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Gastric Flora in Gastrostomy Fed Children with Neurological Impairment on Antacid Medication

This prospective cohort study aimed to: (1) describe types, concentrations and sensitivity profiles of bacteria found in gastric aspirates of neurologically impaired children; (2) compare flora between outpatients and those admitted with aspiration pneumonia; and (3) examine predictors of bacterial...

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Detalles Bibliográficos
Autores principales: De Souza, Bradley, Richardson, Susan E., Cohen, Eyal, Mahant, Sanjay, Avitzur, Yaron, Carsley, Sarah, Rapoport, Adam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7599560/
https://www.ncbi.nlm.nih.gov/pubmed/33003430
http://dx.doi.org/10.3390/children7100154
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author De Souza, Bradley
Richardson, Susan E.
Cohen, Eyal
Mahant, Sanjay
Avitzur, Yaron
Carsley, Sarah
Rapoport, Adam
author_facet De Souza, Bradley
Richardson, Susan E.
Cohen, Eyal
Mahant, Sanjay
Avitzur, Yaron
Carsley, Sarah
Rapoport, Adam
author_sort De Souza, Bradley
collection PubMed
description This prospective cohort study aimed to: (1) describe types, concentrations and sensitivity profiles of bacteria found in gastric aspirates of neurologically impaired children; (2) compare flora between outpatients and those admitted with aspiration pneumonia; and (3) examine predictors of bacterial colonization. Gastric aspirates from gastrostomy fed, neurologically impaired children on antacid medication were measured for pH and sent for microbiological testing. The outpatient arm included 26 children at their baseline; the inpatient arm included 31 children with a clinical diagnosis of aspiration pneumonia. Descriptive statistics summarized the ecology and resistance patterns of microbial flora. Predictors of total bacterial colonization were explored with linear regression. High concentrations of potentially pathogenic fecal-type bacteria were detected in 50/57 (88%) gastric aspirates. pH was found to be the only predictor of bacterial growth; children with gastric pH ≥ 4 had significantly higher concentrations of aerobic growth, while those with no bacterial growth had a pH < 4. Further studies to evaluate optimal gastric pH, the role of gastric bacteria in causing aspiration pneumonia, and the optimal empiric therapy for aspiration pneumonia are recommended.
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spelling pubmed-75995602020-11-01 Gastric Flora in Gastrostomy Fed Children with Neurological Impairment on Antacid Medication De Souza, Bradley Richardson, Susan E. Cohen, Eyal Mahant, Sanjay Avitzur, Yaron Carsley, Sarah Rapoport, Adam Children (Basel) Article This prospective cohort study aimed to: (1) describe types, concentrations and sensitivity profiles of bacteria found in gastric aspirates of neurologically impaired children; (2) compare flora between outpatients and those admitted with aspiration pneumonia; and (3) examine predictors of bacterial colonization. Gastric aspirates from gastrostomy fed, neurologically impaired children on antacid medication were measured for pH and sent for microbiological testing. The outpatient arm included 26 children at their baseline; the inpatient arm included 31 children with a clinical diagnosis of aspiration pneumonia. Descriptive statistics summarized the ecology and resistance patterns of microbial flora. Predictors of total bacterial colonization were explored with linear regression. High concentrations of potentially pathogenic fecal-type bacteria were detected in 50/57 (88%) gastric aspirates. pH was found to be the only predictor of bacterial growth; children with gastric pH ≥ 4 had significantly higher concentrations of aerobic growth, while those with no bacterial growth had a pH < 4. Further studies to evaluate optimal gastric pH, the role of gastric bacteria in causing aspiration pneumonia, and the optimal empiric therapy for aspiration pneumonia are recommended. MDPI 2020-09-29 /pmc/articles/PMC7599560/ /pubmed/33003430 http://dx.doi.org/10.3390/children7100154 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
De Souza, Bradley
Richardson, Susan E.
Cohen, Eyal
Mahant, Sanjay
Avitzur, Yaron
Carsley, Sarah
Rapoport, Adam
Gastric Flora in Gastrostomy Fed Children with Neurological Impairment on Antacid Medication
title Gastric Flora in Gastrostomy Fed Children with Neurological Impairment on Antacid Medication
title_full Gastric Flora in Gastrostomy Fed Children with Neurological Impairment on Antacid Medication
title_fullStr Gastric Flora in Gastrostomy Fed Children with Neurological Impairment on Antacid Medication
title_full_unstemmed Gastric Flora in Gastrostomy Fed Children with Neurological Impairment on Antacid Medication
title_short Gastric Flora in Gastrostomy Fed Children with Neurological Impairment on Antacid Medication
title_sort gastric flora in gastrostomy fed children with neurological impairment on antacid medication
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7599560/
https://www.ncbi.nlm.nih.gov/pubmed/33003430
http://dx.doi.org/10.3390/children7100154
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