Abstract

deficiency of premature infants. We used germ-free quails infected only with C butyricum to develop a suitable experimental model to study the enteropathogenicity of this species. Lactose fermentation into butyric acid and hydrogen appeared to be a prerequisite in the caecal NEC-like lesions and removal of dietary lactose suppressed all mucosal damage (table). 6 To extend our previous findings with strains from premature neonates, we have tested the type strain of C butyricum which is part of the autochthonous intestinal flora of pigs (VPI 3266 1 type strain). 12 germ-free quails were infected by inoculation per os with an 18 h culture containing 10 8 viable cells/mL. The quails were fed a semi-synthetic diet containing 8% lactose, which is similar to the proportion of lactose in milk. 4 weeks after inoculation, necropsy findings showed caecal pathological changes in six of the 12 quails tested—ie, significant thickening of the caecal wall, haemorrhagic ulcerations, necrotic areas and, in five cases, gas cysts. Acetic, butyric, and isobutyric acids were the three major short-chain fatty acids (SCFAs) detected (mean ratio: 61:31:3). There were no differences in caecal lesions, level of bacterial population, and SCFA profile between quails infected with C butyricum type strain in our study and quails infected with C butyricum isolated from healthy neonates or neonates with NEC in Bousseboua and colleagues’ 6 study (table). Quails display a host-mediated response similar to that of premature infants: 40% of the quails fed a lactose diet were free of caecal lesions. This response was not related to the levels of C butyricum, which were similar in healthy and sick quails. Our experimental findings show that C butyricum has a primary role in the pathogenesis of NEC via the fermentation of carbohydrate products. The role of butyric acid, reported to be a cytotoxic agent in several cell lines, is questionable. Thus, depending on the lactase deficiency of the premature infant and the susceptibility of the host, C butyricum may or may not be a pathogen.

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