Features of the microbial landscape of the stomach in children, feeding through the gastrostomy or nasogastric tube

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Abstract

BACKGROUND: In children with dysphagia, an increase in body weight is observed after the placement of a feeding tube, however, subsequently, a regression of body weight is noted, symptoms of an erosive and ulcerative lesion of the gastrointestinal tract appear.

AIM: To identify the features of the gastric microbiome in children fed through a gastrostomy or a tube.

MATERIALS AND METHODS: A study of aspirates of gastric contents in 21 patients was carried out using metagenomic sequencing. The participants were divided into 2 groups: group 1 — 11 children fed through the gastrostomy for less than 1 year; group 2 — 10 children, fed through the gastrostomy for more than 1 year.

RESULTS: In group 1, from 8 to 19 phyla were identified, median 12.0. In the second group from 4 to 13, median 7.5, the differences are statistically significant (p < 0.05). The samples of both groups were dominated by the phyla Firmicutes, Proteobacteria, Bacteroidota, Actinobacteria, Fusobacteria. The number of representatives of the Bacteroidia and Fusobacteriia classes was significantly reduced in patients with long-term nutrition through the gastrostomy. At the same time, a small number of classes were observed in patients with a gastrostomy in the stomach for about 80 months, as well as in patients with identified gastric pathology. There were about 66 genera for each specimen. At the same time, in children fed through a gastrostomy for less than 1 year, the median is 69.5 OTU. In children fed through a gastrostomy for more than 1 year, even with its regular replacement, the median is significantly less — 41 OTU. A significant decrease in microbial biodiversity was revealed with an increase in the standing time of the gastrostomy, the median value of the Shannon index in group 1 was 1.95, in group 2 1.69 (p ≤ 0.05).

CONCLUSIONS: In patients with a long stay of the feeding tube in the stomach, the number of anti-inflammatory symbionts of the genus Prevotella, Parabacteroides is reduced. The contamination of the stomach with Helicobacter pylori was 50%, which further increased the predisposition of the gastric mucosa to inflammation.

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About the authors

Yuliya V. Kuznetsova

Saint Petersburg State Pediatric Medical University

Author for correspondence.
Email: u-piter@mail.ru
ORCID iD: 0000-0003-3871-0457
SPIN-code: 2836-1414

PhD, Associate Professor, Department of General Medical Practice

Russian Federation, Saint Petersburg

Anna N. Zavyalova

Saint Petersburg State Pediatric Medical University

Email: anzavjalova@mail.ru
SPIN-code: 3817-8267

MD, PhD, Associate Professor, Department of General Medical Practice

Russian Federation, Saint Petersburg

Oleg V. Lisovskii

Saint Petersburg State Pediatric Medical University

Email: oleg.lisovsky@rambler.ru
SPIN-code: 7510-5554

MD, PhD, Associate Professor, Head of the Department of General Medical Practice

Russian Federation, Saint Petersburg

Maxim V. Gavshchuk

Saint Petersburg State Pediatric Medical University

Email: gavshuk@mail.ru
SPIN-code: 2703-3589

MD, PhD, Associate Professor, Department of General Medical Practice

Russian Federation, Saint Petersburg

Milad M. Al-Hares

Saint Petersburg State Pediatric Medical University

Email: haresmilad@gmail.com
SPIN-code: 3485-1655

Assistant lecturer, Department of General Medical Practice

Russian Federation, Saint Petersburg

Vasilisa V. Dudurich

LLC “Serbalab”

Email: vasilisadudurich@gmail.com

Genetic Biologist, Genetic Laboratory

Russian Federation, Saint Petersburg

Alexandr A. Pak

Boarding House for Children with Mental Development Disabilities No. 4

Email: shura.pak.1984@mail.ru

Deputy Director, Medical Department

Russian Federation, Pavlovsk, Saint Petersburg

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Feeding through a nasogastric tube

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3. Fig. 2. Feeding through a gastrostomy tube

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4. Fig. 3. Gastric bacterial phyla in patients with feeding tubes (according to taxonomic classifier SILVA 138.1)

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5. Fig. 4. Proportion of representatives of the Bacteroidia (a) and Fusobacteria (b) class in patients of the group 1 and 2

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6. Fig. 5. Proportion of representatives of the Gammaproteobacteria (a), Alphaproteobacteria (b), Bacilli (с) и Actinobacteria (d) classes in patients of the group 1 and 2

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