Alterations in intestinal microbiota relate to intestinal failure-associated liver disease and central line infections

J Pediatr Surg. 2017 Aug;52(8):1318-1326. doi: 10.1016/j.jpedsurg.2017.04.020. Epub 2017 May 3.

Abstract

Background: The gut microbiota plays a vital role in modulating the metabolic and immune functions of the intestines. We aimed to analyze the dysbiosis of microbiota in infants with short bowel syndrome (SBS) with different complications.

Procedure: We included 26 fecal samples from 18 infants with SBS during parenteral nutrition. The samples were categorized into three groups: asymptomatic, parenteral nutrition-associated liver disease (PNALD), and central line-associated bloodstream infection (CLABSI). Seven healthy infants were enrolled as controls. Fecal microbiota, secretory IgA, calprotectin, bile acids, and short chain fatty acids were detected.

Results: The bacterial diversity of the Asymptomatic and Control Groups was significantly higher than that in the PNALD and CLABSI Groups. Proteobacteria was the most pronounced phylum in the PNALD and CLABSI Groups. Decreased acetate was observed in all SBS samples; however, fecal secretory IgA and calprotectin and the proportion of primary and secondary bile acids did not differ from those in healthy controls.

Conclusions: Marked alterations of the intestinal microbiota with decreased level of acetate were shown in SBS patients compared with healthy controls. Over-abundance of Proteobacteria (especially Enterobacteriaceae) was found in the samples from the PNALD and CLABSI Groups.

Level of evidence: Prognosis Study, Level I.

Keywords: Complication; Infant; Intestinal microbiota; Short bowel syndrome.

MeSH terms

  • Bacteria / genetics*
  • Bacteria / isolation & purification
  • Bacterial Infections / complications*
  • Bacterial Infections / metabolism
  • Bacterial Infections / microbiology
  • DNA, Bacterial / analysis*
  • Enzyme-Linked Immunosorbent Assay
  • Feces / chemistry
  • Feces / microbiology
  • Female
  • Gastrointestinal Microbiome*
  • Humans
  • Infant
  • Intestinal Mucosa / metabolism
  • Intestines / microbiology*
  • Leukocyte L1 Antigen Complex / metabolism
  • Liver Diseases / complications*
  • Liver Diseases / metabolism
  • Liver Diseases / microbiology
  • Male
  • Mass Spectrometry
  • Short Bowel Syndrome / etiology
  • Short Bowel Syndrome / metabolism
  • Short Bowel Syndrome / microbiology*

Substances

  • DNA, Bacterial
  • Leukocyte L1 Antigen Complex