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


RESULTS
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.
Department of Women's and Children's Health, Uppsala University, Uppsala, 751 85 Sweden.
Helene
H
Engstrand Lilja
Department of Microbiology, Tumor and Cell Biology and Science for Life Laboratory, Karolinska Institute, Stockholm, 171 77 Sweden.
Hugo
H
Wefer
Department of Women's and Children's Health, Uppsala University, Uppsala, 751 85 Sweden.
Niklas
N
Nyström
Department of Clinical Science and Education, Karolinska Institute, Stockholm, 118 83 Sweden ; Sachs' Children's and Youth Hospital, Stockholm, 118 83 Sweden.
Yigael
Y
Finkel
Department of Microbiology, Tumor and Cell Biology and Science for Life Laboratory, Karolinska Institute, Stockholm, 171 77 Sweden ; Clinical Genomics Facility, Science for Life Laboratory, Solna, 171 65 Sweden.
Lars
L
Engstrand
Bacterial diversity; Dysbiosis; Gut microbiota; Short bowel syndrome