title: Detection of intestinal bifidobacteria and lactobacilli in patients with Hirschsprung's disease associated enterocolitis.
abstract: BACKGROUND
  The etiology of Hirschsprung's disease associated enterocolitis (HAEC) is unknown. Previous investigations have suggested that several factors such as dilation of proximal bowel, changes in colonic mucosal defence, and overgrowth of toxigenic bacteria may be related with it. This study was to quantify bifidobacteria and lactobacilli in the feces of Hirschsprung's disease (HD) patients with or without enterocolitis and those of normal children.
  
  
  METHODS
  Fresh stool specimens were collected at the first three days of the admission from 30 HD patients (aged 2 weeks to 2 years) and 15 healthy age-matched non-HD patients in the morning once a day for at least three days. All of them have not been given probiotics or antibiotics at least 7 days before stool collection. Hematoxylin-eosin and acetylcholinesterase histochemical staining on rectal biopsies of patients with HD confirmed the diagnosis of HD in all 30 patients. The 30 HD patients were divided into two groups based on the clinical history of enterocolitis: the HAEC group (n=10) and HD group (n=20). Fecal bifidobacteria and lactobacilli were consecutively quantified by SYBR Green I-based real-time PCR assay. Data were analyzed using SAS v. 12.6 for Windows. All tests were two-tailed, and P values <0.05 were considered statistically significant.
  
  
  RESULTS
  The mean levels of bifidobacteria were 7.35+/-0.59, 8.16+/-1.17, and 8.35+/-0.74 in the HAEC, HD and control groups, respectively. The bifidobacteria colonization levels were lower in the HAEC group than in the HD and control groups (P<0.05, P<0.001 respectively). The mean level of lactobacilli in the HAEC (5.51+/-0.65) and HD groups (5.87+/-0.78) was significantly lower than that in the control group (6.39+/-0.56) (P<0.05). But there was no difference in log numbers of lactobacilli between HAEC and HD groups (P>0.05).
  
  
  CONCLUSIONS
  The scarcity of bifidobacteria and lactobacilli in HAEC patients may result in a decrease in epithelial barrier function and be a predisposing factor in the development of HAEC. This decline suggests that treatment with probiotics or prebiotics may be beneficial in these individuals. Further research will focus on whether probiotics can decrease the incidence of HAEC.
authors.affiliation: Department of Pediatric Surgery, Xin Hua Hospital, School of Medicine, Shanghai JiaoTong University, 1665 Kongjiang Road, Shanghai, 200092, China.
authors.forename: Di-Hua
authors.initials: DH
authors.lastname: Shen
authors.forename: Cheng-Ren
authors.initials: CR
authors.lastname: Shi
authors.forename: Jing-Jing
authors.initials: JJ
authors.lastname: Chen
authors.forename: Shi-Yao
authors.initials: SY
authors.lastname: Yu
authors.forename: Yan
authors.initials: Y
authors.lastname: Wu
authors.forename: Wen-Bo
authors.initials: WB
authors.lastname: Yan
mesh_terms: D001644:Bifidobacterium / Q000302:isolation & purification*; D004760:Enterocolitis / Q000209:etiology / Q000382:microbiology*; D005243:Feces / Q000382:microbiology*; D005260:Female; D006627:Hirschsprung Disease / Q000150:complications* / Q000382:microbiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007778:Lactobacillus / Q000302:isolation & purification*; D008297:Male
references.citation: Clin Exp Allergy. 2003 Dec;33(12):1634-40
references.pmid: 14656348
references.citation: J Pediatr Surg. 1992 Mar;27(3):351-5; discussion 355-6
references.pmid: 1501010
references.citation: Am J Physiol Gastrointest Liver Physiol. 2004 Apr;286(4):G613-26
references.pmid: 15010363
references.citation: J R Coll Surg Edinb. 1988 Aug;33(4):185-8
references.pmid: 3221335
references.citation: J Pediatr Surg. 1989 May;24(5):462-4
references.pmid: 2661794
references.citation: Microbiol Immunol. 2004;48(7):497-500
references.pmid: 15272194
references.citation: J Dairy Res. 2003 May;70(2):165-73
references.pmid: 12800870
references.citation: Curr Microbiol. 2005 Apr;50(4):202-7
references.pmid: 15902467
references.citation: Appl Environ Microbiol. 1997 Apr;63(4):1268-73
references.pmid: 9097423
references.citation: Appl Environ Microbiol. 2000 Jun;66(6):2578-88
references.pmid: 10831441
references.citation: Clin Nutr. 2007 Oct;26(5):559-66
references.pmid: 17507117
references.citation: Appl Environ Microbiol. 2001 Feb;67(2):504-13
references.pmid: 11157210
references.citation: J Nutr. 1997 Jan;127(1):137-45
references.pmid: 9040557
references.citation: J Pediatr Surg. 1999 Feb;34(2):273-6
references.pmid: 10052803
references.citation: J Pediatr Surg. 1995 May;30(5):655-8
references.pmid: 7623220
references.citation: Infection. 1992 Sep-Oct;20(5):253-7
references.pmid: 1428181
references.citation: J Pediatr Surg. 1989 Dec;24(12):1271-7
references.pmid: 2593059
references.citation: Acta Paediatr. 1995 Dec;84(12):1347-56
references.pmid: 8645949
references.citation: J Infect Chemother. 2002 Mar;8(1):43-9
references.pmid: 11957119
references.citation: Appl Environ Microbiol. 2002 Jan;68(1):114-23
references.pmid: 11772617
references.citation: Curr Issues Intest Microbiol. 2001 Sep;2(2):43-53
references.pmid: 11721280
references.citation: Semin Pediatr Surg. 1998 Aug;7(3):162-9
references.pmid: 9718654
references.citation: J Pediatr Surg. 1986 Jan;21(1):22-5
references.pmid: 3511213
references.citation: J Pediatr Surg. 1995 Jan;30(1):76-83
references.pmid: 7722836