Intestinal dysbiosis in children with short bowel syndrome is associated with impaired outcome

Helene Engstrand Lilja, Hugo Wefer, Niklas Nyström, Yigael Finkel, Lars Engstrand, Helene Engstrand Lilja, Hugo Wefer, Niklas Nyström, Yigael Finkel, Lars Engstrand

Abstract

Background: The composition of the intestinal microbiota seems to be an important factor in determining the clinical outcome in children with short bowel syndrome (SBS). Alterations in the microbiota may result in serious complications such as small bowel bacterial overgrowth (SBBO) and intestinal mucosal inflammation that lead to prolonged parenteral nutrition (PN) dependency with subsequently increased risk of liver failure and sepsis. To date, there are no reported mappings of the intestinal microbiome in children with SBS. Here, we present the first report on the intestinal microbial community profile in children with SBS.

Findings: The study includes children diagnosed with SBS in the neonatal period. Healthy siblings served as controls. Fecal samples were collected, and microbial profiles were analyzed by using 16S rRNA gene sequencing on the Illumina MiSeq platform. We observed a pronounced microbial dysbiosis in children with SBS on PN treatment with an increased and totally dominating relative abundance of Enterobacteriacae in four out of five children compared to children with SBS weaned from PN and healthy siblings.

Conclusions: The overall decreased bacterial diversity in children with SBS is consistent with intestinal microbiome mappings in inflammatory bowel diseases such as Crohn's disease and necrotizing enterocolitis in preterm infants. Our findings indicate that intestinal dysbiosis in children with SBS is associated with prolonged PN dependency.

Keywords: Bacterial diversity; Dysbiosis; Gut microbiota; Short bowel syndrome.

Figures

Figure 1
Figure 1
Shannon diversity index in children with SBS still on PN compared to children weaned from PN.
Figure 2
Figure 2
Microbial communities in children with SBS on PN (1A, 3A, 8A, 9A, 12A), SBS children weaned from PN (2A, 4A, 11A, 13A, 16A, 18A), and siblings (2C1, 2C2, 11C1, 11C2, 12C, 13C1, 13C2). The figure is showing the relative abundance of the 19 most common taxonomic families that accounts for at least 84% of the abundance in all samples.
Figure 3
Figure 3
Shannon diversity index in children with SBS on PN (1A, 3A, 8A, 9A, 12A), SBS children weaned from PN (2A, 4A, 11A, 13A, 16A, 18A), and siblings (2C1, 2C2, 11C1, 11C2, 12C, 13C1, 13C2).
Figure 4
Figure 4
PCoA plot describing unweighted UniFrac distance between samples. Pairwise distances between all samples are projected onto a two-dimensional space where the axis PC1 describes the highest degree of variation. Samples that are clustered closely together are thus considered to share a larger proportion of the phylogenetic tree in comparison to samples that are more separated.

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Source: PubMed

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