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Small bowel bacterial flora in normal and in children with acute diarrhea
Insights
Prolonged intubation alters the upper small bowel
Area of Science:
- Microbiology
- Pediatrics
- Gastroenterology
Background:
- The aerobic bacteria microflora of the upper small bowel is crucial for pediatric health.
- Understanding microbial shifts in children with gastrointestinal issues is vital.
- Intubation duration can potentially impact the gastrointestinal microbiome.
Purpose of the Study:
- To investigate the aerobic bacteria microflora in the upper small bowel of children.
- To compare microflora in well-nourished children with varying intubation times versus those with acute diarrhea.
- To identify potential correlations between intubation, diarrhea, and microbial composition.
Main Methods:
- Studied aerobic bacteria microflora in 41 children (2 months to 5 years).
- Divided children into three groups: short intubation (<4h), prolonged intubation (4-24h), and acute diarrhea.
- Analyzed jejunal fluid for bacterial and fungal growth.
Main Results:
- Prolonged intubation (Group II) led to non-sterile jejunal fluid with mixed Gram-positive and Gram-negative flora (Enterobacteria) in 73% of cases, unlike Group I.
- Children with acute diarrhea (Group III) showed altered aerobic microflora in 76.4% compared to Group I, with fecal flora resemblance in 47.05%.
- Pseudomonas aeruginosa and yeasts were identified in Group III, suggesting infection prevalence in underdeveloped regions due to poor sanitation.
Conclusions:
- Prolonged intubation significantly alters the upper small bowel's aerobic microflora.
- Acute diarrhea in children is associated with distinct microbial profiles, including potential pathogens.
- Findings support the hypothesis of higher bacterial and fungal infection prevalence in underdeveloped countries linked to sanitation.
Abstract:
The aerobic bacteria microflora of the upper small bowel in normal children and in children with acute diarrhea was studied. Forty one children aging between 2 months and 5 years were divided in 3 groups: Group I--13 wellnourished children with no signs of gastrointestinal abnormalities remained intubated for less than 4 hours; Group II--11 wellnourished children that remained intubated for a period of time varying from 4 to 24 hours; Group III--17 children with acute diarrhea. There was a striking difference in the bacterial pattern between children from groups I and II and these findings were attributed to the prolonged time of intubation. In group I the jejunal fluid was sterile in approximately 40% of the children and in the others there was only growth of a GRAM positive flora while in group II the jejunal fluid never presented as a sterile one, and in approximately 73% of the cases there was a growth of a mixed GRAM positive and GRAM negative microflora, mainly due to Enterobacteria. In group III an aerobic microflora different from that one verified in group I was found in 76,4% of the patients. In 47.05% of the cases a bacterial growth equivalent to the fecal flora has been observed, in 5.89% Pseudomonas aeruginosa was located and in 23.52% yeasts were cultured from the jejunal fluid. These data confirm the hypothesis that bacterial and fungi infections are most prevalent in underdeveloped countries. This is probably due to the poor sanitary conditions observed in these countries associated with a high index of environmental contamination.