Intestinal Microbial Dysbiosis Of Infantile Short Bowel Syndrome With Different Complications

Background & Aims: The gut microbiota plays a vital role in modulating the metabolic and immune functions of the intestines.We aimed to analyzed the dysbiosis of microbiota in infants with short bowel syndrome under different clinical conditions,such as parenteral nutrition administration,and the occurrence of associated complications.Methods: Twenty-six fecal samples were collected from 18 infants diagnosed with SBS during parenteral nutrition,and divided into three groups according to complications: Asymptomatic,parenteral nutrition associated liver disease(PNALD)and central line-associated bloodstream infections(CLABSI).Seven healthy infants aged from 4 to 10 months were enrolled as controls.Fecal microbiota,secretory Ig A and calprotectin,bile acids and short chain fatty acids were detected by 16 S r RNA gene sequencing,ELISA and liquid/gas chromatography.Results: The diversity of microbiota in samples with asymptomatic SBS was similar to that in the healthy controls,and the diversity in both these two sample groups was higher than in SBS samples with complications.We observed an increased proportion of Firmicutes and Proteobacteria in Asymptomatic group,while Proteobacteria was the most pronounced phylum in PNALD and CLABSI groups.Decreased acetate was observed in all SBS samples,however,fecal secretory Ig A and calprotectin,and proportion of primary and secondary bile acids did not differ from those in healthy controls.Conclusion: Marked alterations of the intestinal microbiota with decreased level of acetate were shown in SBS with complications compared with the healthy controls.The over-abundance of Proteobacteria(especially Enterobacteriaceae)may contribute to the complications of SBS.