferous vegetables and wheat bran, and decrease with a resistant starch diet.

Decreased and normal levels of Lactobacillus spp. have been reported in patients with irritable bowel syndrome. Lactobacillus spp. abundance was shown to be lower in the active phase of ulcerative colitis. Lactobacillus levels were shown to be increased after inulin consumption, but decreased after consumption of maltodextrin. Polyphenols derived from chocolate, green tea, blackcurrant, red wine
and grape seed extracts have been shown to increase Lactobacillus species. The increased abundance of Lactobacillus species has been associated with amelioration (=improvement) of inflammation.

Lactobacillus species is a type of bacteria. There are lots of different species of lactobacillus.

Lactobacillus bacteria are commonly found in the human gut, mouth and vagina. They are considered generally as “good bacteria”, and in fact may contribute to good health, often being included in probiotic supplements. These bacteria are characterized by their ability to produce lactic acid as a byproduct of glucose metabolism.

Mycoplasma hominis is from the Tenericutes phylum.

Tenericutes are cell wall-less bacteria that do not synthesize precursors of peptidoglycan. Tenericutes consist of four main clades designated as the Acholeplasma, Spiroplasma, Pneumoniae and Hominis clusters. Tenericutes are typically parasites or commensals of eukaryotic hosts.

Mycoplasma hominis is a fastidious bacterium, which usually colonizes the lower urogenital tract and may cause systemic infections in neonates and genital infections in adults. It can also be the cause of serious extra-genital infections, mainly in immunosuppressed or predisposed subjects.

Norovirus affects people of all ages causing 19 to 21 million illnesses in the US per year. It is the leading contributor to acute gastroenteritis (AGE) across all age groups. While infections can occur year-round, Norovirus outbreaks tend to peak in cold weather. Norovirus infection symptoms include vomiting with watery, non-bloody diarrhea and abdominal cramps; occasionally fever, headache, muscle aches, or fatigue.

The abundance of Parabacteroides spp., major anaerobic producers of acetate and succinate is increased with a high fat diet and is positively correlated with body weight. Parabacteroides spp., along with certain Bacteroides spp., have been shown to distinguish healthy adults from patients with irritable bowel syndrome or ulcerative colitis. Reduced abundance of this group of bacteria has also been linked to Crohn’s disease in children. Parabacteroides spp. has been found to be less abundant in patients with multiple sclerosis.

The abundance of Parabacteroides spp., major anaerobic producers of acetate and succinate is increased with a high fat diet and is positively correlated with body weight. Parabacteroides spp., along with certain Bacteroides spp., have been shown to distinguish healthy adults from patients with irritable bowel syndrome or ulcerative colitis. Reduced abundance of this group of bacteria has also been linked to Crohn’s disease in children. Parabacteroides spp. has been found to be less abundant in patients with multiple sclerosis.

Phascolarctobacterium faecium can produce short-chain fatty acids, including acetate and propionate, and may be associated with metabolic effects and mental state of the host.

Proteobacteria (phylum)

Proteobacteria include a wide variety of pathogens, including species within the Escherichia, Shigella Salmonella, Vibrio, and Helicobacter genera. The phylum includes a number of species that are permanent residents of the microbiota and capable of inducing nonspecific inflammation and diarrhea when their presence is increased. Proteobacteria make up approximately 2% of the gut microbiota in healthy adults.

A high-fat diet is positively associated with an abundance of Proteobacteria. Slightly increased abundance of Proteobacteria may be associated with low-grade inflammation. Proteobacteria are increased in inflammatory bowel disease and irritable bowel syndrome. Higher abundance of Proteobacteria has been associated with a moderate to severe disease course in newly discovered ulcerative colitis patients. They are associated with diarrhea in IBS.

Red Blood Cells (RBC) in the stool may be associated with a parasitic or bacterial infection, or an inflammatory bowel condition such as ulcerative colitis. Colorectal cancer, anal fistulas, and hemorrhoids should also be ruled out.

Rotaviruses are classified into seven serogroups (A-G); however, only groups A, B, and C are human pathogens.

The Group A Rotaviruses are responsible for the majority of infections.

Globally, Rotavirus is estimated to cause more than 125 million cases of gastroenteritis in children each year. Rotavirus symptoms can include non-bloody watery diarrhea, loss of appetite, low-grade fever, vomiting and abdominal cramping. Symptoms may be severe in infants, young children and virus may shed after resolution. While Rotavirus predominately infects children, it can also affect adults, and produces a more severe disease in immuno-compromised hosts. Transmission is via direct contact or fecal-oral via contaminated objects, food or water (drinking or recreational). Incubation period is typically two days and virus may shed prior to symptom presentation. Anti-emetics may be considered for children > 6 months old. Studies indicate that zinc may reduce severity of illness. The scientific literature does not currently support any specific herbal or nutritional antiviral therapies for this virus type. Lactobacillus casei GG and Saccharomyces boulardii may provide moderate clinical benefit in the treatment of watery diarrhea.

Imbalanced bacteria are usually neither pathogenic nor beneficial to the host GI tract. Imbalances can occur when there are insufficient levels of beneficial bacteria and increased levels of commensal bacteria. Certain commensal bacteria are reported as dysbiotic at higher levels.

Members of Ruminococcus sensu produce acetate, but not butyrate. Ruminococcus gnavus, like Akkermansia muciniphila is a mucin degrading specialist.

HIGHER LEVELS:

- Higher levels of Ruminococcus spp. were associated with non-alcoholic fatty liver disease and non-alcoholic steatohepatitis.

- Increased abundance of Ruminococcus spp. has been reported in irritable bowel syndrome (IBS)

- Ruminococcus gnavus has been found to be in higher abundance in diarrhea predominant IBS.

- Intake of resistant starch has been associated with increased levels of R. bromii.

LOWER LEVELS:

- Reduced levels of R. bromii were observed in patients with primary biliary cirrhosis.

- Ruminococcus spp. are reportedly decreased in abundance with Crohn’s disease and ulcerative colitis.

- A diet rich in animal protein and fat was found to reduce the abundance of this species in human gut.

Members of Ruminococcus sensu produce acetate, but not butyrate.

Ruminococcus gnavus, like Akkermanisia muciniphila is a mucin degrading specialist. 

Salmonella are facultative anaerobic bacteria in the family of Enterobacteriaceae. There are two species of Salmonella, Salmonella enterica and Salmonella bongori that include over 2,600 different serotypes. The majority of the pathogenic serotypes of Salmonella that affect humans are within the species of Salmonella enterica (S. enterica). Worldwide, Salmonella spp. causes an estimated 93.8 million cases of gastroenteritis each year.

Fecal Secretory IgA is a marker of gut secretory immunity and barrier function.

Immunoglobulin A (IgA) is an antibody playing a critical role in mucosal immunity and is produced in greater quantities than all other types of antibody combined.

In its secretory form, Secretory IgA is the main immunoglobulin found in mucous secretions and provides protection against potentially pathogenic microbes, due to its ability to resist degradation by enzymes and survive in harsh environments such as GI and respiratory tracts.

E. coli are a diverse group of bacteria that normally live in the intestines of humans and animals. Although most strains of these bacteria are harmless, some produce toxins that can make you sick and cause diarrhea (loose stool/poop) such as Shiga toxin-producing E. coli (STEC).

Anyone can get STEC infection. Young children and the elderly are more susceptible to develop serious infection, but healthy older children and young adults can also become seriously ill.

Shigella spp. are non-sporulating bacteria that belong to the family Enterobacteriaceae. Shigella infections account for 5% to 20% of all diarrheal episodes throughout the world, and although these infections are commonly seen in children younger than five years old, they can be found in adults of all ages. Shigellosis often begins with fever, watery diarrhea, and abdominal cramps, and can progress to bloody diarrhea.

Streptococcus agalactiae, also known as Lancefield’s group B streptococcus (GBS), is a gram-positive facultative anaerobe. Found in around 30% of healthy adult gastrointestinal tracts and vaginas, it can cause severe infections. The bacterium is the leading cause of septicaemia, pneumonia and meningitis in neonates. Additionally, a recent study showed that neonates of GBS+ women have a different microbiota composition compared to GBS-, possibly leading to disease development later in life.

Eubacterium is a genus of gram-positive bacteria. They are one of the most abundant species in healthy colons and use lactate and acetate to produce butyrate, and 1,2 propanediol to produce propionate.

Depletion of Eubacterium rectale has been associated with high fat diets, colorectal cancer and ulcerative colitis. Species belonging to this genus are also involved in the metabolism of polyphenols - health-promoting metabolites, which can reduce incidence of carcinogenesis. Eubacterium rely on sources of resistant starches for survival.

Imbalanced bacteria are usually neither pathogenic nor beneficial to the host GI tract. Imbalances can occur when there are insufficient levels of beneficial bacteria and increased levels of commensal bacteria. Certain commensal bacteria are reported as dysbiotic at higher levels.

Streptococcus is a member of Gram-positive lactic acid-producing bacteria (LAB) that belonged to Firmicutes phylum. Many strains of Streptococcus are non-pathogenic and occur as commensal flora on the skin, the oral cavity, nasopharynx, upper respiratory tract, urogenital, and gastrointestinal tracts.

Higher abundance of S. salivarius and S. thermophilus (Firmicutes phylum) have been associated with a moderate to severe disease course in newly diagnosed ulcerative colitis (UC) patients.

These findings are in accordance with a study that showed that UC patients have significantly increased Streptococcus spp. and depletion of Bifidobacterium spp. Higher levels of Streptococcus spp. were also observed in patients with colorectal cancer compared to healthy controls. Administration of S. salivarius together with Bifidobacterium bifidum was shown to reduce the incidence of acute diarrhea and rotavirus shedding in infants. S. salivarius and S. thermophilus are also widely used in dairy products like yogurt and cheese.

Higher abundance of S. salivarius and S. thermophilus (Firmicutes phylum) have been associated with a moderate to severe disease course in newly diagnosed ulcerative colitis (UC) patients.

Higher abundance of S. salivarius and S. thermophilus (Firmicutes phylum) have been associated with a moderate to severe disease course in newly diagnosed ulcerative colitis (UC) patients. These findings are in accordance with a study that showed that UC patients have significantly increased Streptococcus spp. and depletion of Bifidobacterium spp. Higher levels of Streptococcus spp. were also observed in patients with colorectal cancer compared to healthy controls.

Administration of S. salivarius together with Bifidobacterium bifidum was shown to reduce the incidence of acute diarrhea and rotavirus shedding in infants. S. salivarius and S. thermophilus are also widely used in dairy products like yogurt and cheese.

Higher abundance of S. salivarius and S. thermophilus (Firmicutes phylum) have been associated with a moderate to severe disease course in newly diagnosed ulcerative colitis (UC) patients. These findings are in accordance with a study that showed that UC patients have significantly increased Streptococcus spp. and depletion of Bifidobacterium spp. Higher levels of Streptococcus spp. were also observed in patients with colorectal cancer compared to healthy controls.

Administration of S. salivarius together with Bifidobacterium bifidum was shown to reduce the incidence of acute diarrhea and rotavirus shedding in infants. S. salivarius and S. thermophilus are also widely used in dairy products like yogurt and cheese.

Higher abundance of S. salivarius and S. thermophilus (Firmicutes phylum) have been associated with a moderate to severe disease course in newly diagnosed ulcerative colitis (UC) patients. These findings are in accordance with a study that showed that UC patients have significantly increased Streptococcus spp. and depletion of Bifidobacterium spp. Higher levels of Streptococcus spp. were also observed in patients with colorectal cancer compared to healthy controls. Administration of S. salivarius together with Bifidobacterium bifidum was shown to reduce the incidence of acute diarrhea and rotavirus shedding in infants. S. salivarius and S. thermophilus are also widely used in dairy products like yogurt and cheese.

Veillonella are anaerobic, gram-negative cocci, part of the normal flora of the mouth, gastrointestinal tract, and vaginal tract.

Vibrio cholerae is one of the most common causes of diarrhea worldwide. While diarrhea associated with V. cholerae is predominately seen in the Indian subcontinent, South East Asia, Africa, and South America, sporadic cases of V. cholerae-induced diarrhea have been reported in the United States. Gastrointestinal disease caused by V. cholerae is due to production of the cholera toxin. Two types of infection occur; cholera, which is a severe illness presents with profuse, “rice-water” diarrhea, vomiting, tachycardia, dehydration, muscle cramps, restlessness or irritability, and vibriosis, which is characterized by abdominal cramps, nausea, vomiting, fever and chills which is a self-limited illness of 3-4 days.

Yeast may normally be present in small quantities on the skin, in the mouth and intestine. While small quantities of yeast may be normal, yeast observed in higher quantities is considered abnormal.