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Related Experiment Videos

Megaesophagus microbiota: a qualitative and quantitative analysis.

Denis Pajecki1, Bruno Zilberstein, Manoel Armando Azevedo dos Santos

  • 1Department of Gastrointestinal Surgery, University of São Paulo School of Medicine, Brazil.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|October 26, 2002
PubMed
Summary
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Patients with megaesophagus have significantly altered esophageal microbiota, with increased bacterial concentrations correlating to dilation severity. This study reveals a diverse bacterial presence, unlike healthy esophagi, highlighting potential infection risks.

Area of Science:

  • Microbiology
  • Gastroenterology
  • Esophageal Diseases

Background:

  • Bacterial overgrowth in megaesophagus is linked to pulmonary infections, surgical complications, and esophageal cancer.
  • The esophageal microbiota in megaesophagus patients has not been previously characterized.

Purpose of the Study:

  • To analyze the qualitative and quantitative characteristics of the esophageal microbiota in patients with chagasic megaesophagus.
  • To compare the esophageal microbiota of megaesophagus patients with that of a healthy control group.

Main Methods:

  • Prospective study of 25 patients (15 with chagasic megaesophagus, 10 controls).
  • Megaesophagus patients were categorized into three grades (MG1, MG2, MG3) based on esophageal dilation.
  • Esophageal samples were collected using a specialized method to prevent oral contamination, followed by microbiological culture and analysis.

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Main Results:

  • Esophageal cultures were positive in 93.3% of megaesophagus patients versus 40% in controls.
  • Megaesophagus microbiota showed diverse aerobic gram-positive (e.g., Streptococcus) and anaerobic bacteria (e.g., Veillonella).
  • Bacterial concentrations were significantly higher in megaesophagus patients, particularly in Grade 3 (MG3), compared to lower grades and controls (P < 0.05).

Conclusions:

  • Megaesophagus is associated with a diverse esophageal microbiota, predominantly aerobic gram-positive and anaerobic bacteria.
  • Bacterial concentrations increase with the severity of esophageal dilation in megaesophagus.
  • Characterizing esophageal microbiota is crucial for understanding megaesophagus-related complications.