Pathogenetic role of intestinal microflora in carbohydrate malabsorption syndrome in early-aged children with rotavirus infection

Abstract

The aim is to evaluate the effect of metabolic activity of intestinal microflora on laboratory manifestations of carbohydrate malabsorption syndrome in early-aged children with rotavirus infection by studying the main intestinal metabolites – short-chain fatty acids in faeces. Materials and methods. 60 breastfed children with rotavirus infection aged 1–24 months were examined. The total amount of carbohydrates in faecal samples was determined using Benedict’s test, and the detection of short-chain fatty acids in faeces was carried out using liquid chromatography in the dynamics of the disease – on the 3rd, 5th and 10th day. Results. It was established, that the amount of reducing sugars in faeces decreased with the increasing concentration of intestinal microflora metabolites during the entire period of rotavirus infection. In patients with ≤0.5 % level of carbohydrates in faeces, the total content of short-chain fatty acids was the highest and exceeded by 2.0, 1.8 and 1.7 times the indicators of children with Benedict’s test values >0.5 % on the 3rd, 5th and 10th days of the disease, respectively (p < 0.05). A decrease in the metabolic activity of the intestinal microbiota in the above category of children occurred mainly due to a deficiency in the production of acetic and propionic acids (P < 0.05). In the acute period of the disease, an imbalance in the intestinal microbiota infrastructure was noted towards a deficiency of obligate anaerobes that was expressed in a decrease in the anaerobic index (P < 0.05). The severity of these disorders influenced the severity of carbohydrate malabsorption: with an increase in the level of undigested sugars in faeces >0.5 %, the anaerobic index values were 3 and 5 times lower than at a carbohydrate level ≤0.5 % on the 3rd and 5th days of the disease, respectively (P < 0.05). Conclusions. It has been found that early-aged children with rotavirus infection have structural and functional disorders of the intestinal microflora, which influence the severity of carbohydrate malabsorption syndrome. The lower the saccharolytic activity of intestinal bacteria, the more pronounced the manifestations of this syndrome during the entire period of the disease.