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Factors Affecting the Gut Microbiome in Pediatric Intestinal Failure.

Saurabh Talathi^1,2, Linda Wilkinson³, Katie Meloni⁴

¹From the Department of Pediatrics, Division of Pediatric Gastroenterology, University of Oklahoma Health Sciences Center, Oklahoma City, OK.

Journal of Pediatric Gastroenterology and Nutrition

|May 15, 2023

Summary

Pediatric intestinal failure (PIF) gut microbiome diversity is impacted by medications, parenteral nutrition, infections, feeding type, and age. These factors influence microbial composition in children with PIF.

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Area of Science:

Gastroenterology
Microbiology
Pediatric Medicine

Background:

Limited data exists on the gut microbiome and dysbiosis factors in pediatric intestinal failure (PIF).
Understanding these factors is crucial for managing PIF and improving patient outcomes.

Purpose of the Study:

To characterize the gut microbiome in children with PIF.
To identify factors influencing microbial composition and diversity in this population.

Main Methods:

A single-center, prospective cohort study involving children with PIF.
Longitudinal stool sample collection over one year with concurrent collection of demographic, clinical, and medication data.
Assessment of gut microbial diversity (alpha and beta diversity) and comparison based on host characteristics.

Main Results:

Reduced gut microbial alpha diversity was associated with prophylactic antibiotics, central line-associated bloodstream infections (CLABSI), acid blocker use, and high parenteral nutrition (PN) caloric delivery.
Increasing age correlated with improved alpha diversity.
Beta diversity was influenced by age, CLABSI, antibiotics, acid blockers, PN, and oral feeding status.
Specific microbial taxa were significantly associated with various host characteristics.

Conclusions:

Gut microbial diversity in PIF is significantly influenced by factors integral to intestinal rehabilitation, including medications, PN dependence, CLABSI, oral feeding, and patient age.
Further multi-center investigations are warranted to elucidate the clinical impact of these microbial alterations on PIF outcomes.