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Increased Fecal Lactobacillus Is Associated With a Positive Glucose Hydrogen Breath Test in Bangladeshi Children

Jeffrey R Donowitz1,2, Hardik I Parikh3, Mami Taniuchi2

  • 1Division of Pediatric Infectious Diseases, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia.

Open Forum Infectious Diseases
|July 9, 2019
PubMed

Insights

Small intestine bacterial overgrowth (SIBO) in children from low-income countries is linked to malnutrition. A study found an overgrowth of Lactobacillus bacteria in children with SIBO, suggesting a potential cause for this association.

Area of Science:

  • Microbiome research
  • Pediatric gastroenterology
  • Nutritional science

Background:

  • Glucose hydrogen breath testing is a noninvasive method to diagnose small intestine bacterial overgrowth (SIBO).
  • SIBO is prevalent in children from low-income countries and associated with malnutrition and stunted growth.
  • The specific microbiome alterations in SIBO-positive children in these settings are not well understood.

Purpose of the Study:

  • To investigate the gut microbiome composition in Bangladeshi children with SIBO.
  • To identify specific bacterial genera associated with SIBO positivity in this population.

Main Methods:

  • 16S V4 rDNA microbiome sequencing was performed on stool samples from 90 children.
  • Children were tested for SIBO using glucose hydrogen breath testing.
  • Linear discriminant analysis effect size was used to identify differentially abundant taxa.

Main Results:

  • Lactobacillus was identified as significantly over-represented in SIBO-positive children (15 out of 90).
  • The association was confirmed using Wilcoxon's rank-sum test to avoid outlier bias.

Conclusions:

  • SIBO positivity in children from low-income settings may be characterized by an upper intestinal Lactobacillus bloom.
  • This Lactobacillus overgrowth could contribute to gut damage and inflammation, leading to malnutrition.
  • Further research is needed to elucidate the causal mechanisms linking SIBO, Lactobacillus, and malnutrition.
Abstract

Keywords:
Lactobacillusenvironmental enteric dysfunctionfecal microbiomehydrogen breath testingsmall intestine bacterial overgrowth

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