Fecal microflora in a patient with short-bowel syndrome and identification of dominant lactobacilli

Abstract

Fecal microflora and lactate concentrations in blood and feces obtained from a patient (a 5 year-old boy) with short-bowel syndrome (SBS) were compared during acidosis to results for the normal condition (no SBS symptoms). The taxonomical position of the lactobacilli found predominantly in the feces sample obtained 2 days before the fifth attack was also studied. The D-lactate level in serum obtained 1 day after the fourth attack was 10-fold higher than that for the normal condition, although there was not a great difference in L-lactate levels. D-Lactate (3.91 mM) and L-lactate (2.86 mM) were also detected in the feces samples collected 2 days before the fifth attack, while no lactate was detected in the feces sample for the normal condition. The counts of total fecal bacteria, especially anaerobic bacteria such as members of the family Bacteroidaceae, were found to be low. The counts of lactobacilli and the total population of lactobacilli relative to total fecal bacteria in the feces 2 days before the fifth attack (40.4%) were extremely high. In this case, a majority of the lactobacilli were D-lactate producers as determined by homolactic fermentation. These lactobacilli were identified as Lactobacillus delbrueckii subsp. lactis. The percentages of bifidobacteria relative to total fecal bacteria in feces samples obtained both 2 days before the fifth attack (50.9%) and for normal condition (61.9%) were also high, although these bacteria were L-lactate producers. In the feces samples for the normal condition, the D-lactate producers decreased to less than 10 9 per g, while the counts of L-or DL-lactate producers were 100-fold higher than the numbers in feces samples obtained 2 days before the fifth attack. These results suggested that an increase in the level of D-lactate producers, such as L. delbrueckii subsp. lactis, in the colon may be associated with the clinical expression of metabolic acidosis.

Intestinal Microbiota Signatures Associated With Histological Liver Steatosis in Pediatric‐Onset Intestinal Failure

“…Concordant with earlier studies, we found a striking overabundance of Lactobacilli related to L plantarum in patients with a short remaining small bowel, most of whom had weaned from PN. Accordingly, Lactobacilli, especially relatives of L plantarum and Lactobacillus gasseri , have been shown to dominate the intestinal microbiota of patients of all ages with short bowel syndrome after weaning from PN 5 , 7 , 40 . ‐ 44 Small bowel resection induces Lactobacillus overgrowth also in mice not receiving PN 45 .…”

“…In the healthy gut, bacterial disposal of lactate, especially by butyrate‐producing organisms (such as members of Clostridium clusters IV and XIVa), exceeds its production 47 . Hence, Lactobacillus overgrowth and the lack of normally abundant members of the Clostridium clusters may cause D‐lactic acidosis in patients with short bowel syndrome patients 7 , 41 , 43 , 48 …”

Bacteria, Bones, and Stones: Managing Complications of Short Bowel Syndrome

“…6 In the jejunum and colon, numerous and predominantly anaerobic microbial organisms reside, such as Bacteroides, Bifidobacteria, and Clostridia, with Lactobacilli making up <1%. 7 In patients with SBS, the overall amount of bacteria are found to be quantitatively similar, but the difference is noticed in the variety of microbial species. The changes observed in a resected intestine is that the bacterial diversity is noticeably reduced, and there is a shift between dominant and subdominant organisms.…”

“…For example, after a small bowel resection, the microbiota of fecal matter and the remaining distal intestine becomes depleted in the variety of Bacteroides and Clostridium species; Lactobacilli become more predominant in the entire remaining intestine. 7,8 Another observed change is the presence of some strains such as Lactobacillus mucosae, which have never been accounted for in the intestinal microbiota of healthy human adults, but have been found in SBS patients. 8 In the setting of SBS, the microbial contents of the colon and the metabolic capabilities of the microbiota have an influence on a variety of intestinal functions and become an essential component in the course of management.…”

Quantifying the metabolic activities of human-associated microbial communities across multiple ecological scales

“…Using enrichment culturing to identify microorganisms active on a given substrate Enrichment culturing, whereby specific microorganisms are isolated by their ability to grow on a selective medium, has been extensively used to characterize the metabolism of a number of compounds. For example, many members of the human gut microbiota produce lactic acid, but this fermentation product is rarely detected in human feces or gut contents, while it accumulates in individuals with ulcerative colitis or with gut resections (Hove et al, 1994;Kaneko et al, 1997). Enrichment culturing on media with lactate as a sole carbon source identified nine strains of bacteria capable of subsisting on lactate (Duncan et al, 2004), suggesting that members of the gut microbiota can readily consume this common substrate.…”