Carolina Santos Mello

Methane production and small intestinal bacterial overgrowth in children living in a slum.

AIM To analyze small intestinal bacterial overgrowth in school-aged children and the relationship between hydrogen and methane production in breath tests. METHODS This transversal study included 85 children residing in a slum and 43 children from a private school, all aged between 6 and 10 years, in Osasco, Brazil. For characterization of the groups, data regarding the socioeconomic status and basic housing sanitary conditions were collected. Anthropometric data was obtained in children from both groups. All children completed the hydrogen (H(2)) and methane (CH(4)) breath test in order to assess small intestinal bacterial overgrowth (SIBO). SIBO was diagnosed when there was an increase in H(2) ≥ 20 ppm or CH(4) ≥ 10 ppm with regard to the fasting value until 60 min after lactulose ingestion. RESULTS Children from the slum group had worse living conditions and lower nutritional indices than children from the private school. SIBO was found in 30.9% (26/84) of the children from the slum group and in 2.4% (1/41) from the private school group (P = 0.0007). Greater hydrogen production in the small intestine was observed in children from the slum group when compared to children from the private school (P = 0.007). A higher concentration of hydrogen in the small intestine (P < 0.001) and in the colon (P < 0.001) was observed among the children from the slum group with SIBO when compared to children from the slum group without SIBO. Methane production was observed in 63.1% (53/84) of the children from the slum group and in 19.5% (8/41) of the children from the private school group (P < 0.0001). Methane production was observed in 38/58 (65.5%) of the children without SIBO and in 15/26 (57.7%) of the children with SIBO from the slum. Colonic production of hydrogen was lower in methane-producing children (P = 0.017). CONCLUSION Children who live in inadequate environmental conditions are at risk of bacterial overgrowth and methane production. Hydrogen is a substrate for methane production in the colon.

Lactobacilli and bifidobacteria in the feces of schoolchildren of two different socioeconomic groups: children from a favela and children from a private school

OBJECTIVE: To determine the number of lactobacillus and bifidobacterium colonies in the feces of schoolchildren from two different socioeconomic levels. METHODS: We analyzed fecal samples of children aged 6 to 10 years without gastrointestinal symptoms or recent use of antimicrobials. The first group included 86 children living in a favela in the city of Osasco, state of Sao Paulo, southeastern Brazil. The second group included 36 children attending a private school in the same city. Body mass index (BMI) was used to assess nutritional status according to the reference values of the National Center for Health Statistics (NCHS). Specific anaerobic culture media were used for isolation of colonies for 48 and 72 hours at 37 °C. The number of colonies was determined using the plate-counting method. RESULTS: The mean lactobacillus (1.125 x 109 colony-forming units, CFU/g) and bifidobacterium (1.675 x 109 CFU/g) counts in the private school group were higher (p -1.0 SD (n = 57): 0.350 x 109 and 0.420 x 109 CFU/g, respectively. CONCLUSION: The microbiota of schoolchildren living in unfavorable environmental conditions shows lower numbers of fecal lactobacillus and bifidobacterium colonies, especially in children with lower BMI values.

Effectiveness of trimethoprim-sulfamethoxazole and metronidazole in the treatment of small intestinal bacterial overgrowth in children living in a slum.

ABSTRACT Trimethoprim-sulfamethoxazole and metronidazole were used for 14 days to treat 20 children with small intestine bacterial overgrowth (SIBO). SIBO was diagnosed using the lactulose hydrogen breath test. The breath test was repeated 1 month after treatment, and 19 (95.0%) of 20 children showed no evidence of SIBO (P < 0.001). The area under the individual curves showed that children with SIBO exhibited greater hydrogen production before treatment in both the first hour and between 60 and 180 minutes after the breath test. The treatment did not decrease methane production. In conclusion, trimethoprim-sulfamethoxazole and metronidazole was effective in treating children with SIBO.

Children Living near a Sanitary Landfill Have Increased Breath Methane and Methanobrevibacter smithii in Their Intestinal Microbiota

This study evaluated the breath CH4 excretion and concentration of M. smithii in intestinal microbiota of schoolchildren from 2 slums. One hundred and eleven children from a slum near a sanitary landfill, 35 children of a slum located away from the sanitary landfill, and 32 children from a high socioeconomic level school were included in the study. Real-time PCR was performed to quantify the M. smithii nifH gene and it was present in the microbiota of all the participating children, with higher (P < 0.05) concentrations in those who lived in the slum near the landfill (3.16 × 107 CFU/g of feces), comparing with the children from the slum away from the landfill (2.05 × 106 CFU/g of feces) and those from the high socioeconomic level group (3.93 × 105 CFU/g of feces). The prevalence of children who present breath methane was 53% in the slum near the landfill, 31% in the slum further away from the landfill and, 22% in the high socioeconomic level group. To live near a landfill is associated with higher concentrations of M. smithii in intestinal microbiota, comparing with those who live away from the landfill, regardless of their socioeconomics conditions.

Gut Microbiota Differences in Children from Distinct Socioeconomic Levels Living in the Same Urban Area in Brazil.

Objective: To compare gut microbiota in impoverished children versus children of high socioeconomic status living in the same urban area in Brazil. Methods: A cross-sectional study was conducted to evaluate 100 children living in a slum and 30 children from a private school, ages between 5 and 11 years old, in Sao Paulo State, Brazil. To characterize the groups, data based on socioeconomic status, sanitation, and housing conditions were collected. Anthropometric measurements and neonatal data were obtained from both groups. Gut microbiota were quantified in fecal samples by real-time polymerase chain reaction. Results: The children in the private school group had higher rates of cesarean delivery and premature birth than the children in the slum group. Staphylococcus aureus (90% vs 48.0%) and Clostridium difficile (100% vs 43.0%) were more commonly found in the children from the private school than in the impoverished children (P < 0.0001). C perfringens was most frequently identified in the group of children from the slum (92.0% vs 80%; P = 0.064). Higher counts of total eubacteria, Firmicutes and Bacteroidetes phyla organisms, Escherichia coli, Lactobacillus spp., and Methanobrevibacter smithii were found in the children living in poverty, whereas higher counts of Salmonella spp., C difficile, and C perfringens were observed in the children living in satisfactory housing conditions (P < 0.05). Conclusions: Important differences were observed between the gut microbiota of children living under distinct socioeconomic and environmental conditions within the same city. Our findings suggest that children of high socioeconomic status have less favorable gut microbiota than do children who live in poverty.

Parasitoses intestinais se associam a menores índices de peso e estatura em escolares de baixo estrato socioeconômico

OBJETIVO: Evaluar la prevalencia de parasitosis intestinales correlacionandolas con los factores socioeconomicos y ambientales, peso, estatura y hemoglobina, en ninos de dos niveles socioeconomicos en el municipio de Osasco, Sao Paulo (Brasil). METODOS: Se realizo un estudio transversal, comparando 84 ninos entre 6 y 10 anos, residentes en area sin saneamiento ambiental y vivienda precaria, con 35 ninos de escuela privada en el mismo municipio, que poseian buenas condiciones socioeconomicas y de vivienda. Se excluyeron aquellas con diarrea hace menos de 30 dias o enfermedad grave. Se utilizo cuestionario estandarizado para evaluar las condiciones socioambientales. La evaluacion nutricional fue realizada mediante escores Z de peso para la edad, estatura para la edad e indice de masa corporal. La determinacion de la hemoglobina en muestra de sangre capilar fue realizada por el metodo Hemocueâ y la investigacion de parasitas intestinales por los metodos de Hoffman, Ritchie, Kinyoun y Swab anal. RESULTADOS: Parasitosis intestinal ocurrio en 60,7% de los ninos del suburbio y en 5,9% de los ninos de la escuela privada (p<0,001; OR 24,7). El promedio de los escores Z de peso para la edad, estatura para la edad e indice de masa corporal fue menor en los ninos parasitados (-0,78±0,84; +0,50±0,90; -0,76±0,96) respecto a aquellos no parasitados (-0,18±1,18; +0,03±1,10; -0,28±1,16), siendo las diferencias estadisticamente significantes (p<0,05). No hubo diferencia en los valores promedios de hemoglobina entre los ninos parasitados y los no parasitados del grupo del suburbio (12,6±1,1g/dL y 12,8±1,2g/dL), (p=0,58). CONCLUSIONES: La parasitosis intestinal fue mas prevalente en ninos del suburbio y se asocio a menores indices de peso y estatura.

Intestinal parasitoses are associated with lower values of weight and height in school-aged children from low socioeconomic level

OBJETIVO: Evaluar la prevalencia de parasitosis intestinales correlacionandolas con los factores socioeconomicos y ambientales, peso, estatura y hemoglobina, en ninos de dos niveles socioeconomicos en el municipio de Osasco, Sao Paulo (Brasil). METODOS: Se realizo un estudio transversal, comparando 84 ninos entre 6 y 10 anos, residentes en area sin saneamiento ambiental y vivienda precaria, con 35 ninos de escuela privada en el mismo municipio, que poseian buenas condiciones socioeconomicas y de vivienda. Se excluyeron aquellas con diarrea hace menos de 30 dias o enfermedad grave. Se utilizo cuestionario estandarizado para evaluar las condiciones socioambientales. La evaluacion nutricional fue realizada mediante escores Z de peso para la edad, estatura para la edad e indice de masa corporal. La determinacion de la hemoglobina en muestra de sangre capilar fue realizada por el metodo Hemocueâ y la investigacion de parasitas intestinales por los metodos de Hoffman, Ritchie, Kinyoun y Swab anal. RESULTADOS: Parasitosis intestinal ocurrio en 60,7% de los ninos del suburbio y en 5,9% de los ninos de la escuela privada (p<0,001; OR 24,7). El promedio de los escores Z de peso para la edad, estatura para la edad e indice de masa corporal fue menor en los ninos parasitados (-0,78±0,84; +0,50±0,90; -0,76±0,96) respecto a aquellos no parasitados (-0,18±1,18; +0,03±1,10; -0,28±1,16), siendo las diferencias estadisticamente significantes (p<0,05). No hubo diferencia en los valores promedios de hemoglobina entre los ninos parasitados y los no parasitados del grupo del suburbio (12,6±1,1g/dL y 12,8±1,2g/dL), (p=0,58). CONCLUSIONES: La parasitosis intestinal fue mas prevalente en ninos del suburbio y se asocio a menores indices de peso y estatura.

Fecal microbiota analysis of children with small intestinal bacterial overgrowth among residents of an urban slum in Brazil

OBJECTIVE To analyze the fecal microbiota composition of children living in an urban slum in Brazil, with or without small intestinal bacterial overgrowth, and to investigate the occurrence of stunting and anemia. METHODS A total of 100 children were studied, aged 5-11 years, from the municipality of Osasco, São Paulo. Small intestinal bacterial overgrowth was screened through hydrogen and methane breath test with lactulose. Weight and height were measured, and the height-for-age and body mass-for-age anthropometric indexes were calculated. The occurrence of anemia was investigated by capillary hemoglobin. Analysis of bacterial phylum, genus, and species was performed by real-time polymerase chain reaction in fecal samples. RESULTS Small intestinal bacterial overgrowth was identified in 61.0% of the children. A lower mean of height-for-age Z-score ([-0.48±0.90] vs. [-0.11±0.97]; p=0.027), as well as capillary hemoglobin ([12.61±1.03g/dL] vs. [13.44±1.19g/dL]; p<0.001) was demonstrated in children with SIBO when compared with children without small intestinal bacterial overgrowth. Children with small intestinal bacterial overgrowth presented a higher frequency of Salmonella spp., when compared to those without small intestinal bacterial overgrowth (37.7% vs. 10.3%; p=0.002). Higher counts of total Eubacteria (p=0.014) and Firmicutes (p=0.038) were observed in children without small intestinal bacterial overgrowth; however, a higher count of Salmonella (p=0.002) was found in children with small intestinal bacterial overgrowth. CONCLUSION Children who lived in a slum and were diagnosed with small intestinal bacterial overgrowth showed lower H/A Z-scores and hemoglobin levels. Furthermore, differences were observed in the fecal microbiota of children with small intestinal bacterial overgrowth, when compared to those without it; specifically, a higher frequency and count of Salmonella, and lower counts of Firmicutes and total Eubacteria.

Artigo de revisãoBrazilian infant and preschool children feeding: literature reviewAlimentação do lactente e do pré‐escolar brasileiro: revisão da literatura☆

Objective To assess the feeding profile of Brazilian infants and preschool children aged 6 months to 6 years, based on the qualitative and quantitative analysis of food and nutrient intake.

Parasitosis intestinales se asocian con menores índices de peso y estatura en niños de bajo nivel económico

OBJETIVO: Evaluar la prevalencia de parasitosis intestinales correlacionandolas con los factores socioeconomicos y ambientales, peso, estatura y hemoglobina, en ninos de dos niveles socioeconomicos en el municipio de Osasco, Sao Paulo (Brasil). METODOS: Se realizo un estudio transversal, comparando 84 ninos entre 6 y 10 anos, residentes en area sin saneamiento ambiental y vivienda precaria, con 35 ninos de escuela privada en el mismo municipio, que poseian buenas condiciones socioeconomicas y de vivienda. Se excluyeron aquellas con diarrea hace menos de 30 dias o enfermedad grave. Se utilizo cuestionario estandarizado para evaluar las condiciones socioambientales. La evaluacion nutricional fue realizada mediante escores Z de peso para la edad, estatura para la edad e indice de masa corporal. La determinacion de la hemoglobina en muestra de sangre capilar fue realizada por el metodo Hemocueâ y la investigacion de parasitas intestinales por los metodos de Hoffman, Ritchie, Kinyoun y Swab anal. RESULTADOS: Parasitosis intestinal ocurrio en 60,7% de los ninos del suburbio y en 5,9% de los ninos de la escuela privada (p<0,001; OR 24,7). El promedio de los escores Z de peso para la edad, estatura para la edad e indice de masa corporal fue menor en los ninos parasitados (-0,78±0,84; +0,50±0,90; -0,76±0,96) respecto a aquellos no parasitados (-0,18±1,18; +0,03±1,10; -0,28±1,16), siendo las diferencias estadisticamente significantes (p<0,05). No hubo diferencia en los valores promedios de hemoglobina entre los ninos parasitados y los no parasitados del grupo del suburbio (12,6±1,1g/dL y 12,8±1,2g/dL), (p=0,58). CONCLUSIONES: La parasitosis intestinal fue mas prevalente en ninos del suburbio y se asocio a menores indices de peso y estatura.