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Research Project: Pediatric Clinical Nutrition

Location: Children's Nutrition Research Center

Title: The fecal microbiome in pediatric patients with short bowel syndrome

item DAVIDOVICS, ZEV - Baylor College Of Medicine
item CARTER, BETH - Baylor College Of Medicine
item LUNA, RUTH - Texas Children'S Hospital
item HOLLISTER, EMILY - Texas Children'S Hospital
item SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)
item VERSALOVIC, JAMES - Texas Children'S Hospital

Submitted to: Journal of Parenteral and Enteral Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/18/2015
Publication Date: 6/9/2015
Citation: Davidovics, Z.H., Carter, B.A., Luna, R.A., Hollister, E.B., Shulman, R.J., Versalovic, J. 2015. The fecal microbiome in pediatric patients with short bowel syndrome. Journal of Parenteral and Enteral Nutrition. 20(10):1-8.

Interpretive Summary: Some people are born with malformed intestines, part of which has to be removed. In others, disease or injuries require that parts of their intestine have to be removed. If too much intestine is removed, patients are not able to digest and absorb adequate amounts of food. These patients are termed as having short bowel syndrome (SBS). Patients with SBS are predisposed to having bacteria get into the blood from the intestines. We studied how SBS affects the types of bacteria in the intestines of children. Not only are the types of bacteria different in SBS compared with healthy children, there is some relationship between the types of bacteria and the amount of diarrhea children with SBS experience. This information will help us design ways to correct the bacterial imbalance in the intestines.

Technical Abstract: Changes in the intestinal microbiome of patients with short bowel syndrome (SBS) are thought to significantly affect clinical outcome. These changes may not only delay enteral diet advancement but may also predispose patients to bacterial translocation, bacteremia, and liver disease. Patients with SBS are thought to be more susceptible to changes in gut microbial communities due to intestinal dysmotility and/or lack of anatomic safeguards such as the ileocecal valve. We analyzed the bacterial composition of 21 fecal specimens from 9 children with SBS and 8 healthy children ages 4 months to 8 years by 16S ribosomal RNA gene sequencing. The sequences were quality filtered and analyzed using QIIME, the Ribosomal Database Project Classifier, and the randomForest supervised learning algorithm. The fecal microbiome of patients with SBS is different from that of healthy controls. Stool from patients with SBS had a significantly greater abundance of the bacterial classes Gammaproteobacteria and Bacilli. Stool from patients with SBS who experienced increased stool frequency tended to have increased abundance of Lactobacillus (P = .057) and decreased abundance of Ruminococcus. This study shows that the fecal microbiome of patients with SBS is significantly different from that of healthy controls when analyzed by 16S metagenomics. Differences in the composition and function of gut microbiomes in children with SBS may affect bowel physiology, and these findings may provide new opportunities for intestinal rehabilitation and clinical management.