DOZ047.04: Upper gastrointestinal microbiome in esophageal atresia. (24th June 2019)

• Record Type: Journal Article
• Authors: Krishnan, U; Singh, H; Kaakoush, N
• Is Part Of: Diseases of the esophagus. Volume 32(2019)Supplement 1
• Publication Date: 2019-06-24
• Subjects: Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1093/dote/doz047.04
• Languages: English
• ISSNs: 1120-8694

Abstract

Abstract: Background: Esophageal atresia (EA) is a rare defect, resulting in the condition being understudied. Specifically, information on the upper gastrointestinal (GI) microbiome of EA patients is lacking. Aims: This study aimed to examine the composition of the upper GI (oral, esophageal, and gastric fluid) microbiomes of EA patients as compared to controls. Methods: A pediatric cohort was prospectively recruited at Sydney Children's Hospital in 2018, and comprised children with a history of EA and those without EA. The groups were subdivided into children with GERD, eosinophilic esophagitis (EoE), and those with no disease. Biopsies, saliva, blood, and both tracheal and gastric aspirates were collected. Histology was reviewed for changes related to reflux and peak eosinophil count in subjects with EoE. Ethics approval has been granted and informed consent obtained from all patients and/or their guardians. The bacterial component (16S rRNA gene) of the microbiome was amplified using the 515F–806R primers and sequenced with Illumina MiSeq 2 × 250 bp chemistry. Reads were analyzed using mothur and R. Results: Within the cohort ( n = 47), 29 (61.7%) had EA and 18 (39.3%) were non-EA patients. The mean age of the whole cohort was 8.36 years (SD 5.05) and 24 (44%) were male. Non-EA patients were having endoscopic assessment of GERD, EoE, suspected celiac or inflammatory bowel disease (IBD). Active GERD, defined as histological changes on biopsy, an abnormal acid reflux index, or retrograde bolus movement on pH/impedance testing, was present in 11 (23.4%; 5 with EA) children. The mean eosinophil count in patients with EoE was 11.1 (SD 14.74) in the EA cohort and 15.9 (SD 21) in the non-EA cohort. Proton pump inhibitors were used by 29 (61.7%; 16 with EA). EoE was present in 18 (44.4%; 8 with EA). Swallowed steroids were used in 13 (27.6%) patients with EoE. Microbiome changes were observed in patients with EA as compared to controls. Conclusions: This study is the first to examine the upper GI microbiome of children with EA. Changes in the upper GI microbiomes of children with EA require validation in larger cohorts.