The following is a summary of “Factors Affecting the Gut Microbiome in Pediatric Intestinal Failure,” published in the September 2023 issue of Pediatrics by Talathi, et al.

There needed to be more data regarding the gut microbiome and the factors contributing to dysbiosis in pediatric intestinal failure (PIF). For a study, researchers sought to elucidate the characteristics of the gut microbiome in PIF patients and identify the factors that influence microbial composition in the specific population.

Conducted as a single-center, prospective cohort study, the research focused on children under our care at the intestinal rehabilitation program. Stool samples were collected longitudinally at regular intervals over one year. Concurrently, comprehensive medical records were reviewed, and demographic and clinical data were compiled. The data encompassed medication history, including using acid blockers, prophylactic antibiotics, and bile acid sequestrants. The gut microbiome diversity among patients was compared to various host characteristics of interest.

The final analysis incorporated 74 specimens from 12 subjects. The study revealed that the use of scheduled prophylactic antibiotics, the presence of central line-associated bloodstream infection (CLABSI) at the time of specimen collection, the use of acid blockers, and the dependency on parenteral nutrition for ≥50% of caloric intake were associated with reduced alpha diversity in the gut microbiome. Conversely, increasing age was linked to improved alpha diversity at various microbial levels (P value <0.05). Beta diversity was found to differ significantly with age, the presence of CLABSI, the use of scheduled antibiotics acid blockers, the percentage of calories received via parenteral nutrition, and the presence of oral feeds at various microbial levels (P value <0.05). Moreover, single taxon analysis identified several taxa at different microbial levels that exhibited significant associations with various host characteristics.

The diversity of the gut microbiome in pediatric intestinal failure patients is significantly influenced by various factors pertinent to the rehabilitation process, including medication regimens, the extent of parenteral nutrition, occurrences of CLABSI, the degree of oral feeding, and patient age. Further research conducted across multiple centers was necessary to comprehensively comprehend the implications of the findings on crucial clinical outcomes in the context of pediatric intestinal failure.

Source: journals.lww.com/jpgn/abstract/2023/09000/factors_affecting_the_gut_microbiome_in_pediatric.20.aspx