The state of the small bowel microflora in chronic gastroduodenitis in children
The objective of the work was to study the incidence rate and character of dysbiotic disorders of the small intestine and their interrelationship with clinical specificities of chronic gastroduodenitis (CGD). The examination involved 64 children aged 9-17 with CGD. According to the findings of the examination all children were divided into 2 groups - the basic (with small bowel bacterial overgrowth syndrome (SBBOS), <i>n </i>= 26) and the reference group (<i>n </i>= 36). All children underwent bacteriological investigation of the small bowel aspirate, morphological examination of the duodenal mucosa bioptates with detection of dipeptidase activity, detection of Н.pylori with subsequent detection of the ureC gene, triple microscopy and PCR of feces to detect giardiasis. In 41% of children dysbiosis of the small intestine and in all of the large intestine (100%) was diagnosed. In children of the basic group staphylococci (28.50%) and <i>Candida albicans </i>(42.87%) were more often plated (<i>p </i>< 0.05), in children of the reference group - enterococci (44.44%) (<i>p </i>< 0.05). As was found, in the basic group lactase activity was considerably lower than in the reference group (0.48 and 0.22 mol/min per 1 g of tissue, respectively). The activity of dipeptidases in both groups did not differ. SBBOS was more often associated with Н.pylori infection (42.65%). An interrelation between the presence of SBBOS and the <i>Н.pylori </i>genotype was found: the cagH gene was reliably more rare in children with SBBOS (<i>p </i>< 0.05). A positive correlation was established between the <i>cagС </i>gene and the levels of bifidobacteria and lactobacilli in the small intestine, and a negative correlation between the presence of the <i>cagА </i>gene and the levels of bifidobacteria and lactobacilli in the large intestine.